Which of the following is the most reliable early indicator of infection in a client with low WBC?
Fever
Chills
Tachycardia
Dyspnea
The Correct Answer is A
Choice A rationale:
Fever is the most reliable early indicator of infection in a client with low WBC because it is a direct physiologic response to the presence of pathogens. When the body detects an infection, it releases pyrogens, which act on the hypothalamus to raise the body's temperature. This elevated temperature helps to create an environment that is less hospitable to bacteria and viruses, and it also stimulates the immune system to fight the infection.
In clients with low WBC, the immune system is already compromised, so the fever response may be even more pronounced. It's important to note that even a slight elevation in temperature (as low as 100.4°F or 38°C) can be significant in these clients.

Choice B rationale:
Chills can also be a sign of infection, but they are not as specific as fever. Chills can occur for other reasons, such as exposure to cold or anxiety.
Choice C rationale:
Tachycardia, or increased heart rate, can also be a sign of infection, but it is not as reliable as fever. Tachycardia can occur for other reasons, such as dehydration, pain, or anxiety.
Choice D rationale:
Dyspnea, or shortness of breath, is not a typical early sign of infection. It is more likely to occur in later stages of infection, when the infection has spread to the lungs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D"]
Explanation
Cardiovascular disease (CVD) is a significant risk factor for gout. This is because CVD often coexists with other conditions that can elevate uric acid levels, such as hypertension, obesity, and chronic kidney disease. Additionally, some medications used to treat CVD, such as thiazide diuretics, can also increase uric acid levels.
Research has shown that people with CVD have a 2-3 times higher risk of developing gout compared to those without CVD.
The mechanisms linking CVD and gout are complex and not fully understood, but they likely involve shared pathways of inflammation and endothelial dysfunction.
Choice D rationale:
Diuretic use, particularly thiazide diuretics, is a well-established risk factor for gout. These medications work by increasing the excretion of fluids and electrolytes from the body, which can also lead to a decrease in the excretion of uric acid.
This can result in a buildup of uric acid in the blood, which can then crystallize in joints and cause gout attacks.
The risk of gout associated with diuretic use is dose-dependent, meaning that higher doses of diuretics are associated with a higher risk of gout.
Choice A rationale:
Depression has not been consistently shown to be an independent risk factor for gout. Some studies have suggested a possible link between depression and gout, but others have not found any association. More research is needed to clarify the relationship between these two conditions.
Choice B rationale:
Deep sleep deprivation has not been studied as a risk factor for gout. There is currently no evidence to suggest that it is directly associated with an increased risk of developing the disease.
Correct Answer is A
Explanation
Choice A rationale:
Phenytoin is an anticonvulsant medication that is typically used long-term to control seizures. It is not a medication that can be stopped abruptly, as this can lead to the recurrence of seizures or even status epilepticus, a life-threatening condition characterized by continuous seizure activity.
The client's statement, "I'll be glad when I can stop taking this medicine," indicates a lack of understanding about the long- term nature of phenytoin therapy and the potential risks associated with stopping the medication prematurely.
Further teaching is needed to emphasize the importance of medication adherence and the potential consequences of non- adherence.
Choice B rationale:
Phenytoin can cause gingival hyperplasia (overgrowth of gum tissue), so it is important for clients taking this medication to see a dentist regularly for checkups and cleanings.
The client's statement, "I have made an appointment to see my dentist next week," indicates an understanding of this potential side effect and the need for regular dental care.
Choice C rationale:
Phenytoin has a narrow therapeutic index, meaning that there is a small difference between the effective dose and the toxic dose.
Switching brands of phenytoin can lead to changes in blood levels of the medication, which could potentially result in therapeutic failure or toxicity.
The client's statement, "I know that I cannot switch brands of this medication," indicates an understanding of this important safety consideration.
Choice D rationale:
Phenytoin can interact with many other medications, including over-the-counter medications and herbal supplements.
It is important for clients taking phenytoin to notify their doctor before taking any other medications to avoid potential drug interactions.
The client's statement, "I will notify my doctor before taking any other medications," indicates an understanding of this potential risk.
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