The nurse is reviewing the laboratory results for a client who is scheduled for a cholecystectomy. Which result is most important for the nurse to report to the surgeon? Reference Range
Glucose [74 to 106 mg/dL (4.1 to 5.9 mmol/L)] Creatine [0.5-1.1 mg/dL (44 to 97 μmol/L)]

Potassium (3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L)] Hemoglobin [16 to 18 g/dL (160 to 180 g/L)]

Blood glucose of 90 mg/dl. (5 mmol/L).

Potassium level of 4 mEq/L (4 mmol/L)

Hemoglobin level of 13 g/dL (130 g/L).

Serum creatinine of 5 mg/dL (442 pmol/L).

Answer and Explanation

The Correct Answer is D

A.   A blood glucose level of 90 mg/dL is within the normal reference range of 74 to 106 mg/dL, so it is not a concern.
B.   A potassium level of 4 mEq/L is also within the normal reference range of 3.5 to 5.0 mEq/L, so it does not need to be reported.
C.   Although the hemoglobin level of 13 g/dL is below the reference range provided, it is not critically low and may not be urgent unless the patient has symptoms of anemia or other related issues.
D.   A serum creatinine level of 5 mg/dL is significantly higher than the normal reference range of 0.5 to 1.1 mg/dL. This indicates renal impairment, which could affect the patient's ability to clear medications used during surgery and could lead to postoperative complications. Therefore, it is crucial to report this finding to the surgeon immediately.

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Correct Answer is ["C","D","G"]

Explanation

A. The client may be developing sepsis.

Sepsis typically presents with symptoms such as fever, increased heart rate, increased respiratory rate, and altered blood pressure. There is no indication of these signs in the provided data,
making sepsis an unlikely cause for the change in the Glasgow Coma Scale (GCS) score.

B. The client may be dehydrated.

Dehydration can affect cognitive function, but there is no evidence suggesting dehydration in this scenario (e.g., normal heart rate, blood pressure, and no noted intake/output imbalance).
C. The client may have increasing symptoms of head injury.

A decrease in GCS score can indicate worsening head injury symptoms, such as increased intracranial pressure or bleeding.
D. The client may have been sleeping.

Sleeping can temporarily affect the GCS score, particularly the eye-opening component.

E. The client may be improving clinically.

Improvement clinically would likely result in a stable or improved GCS score, not a decrease.

F. The client may require more morphine.

Needing more morphine would typically be due to increased pain, but this should not directly affect the GCS score unless severe pain is causing altered consciousness, which is not indicated here.
G. The client may be experiencing sedative effects of morphine.

Morphine, especially given intravenously, can cause sedation, which could lower the GCS score.

H. The client may need food.

Needing food would not typically cause an immediate change in GCS score unless associated with severe hypoglycemia, which is not indicated by the provided data.

A. Ask if the client is experiencing any pain with urination. B. Determine if the client has recently experienced a fall. C. Provide instruction on taking the client's temperature. D. Encourage increased intake of high protein foods. E. Review the client's current food and medication allergies

Correct Answer is ["A","B","C","E"]

Explanation

A. Ask if the client is experiencing any pain with urination. Urinary tract infections (UTIs) are common in older adults and can lead to sudden changes in behavior, including confusion and agitation.
B. Determine if the client has recently experienced a fall. Falls can lead to head injuries or other trauma that may cause confusion or changes in behavior in older adults.
C. Provide instruction on taking the client's temperature. Fever can be a sign of infection, which might be causing the sudden behavioral changes. Monitoring temperature can help identify if an infection is present.
D. Encourage increased intake of high protein foods. While good nutrition is important, it is not directly related to the sudden onset of confusion and agitation, making this a less immediate priority.
E. Review the client's current food and medication allergies. Allergic reactions to foods or
medications can cause sudden behavioral changes. Reviewing allergies can help determine if this is the cause of the symptoms.

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Naxlex Comprehensive Predictor Exams

Exhibits Which may have caused the change in the Glasgow Coma Scale score between 2000 and 2400? Select all that apply.

Correct Answer is ["C","D","G"]

Explanation

Correct Answer is ["A","B","C","E"]

Explanation

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