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Exhibits

Click to highlight the findings that indicate an improvement in the client’s condition

Laboratory Results

1800:

  • WBC count 6,700/mm3 (5,000 to 10,000/mm3)
  • Hemoglobin 12 g/dL (14 to 18 g/dL)
  • Hematocrit 36% (40% to 52%)

Vital Signs

1800:

  • Blood pressure 112/74 mm Hg
  • Heart rate 95/min
  • Respiratory rate 18
  • Temperature 37.5(99.5° F)

A.

WBC count 6,700/mm3 (5,000 to 10,000/mm3)

B.

Hemoglobin 12 g/dL (14 to 18 g/dL)

C.

Hematocrit 36% (40% to 52%)

D.

Blood pressure 112/74 mm Hg

E.

Heart rate 95/min

F.

Respiratory rate 18

G.

Temperature 37.5(99.5° F)

Answer and Explanation

The Correct Answer is ["B","C","D","E"]

Rationale for correct choices:

  • Hemoglobin 12 g/dL: The increase from 9.1 g/dL to 12 g/dL indicates that the client’s anemia is resolving. This suggests effective treatment or stabilization following blood loss, improving oxygen-carrying capacity and overall perfusion.
  • Hematocrit 36%: The rise from 27% to 36% reflects an improvement in the proportion of red blood cells in circulation. This correlates with better tissue oxygenation and a positive response to interventions such as a blood transfusion.
  • Blood pressure 112/74 mm Hg: The increase from 90/50 mm Hg indicates improved hemodynamic stability. This suggests the client is no longer hypovolemic and is better able to maintain adequate perfusion to vital organs.
  • Heart rate 95/min: The decrease from 118/min shows a reduction in compensatory tachycardia. This reflects improved circulatory status and decreased physiological stress following stabilization of blood volume and oxygenation.

Rationale for  incorrect choices:

  • WBC count 6,700/mm³: The WBC count remains unchanged from admission. While within normal limits, it does not specifically indicate improvement in anemia or hemodynamic status, which are the primary concerns in this scenario.
  • Respiratory rate 18/min: The respiratory rate is unchanged and within normal limits. Although stable, it does not provide a direct measure of improvement in anemia or perfusion.
  • Temperature 37.5°C (99.5°F): The temperature is stable but slightly elevated. While not concerning, it does not reflect a specific improvement in the client’s primary condition.


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Related Questions

Correct Answer is ["A","B","C","E"]

Explanation

A. ABG results: pH 7.32 (acidosis), HCO₃⁻ 18 mEq/L (low), PaO₂ 68 mm Hg, SaO₂ 90%. Indicates metabolic acidosis with hypoxemia. This is a significant abnormality needing prompt attention.

B. Amylase results: Elevated amylase is a hallmark of acute pancreatitis and confirms the suspected diagnosis.

C. Temperature: Fever with pancreatitis can signal systemic inflammatory response or infection, requires provider notification.

D. Hematocrit level: 42%, within the normal range (female 38–47%, male 42–52%).

E. Pain report: Severe abdominal pain 8/10, persistent >24 hours. Pancreatitis pain requires provider management (often opioids, supportive care).

F. Glucose level: 108 mg/dL is within normal limits (70–110). It is not concerning at this time.

Correct Answer is C

Explanation

A. Documenting communication with a provider in the progress notes of the client's medical record: Proper documentation of provider communication is standard nursing practice and does not constitute malpractice. It helps ensure continuity of care and legal protection.

B. Placing a yellow bracelet on a client who is at risk for falls: Implementing fall precautions, such as using a yellow wristband, is an appropriate safety measure and standard of care, not malpractice.

C. Administering potassium via IV bolus: Administering potassium as a rapid IV push is extremely dangerous and can cause cardiac arrest. This action violates the standard of care and constitutes malpractice due to potential harm to the client.

D. Leaving a nasogastric tube clamped after administering oral medication: A nasogastric (NG) tube is often clamped for a short period after administering medication to allow the medication to be absorbed. The nurse's action would only be considered negligent if they left the tube clamped for a prolonged period.

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