While changing the dressing of a client with a leg ulcer, the nurse observes a red, tender, and swollen wound at the site of the lesion.
Before reporting this finding to the healthcare provider, the nurse should note which of the client's laboratory values?

Hematocrit.

Serum.

Blood PT level.

Neutrophil count.

Answer and Explanation

The Correct Answer is D

Neutrophils are a type of white blood cell that play a key role in fighting infections.

An elevated neutrophil count can indicate the presence of an infection.

Therefore, before reporting the finding of a red, tender, and swollen wound at the site of the lesion to the healthcare provider, the nurse should note the client’s neutrophil count.

Choice A is not correct because hematocrit is not the laboratory value that the nurse should note before reporting the finding to the healthcare provider.

Choice B is not correct because serum is not a laboratory value.

Choice C is not correct because blood PT level is not the laboratory value that the nurse should note before reporting the finding to the healthcare provider. a

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Correct Answer is C

Explanation

The nurse should first discuss with the client her meaning of heroic measures.

This will help the nurse to understand the client’s wishes and preferences for her care.

Choice A is incorrect because obtaining a do not resuscitate prescription should be done after discussing the client’s wishes and preferences.

Choice B is incorrect because setting up a family conference to discuss the client’s wishes should be done after discussing the client’s wishes and preferences with her.

Choice D is incorrect because consulting the palliative care team about the client’s care should be done after discussing the client’s wishes and preferences with her.

A. Blood pressure. B. Respiratory rate. C. Temperature. D. Pulse rate.

Correct Answer is B

Explanation

If a nurse observes that a client is using accessory muscles, it indicates an obstruction of the airways, which reduces oxygen saturation.

Accessory muscles help in the act of forced expiration to wash out carbon dioxide and improve oxygen saturation 1.

Therefore, the nurse should obtain the respiratory rate first.

Choice A is not the answer because determining pulse pressure will not provide any significant indication of respiratory distress 1.

Choice C is not the answer because temperature does not provide any significant data about the use of accessory muscles in respiration 1.

Choice D is not the answer because pulse rate does not provide any significant data about the use of accessory muscles in respiration 1.

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While changing the dressing of a client with a leg ulcer, the nurse observes a red, tender, and swollen wound at the site of the lesion. Before reporting this finding to the healthcare provider, the nurse should note which of the client's laboratory values?

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Naxlex Comprehensive Predictor Exams

An older woman with end-stage heart disease is hospitalized for severe heart failure. She is alert and requests that no heroic measures be implemented if her breathing stops. What actions should the nurse take first?

Correct Answer is C

Explanation

The nurse observes that a client is using accessory muscles. Which vital sign should the nurse obtain first?

Correct Answer is B

Explanation

The nurse is caring for a male client with decreased circulation in the lower extremities. The client washes his feet in the shower but is unable to bend safely to dry the feet. While drying the client's feet, the nurse should emphasize the need to thoroughly dry which area of the feet?

The nurse is teaching a client how to do active range of motion (ROM) exercises. To exercise the hinge joints, which action should the nurse instruct the client to perform?

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How should the nurse document the finding of pain, numbness, and tingling sensations in the lower legs?

Which response by the nurse is most therapeutic?

While changing the dressing of a client with a leg ulcer, the nurse observes a red, tender, and swollen wound at the site of the lesion.
Before reporting this finding to the healthcare provider, the nurse should note which of the client's laboratory values?