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

Answer and Explanation

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

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Correct Answer is A

Explanation

Choice A reason:

Post-operative pain management is a critical aspect of care for a client recovering from a below-the-knee amputation. Administering pain medication as needed helps to manage pain effectively, which is essential for the client's comfort and recovery. Pain control is also important to facilitate participation in rehabilitation activities.

Choice B reason:

It is not advisable to encourage the client to bear weight on the affected limb immediately after surgery. The residual limb needs time to heal, and premature weight-bearing can lead to complications such as delayed healing or wound dehiscence.

Choice C reason:

While it is important to prevent complications such as deep vein thrombosis, complete restriction of mobility and keeping the client on bed rest is not recommended. Early mobilization, as part of a rehabilitation program, is essential for improving circulation, preventing muscle atrophy, and promoting overall recovery.

Choice D reason:

Applying a tight compression bandage on the residual limb is a common practice in the post-operative care of clients with amputations. The compression bandage helps to control swelling, shape the limb for a prosthesis, and prevent fluid accumulation. However, the bandage must be applied correctly to avoid impairing circulation.

A. A cream to soothe the itching. B. Pain medication. C. An antibiotic. D. A laxative.

Correct Answer is B

Explanation

Choice a reason:

A cream to soothe itching may be used if the client is experiencing pruritus, which can sometimes accompany biliary issues due to bile salts in the skin. However, pruritus is not a direct symptom of biliary colic, which is characterized primarily by pain.

Choice b reason:

Pain medication is the appropriate treatment for biliary colic. Biliary colic is caused by the temporary blockage of the bile duct by a gallstone, leading to intense pain in the upper right abdomen or the center of the abdomen. Pain relief is typically achieved with anti-inflammatory drugs or antispasmodics, and in some cases, opioids may be necessary.

Choice c reason:

An antibiotic would be prescribed if there was an infection, such as cholecystitis or cholangitis. Biliary colic itself does not necessarily indicate an infection unless accompanied by other symptoms such as fever or elevated white blood cell count.

Choice d reason:

A laxative is not typically used to treat biliary colic. While laxatives can help relieve constipation, biliary colic is a result of gallstones obstructing the bile duct, not bowel movement issues.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which nursing action(s) should the nurse include in the post-op plan of care for a client recovering from a below-the-knee amputation?

Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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