A nurse is caring for a patient who reports an increase in bruising. The nurse should expect which of the following laboratory values?

Platelets 110,000 mm3

WBC 8,000 mm3

Hemoglobin 13.0 g/dL

RBC 4.6 million/mm3

Answer and Explanation

The Correct Answer is A

A. Platelets 110,000 mm³ – Correct Answer. A low platelet count (thrombocytopenia) increases the risk of bruising and bleeding. Normal platelet range is 150,000–400,000 mm³.

B. WBC 8,000 mm³ – Normal white blood cell count; does not explain increased bruising.

C. Hemoglobin 13.0 g/dL – Normal hemoglobin level; not related to bruising.

D. RBC 4.6 million/mm³ – Normal RBC count; does not indicate a bleeding risk.

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Correct Answer is C

Explanation

A. The patient states having nasal congestion. – Incorrect. Nasal congestion is a symptom of autonomic dysreflexia, not a trigger.

B. The patient’s blood pressure becomes elevated. – Incorrect. Hypertension is a symptom of autonomic dysreflexia, not the cause.

C. The patient’s bladder becomes distended. – Correct Answer. Bladder distention is the most common trigger of autonomic dysreflexia, a life-threatening condition causing sudden hypertension, bradycardia, and severe headache. Immediate intervention is needed, such as catheterizing the bladder.

D. The patient states having a severe headache. – Incorrect. A severe headache is a symptom of autonomic dysreflexia, not a cause.

A. Reflect on how she's feeling, and encourage her to express other fears that she has about his injury. B. Explain that you aren't sure, but you will ask the physician to talk to her right away. C. Advise her that it isn't in his best interest for her to be so upset, and explain the importance of moral support D. Reassure her that given time and motivation he will return to normal function.

Correct Answer is A

Explanation

A. Reflect on how she's feeling, and encourage her to express other fears that she has about his injury – Acknowledging emotions and encouraging open expression helps the mother process her grief and begin adjusting to the reality of the injury.

B. Explain that you aren't sure, but you will ask the physician to talk to her right away – Deferring to the physician misses an opportunity for emotional support.

C. Advise her that it isn’t in his best interest for her to be so upset, and explain the importance of moral support – This dismisses her emotions rather than addressing them.

D. Reassure her that given time and motivation he will return to normal function – Providing false reassurance is inappropriate, as a C5 spinal cord injury results in permanent loss of function.

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A nurse is caring for a patient who reports an increase in bruising. The nurse should expect which of the following laboratory values?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient who has a T-4 spinal cord injury. Which of the following patient findings should the nurse identify as placing the at risk for developing autonomic dysreflexia?

Correct Answer is C

Explanation

Correct Answer is A

Explanation

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