The nurse is reviewing the laboratory findings for a 34-year-old woman who is scheduled for a Schilling's test for B12 deficiency anemia. Which result should the nurse report immediately to the primary care provider?
Positive pregnancy test
Hemoglobin 9.5 g/dL and Hematocrit 32%
Glycosylated Hemoglobin (A1c) 7.5%
Serum Cholesterol 237 mg/dL
The Correct Answer is A
Choice A Reason:
A positive pregnancy test is crucial information that must be reported immediately as it has significant implications for the patient's health and treatment options. Pregnancy can impact the results of a Schilling's test, which is used to diagnose B12 deficiency anemia, as pregnancy itself can cause changes in B12 metabolism. Therefore, the healthcare provider must be informed to adjust the diagnostic approach and ensure the safety of both the mother and the developing fetus.
Choice B Reason:
While a hemoglobin level of 9.5 g/dL is below the normal range for adult females (11.6 to 15 g/dL) and a hematocrit of 32% is at the lower end of the normal range (36% to 44%)[^10^], these results are consistent with anemia but are not as immediately critical as a positive pregnancy test in the context of a Schilling's test.
Choice C Reason:
A glycosylated hemoglobin (A1c) level of 7.5% is above the normal range (4% to 5.9%), indicating poor blood sugar control over the past two to three months, which could suggest diabetes or prediabetes. However, this is not as urgent as a positive pregnancy test when considering the administration of a Schilling's test.
Choice D Reason:
A serum cholesterol level of 237 mg/dL is considered borderline high (200 to 239 mg/dL), which may increase the risk of heart disease over time. However, this does not require immediate reporting in the context of a Schilling's test for B12 deficiency anemia as compared to a positive pregnancy test.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Using accessory muscles while breathing is a sign of respiratory distress and indicates that the client is working harder to breathe. This is not a desired outcome of treatment and suggests that the asthma exacerbation is not under control.
Choice B Reason:
The ability to answer questions in full sentences suggests that the client's airway is not severely obstructed, which is a positive sign of effective asthma treatment. When asthma is well-controlled, individuals should not experience significant shortness of breath that limits their ability to speak.
Choice C Reason:
Diminished breath sounds can be a sign of severe airway obstruction and are not indicative of effective asthma treatment. Ideally, lung auscultation should reveal clear breath sounds without wheezing, indicating good air movement throughout the lungs.
Choice D Reason:
Restlessness and anxiety can be symptoms of hypoxia, a condition where the body or a region of the body is deprived of adequate oxygen supply. This is not a sign of effective asthma treatment and may indicate that the client's asthma is not well-managed.
Correct Answer is B
Explanation
Choice A Reason
Bradycardia, which is a slower than normal heart rate, is not typically a sign of hypoglycemia. Hypoglycemia can actually cause an increase in heart rate due to the release of adrenaline in response to low blood sugar levels.
Choice B Reason
Tremors are a common sign of hypoglycemia and are caused by the release of adrenaline. When blood sugar levels fall too low, the body releases adrenaline as a part of the "fight or flight" response, which can lead to shaking or trembling.
Choice C Reason
Kussmaul's respirations, which are deep and labored breathing patterns, are more commonly associated with diabetic ketoacidosis, not hypoglycemia. This type of breathing is the body's response to acidosis and is not indicative of low blood sugar levels.
Choice D Reason
Polyuria, or excessive urination, is not a sign of hypoglycemia. It is more commonly associated with hyperglycemia, as the body attempts to eliminate excess glucose through urine.
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