The nurse analyzes the laboratory values of a pediatric client with leukemia who is receiving chemotherapy. The nurse notes the following lab values: platelets 19,500/mcl (nl. 140,000-400,000/mcL), hemoglobin 11 g/dL (nl. 12-16 g/dL), white blood cell count 9,800/mcl (nl. 5,000-10,000/mcL). Based on these findings, which intervention should the nurse prioritize in the plan of care?
Monitoring closely for signs of infection.
Transfusing packed red blood cells.
Administering intravenous immunoglobulins.
Initiating bleeding precautions.
The Correct Answer is D
A. Monitoring for infection is important, but the white blood cell count is within normal limits, so it is not the immediate priority.
B. Although the hemoglobin is slightly low, it is not critically low, so transfusion of packed red blood cells is not immediately necessary.
C. Intravenous immunoglobulins are not indicated based on the current lab values.
D. The platelet count is critically low, placing the client at high risk for bleeding. Initiating bleeding precautions is the priority to prevent hemorrhage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Tender inguinal lymph nodes are not associated with celiac disease and are more indicative of localized infections or lymphadenopathy.
B. An enlarged liver is not typically related to celiac disease but may occur in other conditions such as fatty liver disease.
C. A protuberant abdomen is a common finding in children with celiac disease due to malabsorption and gas accumulation in the intestines. This is often accompanied by abdominal distension and discomfort.
D. Periorbital edema is not characteristic of celiac disease and is more commonly seen in conditions like nephrotic syndrome.
Correct Answer is A
Explanation
A. Hypertension (blood pressure of 136/92 mm Hg) in a child with acute pyelonephritis can indicate a severe condition that may lead to renal damage or worsening kidney function. Immediate intervention is necessary to manage high blood pressure and prevent complications.
B. A heart rate of 100 bpm is within normal limits for a 7-year-old and does not require immediate action.
C. Decreased urine output is concerning and needs monitoring, but hypertension is the more urgent issue.
D. Tea-colored urine suggests hematuria or concentrated urine, which is important but not as immediately life-threatening as high blood pressure.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.