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Exhibits

Which laboratory tests would be helpful in determining the plan of care for this client? Select all that apply.

Coagulation studies

Type and screen

Urine osmolality

Complete blood count

Blood culture

Lipid panel

Arterial blood gas

Electrolytes

Answer and Explanation

Correct Answer : A,B,D,G,H

A. Coagulation Studies: This client has liver and spleen lacerations with blood noted in the peritoneum, increasing the risk of coagulopathy due to active bleeding. The liver is responsible for producing clotting factors, and an injury may impair coagulation. The client also has a low hemoglobin (9.3 g/dL) and hematocrit (30%), suggesting ongoing blood loss. Monitoring prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (aPTT) can guide transfusion therapy (e.g., fresh frozen plasma or platelets).
B. Type and Screen: This client has evidence of hemorrhagic shock (tachycardia, narrow pulse pressure, low hemoglobin/hematocrit) and may require blood transfusion. Type and screen determines ABO blood type and Rh factor to ensure availability of compatible blood products. If bleeding worsens, crossmatching blood would be necessary for transfusion.
C. Urine osmolality: Not a priority in this trauma case. Urine osmolality assesses kidney function and hydration status but does not provide urgent information about blood loss, shock, or ventilation status.
D. Complete Blood Count (CBC): Provides serial hemoglobin and hematocrit (H&H) monitoring to assess for ongoing internal bleeding. White blood cell (WBC) count helps detect infection or inflammation post-operatively. Platelets are critical for clotting and must be monitored, especially in trauma patients at risk for coagulopathy.
E. Blood culture: Used to detect bloodstream infections (sepsis), which is not an immediate concern in this trauma patient. While infection risk is relevant postoperatively, it is not a priority test for acute trauma care.
F. Lipid panel: Lipid panels evaluate cholesterol and triglyceride levels, which are irrelevant in acute trauma management.
G. Arterial Blood Gas (ABG): This client is intubated and ventilated, making ABG analysis essential for evaluating: Oxygenation (PaO₂, SaO₂) and ventilation (PaCO₂), Acid-base balance (pH, bicarbonate levels). Early detection of metabolic acidosis, which may indicate shock or inadequate perfusion.
H. Electrolytes: Trauma and fluid resuscitation can cause electrolyte imbalances, leading to cardiac arrhythmias, fluid shifts, and metabolic disturbances. Potassium (K⁺) is Essential to monitor due to IV fluids with potassium chloride infusion. Sodium (Na⁺), chloride (Cl⁻), and bicarbonate (HCO₃⁻) are crucial in assessing fluid status and acid-base balance. Lactate levels (part of a metabolic panel) can indicate tissue hypoxia and worsening shock.

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

Explanation

A. Immediate notification of the healthcare provider is not warranted unless there are signs of complications, such as excessive bleeding or infection.

B. Applying a cold pack to the scrotal and penile areas can help reduce swelling and discomfort after TURP.

C. Putting a pillow under the buttocks can help reduce pressure on the surgical site and may improve comfort and circulation.

D. The indwelling catheter should not be removed unless there is a medical reason or complication that requires it.

E. A urinalysis is generally not needed unless there are signs of infection or hematuria.

A. Obtain 12-lead electrocardiogram to evaluate return of pacemaker's sensing, firing, and capture. B. Ensure permanent pacemaker interrogated if return of spontaneous circulation is achieved. C. Place self-adhesive defibrillator pads at least 1 inch away from permanent pacemaker site. D. Apply a doughnut magnet over the pacemaker if pacer-mediated tachycardia develops.

Correct Answer is C

Explanation

A. Obtaining a 12-lead ECG is done after return of spontaneous circulation (ROSC), not during defibrillation.
B. Interrogating the pacemaker is important but is not the immediate priority during resuscitation.
C. Defibrillator pads should be placed at least 1 inch away from the pacemaker to prevent damage to the device and ensure effective defibrillation.
D. A doughnut magnet is used to deactivate pacemaker functions in cases like pacemaker-mediated tachycardia but is not relevant in ventricular fibrillation.

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Exhibits Which laboratory tests would be helpful in determining the plan of care for this client? Select all that apply.

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Naxlex Comprehensive Predictor Exams

When assessing a client who had a transurethral resection of the prostate (TURP) one day ago, the nurse observes that his scrotum and penis are edematous. Which intervention(s) should the nurse implement? Select all that apply.

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

Explanation

Correct Answer is C

Explanation

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Exhibits

Which laboratory tests would be helpful in determining the plan of care for this client? Select all that apply.