A nurse is caring for a client who returns to the nursing unit from the recovery room after a sigmoid colon resection for adenocarcinoma. The client had an episode of intraoperative bleeding. Which finding indicates to the nurse that the client may be developing hypovolemic shock?

Decrease in the urinary output from 50 mL to 30 mL per hour.

Increase in the heart rate from 88 to 110/min.

Decrease in the respiratory rate from 20 to 16/min.

Increase in the temperature from 37.5° C (99.5° F) to 38.6° C (101.5° F).

Answer and Explanation

The Correct Answer is B

A. A decrease in urinary output can be a sign of decreased blood volume but is less immediate than changes in heart rate.
B. An increase in the heart rate is a common compensatory response to hypovolemia as the body attempts to maintain adequate perfusion to vital organs.
C. A decrease in the respiratory rate is not typically associated with hypovolemic shock; rather, respiratory rate may increase due to compensatory mechanisms.
D. An increase in temperature is not a specific indicator of hypovolemic shock; it could be related to infection or inflammation rather than immediate hypovolemia.

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Correct Answer is B

Explanation

A. Rheumatoid factor (RF) is a marker for RA but does not directly measure the effectiveness of aspirin therapy.
B. The erythrocyte sedimentation rate (ESR) is a marker of inflammation and can be used to evaluate the effectiveness of anti-inflammatory medications like aspirin in reducing inflammation associated with RA.
C. Antinuclear antibody (ANA) is used to diagnose autoimmune disorders but is not specific to monitoring the effectiveness of RA treatments.
D. The white blood cell (WBC) count is a general marker of infection or inflammation but does not specifically reflect the effectiveness of aspirin in treating RA.

A. An acute infectious process B. Allergic reaction C. Neutropenia D. A resolving inflammatory process

Correct Answer is A

Explanation

A. An elevated WBC count with increased immature neutrophils (bands) indicates an acute infectious process. The presence of bands suggests that the body is responding to an infection and producing neutrophils rapidly to fight off the infection.

B. An allergic reaction is more commonly associated with an elevated eosinophil count rather than neutrophils. The laboratory findings described do not support an allergic reaction.

C. Neutropenia is characterized by a low neutrophil count, not an elevated one. The presence of increased immature neutrophils suggests an infection rather than neutropenia.

D. A resolving inflammatory process would typically show a decrease in immature neutrophils (bands) and a normalization of the WBC count, rather than an elevated WBC with increased bands.

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A nurse is caring for a client who returns to the nursing unit from the recovery room after a sigmoid colon resection for adenocarcinoma. The client had an episode of intraoperative bleeding. Which finding indicates to the nurse that the client may be developing hypovolemic shock?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for an older adult client who has rheumatoid arthritis (RA) and is taking aspirin 650 mg every 4 hours. Which of the following diagnostic tests should the nurse monitor to evaluate the effectiveness of this medication?

Correct Answer is B

Explanation

A nurse is reviewing the laboratory results of an adolescent female client and notes a WBC count of 16,000/mm³ with increased immature neutrophils (bands) and normal monocytes. Which of the following is the appropriate analysis of the results?

Correct Answer is A

Explanation

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