The nurse is assessing a client receiving peritoneal dialysis. Which laboratory result should immediately be reported to the primary healthcare provider (PHCP)?

Calcium 8.6 mg/dL

WBC 19,000 mm3

Serum pH 7.33

Hemoglobin 9 mg/dL

Answer and Explanation

The Correct Answer is B

Choice A rationale: A calcium level of 8.6 mg/dL is within the normal range.

Choice B rationale: An elevated white blood cell count (WBC) of 19,000 mm3 indicates a potential infection or inflammatory process, requiring immediate attention, especially in a client receiving peritoneal dialysis.

Choice C rationale: A serum pH of 7.33 is within the normal range.

Choice D rationale: A hemoglobin level of 9 mg/dL might indicate anemia, but in a client receiving dialysis, it might not require immediate reporting unless it significantly drops further.

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Correct Answer is A

Explanation

Choice A rationale: This patient is likely experiencing hyperosmolar hyperglycemic state (HHS). Rapid administration of IV fluids is crucial to correct severe dehydration associated with HHS.

Choice B rationale: Routine insulin therapy and exercise might be components of diabetes management but wouldn't directly address the immediate concern of severe dehydration and high blood glucose.

Choice C rationale: Cardiac monitoring for potassium changes might be necessary but isn't the primary immediate intervention for HHS.

Choice D rationale: Administering a different antibiotic for the UTI is incorrect, because there is no evidence that the current antibiotic is ineffective or causing adverse effects. The UTI may have triggered the HHS, but it is not the main problem that needs to be addressed urgently.

A. Conus medullaris syndrome B. Concussion C. Neurogenic shock D. Diffuse axonal injury

Correct Answer is C

Explanation

Choice A rationale: Conus medullaris syndrome involves injury or compression to the end portion of the spinal cord and can present with various symptoms but not necessarily lack of normal sympathetic outflow leading to shock.

Choice B rationale: Concussion is a mild traumatic brain injury, and the symptoms described align more with spinal cord injury leading to neurogenic shock.

Choice C rationale: Neurogenic shock occurs due to the loss of sympathetic tone and is characterized by bradycardia, low blood pressure, and vasodilation following spinal cord injury at or above the level of the sixth thoracic vertebra.

Choice D rationale: Diffuse axonal injury typically presents with more widespread brain injury-related symptoms and is not associated with the specific spinal cord-related symptoms described.

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The nurse is assessing a client receiving peritoneal dialysis. Which laboratory result should immediately be reported to the primary healthcare provider (PHCP)?

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

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Correct Answer is C

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