Which diagnostic studies will the nurse monitor for the client being treated for sepsis? Select all that apply.
Platelet count
Urine specific gravity
Lactate level
PaO2
Serum ammonia
Correct Answer : A,C,D
Choice A reason: Monitoring platelet count is important in sepsis as thrombocytopenia can occur due to disseminated intravascular coagulation (DIC).
Choice B reason: Urine specific gravity is not typically monitored for sepsis unless there is a concern for renal function or fluid balance.
Choice C reason: Lactate levels are monitored in sepsis to assess the severity of septic shock and tissue hypoperfusion.
Choice D reason: PaO2 is monitored to assess oxygenation status, which can be compromised in sepsis due to respiratory dysfunction.
Choice E reason: Serum ammonia is not typically monitored for sepsis unless there is a concern for hepatic function or encephalopathy.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: A soft diet with thin liquids may be recommended for patients with Parkinson's disease who have difficulty swallowing (dysphagia), but it is not the most appropriate intervention for all patients. Dysphagia is common in Parkinson's disease due to impaired muscle movement, and a soft diet can help prevent choking and aspiration.
Choice B reason: Assessing for orthostatic hypotension is crucial in the care of patients with Parkinson's disease. Orthostatic hypotension is a common non-motor symptom where there is a significant drop in blood pressure upon standing. Normal blood pressure should not drop more than 20 mm Hg systolic or 10 mm Hg diastolic within 2 to 5 minutes of standing². This condition can increase the risk of falls, which is a significant concern in this population.
Choice C reason: Exophthalmos, the bulging of the eyes, is not associated with Parkinson's disease. It is typically related to thyroid eye disease, such as Graves' disease, and would not be a relevant assessment for a Parkinson's patient unless there is a known co-existing thyroid condition.
Choice D reason: Limiting fluids to prevent urinary incontinence is not an appropriate intervention for Parkinson's disease. Adequate hydration is essential, and urinary incontinence should be managed with other strategies, such as bladder training, scheduled toileting, and possibly medication, depending on the cause.

Correct Answer is B
Explanation
Choice A reason: Monitoring heart rate and rhythm is important in heart failure management, but it does not directly reflect the effectiveness of enalapril and furosemide, which are primarily used to control blood pressure and reduce fluid overload, respectively.
Choice B reason: Auscultating lung fields can reveal the presence of fluid, indicating pulmonary edema, a common complication of left-sided heart failure. Checking BP is essential as enalapril is an ACE inhibitor that lowers BP, and furosemide can also affect BP through its diuretic effect.
Choice C reason: Assessing for JVD can indicate right-sided heart failure, which may develop secondary to left-sided heart failure. However, it is not the primary assessment for the effectiveness of enalapril and furosemide.
Choice D reason: Checking peripheral pulses is a general assessment and, while important, it does not specifically evaluate the effectiveness of the medications in question.
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