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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 A

Explanation

A. Watery diarrhea is a potential sign of Clostridium difficile (C. diff) infection, a serious and common complication associated with antibiotics like linezolid.

B. Nausea and headache are side effects but are less urgent than symptoms suggesting C. diff.

C. Increased fatigue is non-specific and may be related to the infection or the medication, but it is not as immediately concerning as diarrhea.

D. Yellow-tinged sputum is typical of pneumonia and does not indicate an urgent issue related to linezolid therapy.

A. Yellow expectorated sputum B. Shortness of breath on exertion. C. Oral temperature of 100.5 F (38.1°C). D. Bilateral diffuse wheezing.

Correct Answer is D

Explanation

A. Yellow expectorated sputum. This is typical in pneumonia, indicating bacterial infection, but it does not require immediate intervention compared to wheezing.

B. Shortness of breath on exertion. This is common in COPD and pneumonia, but the wheezing represents a more urgent concern for respiratory compromise.

C. Oral temperature of 100.5°F (38.1°C). This is a mild fever, which is common in infections like pneumonia, but it does not warrant immediate intervention like wheezing does.

D. Bilateral diffuse wheezing. Wheezing suggests bronchospasm, which could indicate airway obstruction or respiratory distress. This requires immediate attention, especially in a client with COPD and pneumonia, both of which can compromise respiratory function.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

Correct Answer is D

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.