The nurse is reviewing pre-operative laboratory studies of an adult client on a medical-surgical unit. Which result should be reported to the physician immediately?

Sodium, 152 mEq/L

Potassium, 3.8 mEq/L

Calcium, 10.0 mg/dL

Creatinine, 1.2 mg/dL

Answer and Explanation

The Correct Answer is A

Choice A Reason:
Sodium levels in the blood should normally be between 135 and 145 mEq/L. A level of 152 mEq/L is considered high and can be indicative of hypernatremia, which requires prompt medical attention to address potential dehydration, kidney issues, or other underlying conditions.

Choice B Reason:
Potassium levels should be within the range of 3.5 to 5.2 mEq/L for adults. A result of 3.8 mEq/L falls within the normal range, indicating no immediate concern regarding potassium levels.

Choice C Reason:
Calcium levels in the blood are typically between 8.6 and 10.2 mg/dL for adults. Therefore, a calcium level of 10.0 mg/dL is within the normal range and does not require urgent reporting to a physician.

Choice D Reason:
Creatinine levels in the blood should be between 0.6 to 1.3 mg/dL in adults, depending on factors such as age, gender, and muscle mass. A level of 1.2 mg/dL is at the higher end of the normal range but is not typically considered critical unless there are other signs of kidney dysfunction.

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Correct Answer is D

Explanation

Choice A Reason
A potassium level of 5.0 mEq/L is at the upper limit of the normal range, which is typically between 3.5 and 5.0 mEq/L. While this level should be monitored, especially in the context of diabetes where the patient may be at risk for hyperkalemia due to potential kidney issues, it is not immediately alarming¹.

Choice B Reason
A creatinine level of 4.4 mg/dL is significantly higher than the normal range of 0.6 to 1.2 mg/dL for males and 0.5 to 1.1 mg/dL for females. This indicates severe renal impairment or kidney failure, which is a serious complication of diabetes mellitus. Immediate intervention is required to address this critical issue¹.

Choice C Reason
A hemoglobin level of 10.7 g/dL is slightly below the normal range for adults, which is generally 13.8 to 17.2 g/dL for males and 12.1 to 15.1 g/dL for females. This could indicate mild anemia, which can be a complication of diabetes but is not as immediately concerning as a high creatinine level¹.

Choice D Reason
A Blood Urea Nitrogen (BUN) level of 22 mg/dL is within the normal range, which is typically between 7 and 20 mg/dL. This level does not indicate immediate concern and is not as critical as the elevated creatinine level¹.

A. Urine negative for ketones. B. Sodium 135 mg/dL and Potassium 3.5 mEq/L. C. BUN 34 mg/dL and Creatinine 4.2 mg/dL. D. White blood cell count 12,000/mm³.

Correct Answer is C

Explanation

Choice A Reason
Urine negative for ketones is a normal finding and does not typically indicate an acute problem. Ketones in the urine can be a sign of uncontrolled diabetes or starvation, but their absence is expected in a well-nourished individual who is not in a state of diabetic ketoacidosis.

Choice B Reason
Sodium at 135 mg/dL and Potassium at 3.5 mEq/L are within normal ranges. The normal range for serum sodium is approximately 135-145 mEq/L, and for serum potassium, it is around 3.5-5.0 mEq/L. These values do not indicate an immediate concern for the patient with urosepsis.

Choice C Reason
A BUN of 34 mg/dL and Creatinine of 4.2 mg/dL are concerning. The normal range for BUN is approximately 6-20 mg/dL, and for Creatinine, it is about 0.6-1.2 mg/dL for males and 0.5-1.1 mg/dL for females. Elevated levels of BUN and Creatinine indicate impaired kidney function, which can be a complication of urosepsis and the nephrotoxic effects of gentamicin and vancomycin.

Choice D Reason
A white blood cell count of 12,000/mm³ is slightly elevated, which may be expected in a patient with an infection such as urosepsis. The normal range is approximately 4,500-11,000 WBCs/mm³. While this should be monitored, it does not require immediate reporting unless there is a significant change or it is outside the patient's baseline.

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The nurse is reviewing pre-operative laboratory studies of an adult client on a medical-surgical unit. Which result should be reported to the physician immediately?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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