A client is post-op nephrectomy for renal cancer. Which lab results would cause most concern for the nurse?

Table 34.1 Review of Normal Ranges for Complete Blood Cell Counts (Adult)

Blood Cell

Normal Ranges

Red blood cells (mature, circulating)

Male 4.51-6.01 million/mm3

Female: 4.01-5.51 million/mm3

Hemoglobin

Adult (15-64 yr)

Male 14-17.3 g/dL

Female 11.7-15.5 g/dL

Hematocrit

42% -52% in males

36% -48% in females

Reticulocytes

0.5% -2.5% of total RBC count

White blood cells (total)

4.5-11.1 103/mm3

Neutrophils

59%

Bands 3%

Segs-56%

Eosinophils

2.7%

Basophils

0.5%

Lymphocytes

34%

Monocytes

4%

Platelets

150,000-450,000/mm3

Hemoglobin of 14 g/dL

Platelet count 150,000 mm3

White blood cell count 17,000 mm3

Neutrophils 59%

Answer and Explanation

The Correct Answer is C

A.   This value is within the normal range for adult males (14-17.3 g/dL) and borderline for females (11.7- 15.5 g/dL). While the specific context of the patient (e.g., gender) matters, generally, a hemoglobin level of 14 g/dL would not typically cause concern.

B.   A platelet count of 150,000/mm³ is at the lower limit of normal (150,000-450,000/mm³). While this may be concerning in certain clinical contexts, it is still within the acceptable range and would not typically raise alarm for a post-op nephrectomy patient unless there are other indications of bleeding or clotting issues.
C.   This white blood cell count is elevated (normal range is 4.5-11.1 x 10³/mm³). An elevated WBC count can indicate an infection, inflammation, or a response to surgery, which is particularly concerning post- operatively. This result would warrant further investigation to rule out infection, which is critical for recovery.
D.   The neutrophil percentage of 59% is within the normal range (typically around 40-70% for total WBCs). While it is slightly elevated, it is not concerning on its own without additional context, especially since it may be elevated in response to surgery or stress.

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Correct Answer is B

Explanation

A. A carotid endarterectomy does not involve bypassing the plaques; rather, it directly addresses the blockage.
B. Carotid endarterectomy is a surgical procedure that involves making an incision in the neck to access the carotid artery, where the surgeon removes the atherosclerotic plaques that are causing narrowing and restricting blood flow. This helps reduce the risk of stroke.
C. Carotid endarterectomy is not brain surgery; it is performed on the carotid arteries in the neck. The procedure aims to prevent strokes by improving blood flow to the brain, but it does not involve surgery on the brain itself.
D. This description does not accurately reflect carotid endarterectomy. The procedure does not involve resecting an artery in the brain or using a graft; rather, it focuses on removing plaques from the carotid artery in the neck.

A. look at my scrotum for a painless ulcerated area with swelling." B. examine my penis for a nodular or wart like growth." C. call my doctor if I notice any penile discharge." D. know I have cancer if my penis hurts while urinating."

Correct Answer is B

Explanation

A. This option is not the most relevant for penile cancer detection. While swelling and ulcerated areas may be associated with various conditions affecting the scrotum, they are not specifically indicators of penile cancer. Penile cancer is more typically associated with changes in the penis itself rather than the scrotum.
B. Early signs of penile cancer may include a nodular or wart-like growth on the penis, especially on the glans (head) or shaft. These growths can be painless, making regular self-examination important for early detection. This statement demonstrates an understanding of one of the key indicators of penile cancer.
C. While penile discharge can indicate various conditions, including infections or sexually transmitted diseases, it is not a specific sign of penile cancer. This response does not reflect a direct understanding of the early detection of penile cancer.
D. Pain during urination can be caused by many conditions, such as infections or urinary tract issues, and is not a definitive sign of penile cancer. Additionally, many cases of penile cancer may not present with pain at all, particularly in the early stages.

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Blood Cell	Normal Ranges
Red blood cells (mature, circulating)	Male 4.51-6.01 million/mm3 Female: 4.01-5.51 million/mm3
Hemoglobin	Adult (15-64 yr) Male 14-17.3 g/dL Female 11.7-15.5 g/dL
Hematocrit	42% -52% in males 36% -48% in females
Reticulocytes	0.5% -2.5% of total RBC count
White blood cells (total)	4.5-11.1 103/mm3
Neutrophils	59% Bands 3% Segs-56%
Eosinophils	2.7%
Basophils	0.5%
Lymphocytes	34%
Monocytes	4%
Platelets	150,000-450,000/mm3

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Naxlex Comprehensive Predictor Exams

The physician recommends a carotid endarterectomy for a client with atherosclerosis and a history of transient ischemic attacks (TIAS). The nurse explains that this procedure involves:

Correct Answer is B

Explanation

The nurse is teaching a client about early detection for penile cancer. The nurse knows the teaching is effective when the client states, "I will:

Correct Answer is B

Explanation

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