A nurse is reviewing the CBC findings for a female client who is receiving combination chemotherapy for breast cancer. Which of the following findings should the nurse report to the provider?
WBC 1500/mm3
RBC 5 million/mm3
Platelets 155,000/mm3
Hemoglobin 12 g/dL
The Correct Answer is A
A. A WBC count of 1500/mm3 is significantly low (normal range is 4500-11000/mm3) and indicates neutropenia, placing the client at high risk for infection. This finding should be reported to the provider immediately.
B. An RBC count of 5 million/mm3 is within the normal range for females (4.2-5.4 million/mm3) and does not indicate an immediate concern in the context of chemotherapy.
C. Platelet count of 155,000/mm3 is on the lower end of the normal range (150,000-450,000/mm3) but does not pose an immediate risk compared to neutropenia.
D. A hemoglobin level of 12 g/dL is within the normal range for females (12-16 g/dL) and does not require urgent reporting.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","F","G"]
Explanation
A. Temperature: The client has a fever (39.3°C/102.8°F) indicating a potential infection or inflammatory process. This requires immediate follow-up to address the underlying cause of the fever.
B. Blood pressure: The client’s blood pressure is low (84/58 mm Hg on admission and 88/58 mm Hg current), suggesting possible shock or severe dehydration. This finding requires immediate assessment and intervention.
C. Pain level: The client reports increasing back and suprapubic pain, which could be related to a urinary tract infection or other serious condition. Addressing pain and its cause is critical.
D. Adalimumab frequency: The current medication schedule for Adalimumab is less urgent compared to the acute findings. The frequency of this medication does not require immediate follow-up in this context.
E. Heart sounds: No dysrhythmias were noted on the cardiac monitor, so this finding does not require immediate follow-up at this time.
F. WBC count: The WBC count is elevated with leucocyte esterase positive, indicating an infection. This warrants immediate attention to diagnose and treat the infection.
G. Urinalysis: The urinalysis shows cloudy appearance, foul odor, and alkaline pH with positive leucocyte esterase, suggesting a urinary tract infection. This requires immediate follow-up to start appropriate treatment.
H. Hgb & Hct: While important, these values are not provided in the current context. The immediate concerns are more focused on the acute symptoms and signs provided.
Correct Answer is D
Explanation
A. Obtaining a culture may be necessary if an infection is suspected, but checking the type of drainage takes priority to determine the nature of the fluid.
B. Documenting the amount of drainage is important but should be done after determining the type of drainage.
C. Notifying the provider is crucial if the drainage is abnormal, but identifying the nature of the drainage should come first.
D. Checking the drainage for glucose is critical as it may indicate cerebrospinal fluid (CSF) leakage, a serious complication that requires prompt intervention.
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