The nurse notes that a newborn's white blood cell count (WBC) is 15,000. The nurse is aware that:.
This indicates a severe infection.
This is a normal WBC for a newborn.
This is a lab error.
You must call the doctor.
The Correct Answer is B
Choice A rationale:
A white blood cell count of 15,000 does not necessarily indicate a severe infection. In newborns, WBC counts are typically higher than in adults, and they gradually decrease over the first few days after birth. A value of 15,000 falls within the normal range for a newborn and is not indicative of a severe infection.
Choice B rationale:
A white blood cell count of 15,000 is considered a normal range for a newborn. Newborns have higher WBC counts as a natural response to the stress of birth and exposure to the outside environment. The immune system is still developing, and elevated WBC counts are normal during this period.
Choice C rationale:
Assuming there are no other indications of lab error, such as abnormal results in other tests, it would be premature to label the WBC count as a lab error. Additionally, healthcare professionals should always consider the overall clinical picture before assuming a lab error based on a single result.
Choice D rationale:
There is no immediate need to call the doctor based solely on the WBC count of 15,000. Medical decisions should be made in the context of the newborn's overall clinical condition, and a single lab result does not warrant an immediate call to the doctor.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
The liver's job related to bilirubin is not changing conjugated bilirubin to unconjugated. Conjugated bilirubin is the water-soluble form of bilirubin that is excreted in bile and urine. Unconjugated bilirubin, on the other hand, is the fat-soluble form, which is transported to the liver and conjugated to become water-soluble. The conversion goes from unconjugated to conjugated, not the other way around.
Choice B rationale:
The liver's job related to bilirubin is not the synthesis of vitamin K. The liver is responsible for synthesizing clotting factors, including factors II (prothrombin), VII, IX, and X, but not vitamin K itself. Vitamin K is obtained from dietary sources or supplements and is essential for blood clotting.
Choice C rationale:
This choice is the correct answer. The liver's primary function related to bilirubin is changing unconjugated bilirubin to conjugated bilirubin. As mentioned earlier, unconjugated bilirubin is produced from the breakdown of heme in old red blood cells, and it needs to be processed in the liver to become water-soluble and eventually excreted in bile and urine.
Choice D rationale:
The liver's job related to bilirubin does not involve the removal of meconium. Meconium is the first stool passed by a newborn, and its elimination is unrelated to the liver's function in processing bilirubin.
Correct Answer is B
Explanation
Choice A rationale:
The nurse should not report the client's Hemoglobin level first to the primary health care because it falls within the normal range of 14 to 24 g/dL for a newborn. Therefore, it is not an immediate concern.
Choice B rationale:
The nurse should first report the client's Chest x-ray results to the primary health care. The diffuse pattern of radiopaque areas bilaterally on the chest x-ray suggests possible respiratory distress or other respiratory issues in the newborn. This finding requires immediate attention and intervention to ensure proper respiratory function.
Choice C rationale:
The nurse should not report the client's Glucose level first to the primary health care as 40 mg/dL is within the normal range of 30 to 60 mg/dL for a newborn. Though it is on the lower side, it is not critically low, and there are more urgent concerns to address.
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