A nurse on a pediatric unit is reviewing the laboratory results for a group of clients. Which of the following results should the nurse identify as the priority?

An adolescent who has iron-deficiency anemia and an Hgb level of 11 g/dL (10 to 15.5 g/dL)

A school-age child who has diabetes mellitus and an HbA1c of 8% (less than 7%)

A toddler who has moderate dehydration and an RBC count of 5.6/mm3 (4 to 5.5/mm3)

A preschooler who has cystic fibrosis-related diabetes and a WBC count of 15,000/mm3 (5,000 to 10,000/mm3)

Answer and Explanation

The Correct Answer is D

A. An adolescent who has iron-deficiency anemia and an Hgb level of 11 g/dL (10 to 15.5 g/dL):

An Hgb level of 11 g/dL in an adolescent with iron-deficiency anemia is within the expected range for someone with this condition. While iron-deficiency anemia requires management, it is not an urgent or critical condition requiring immediate intervention.

B. A school-age child who has diabetes mellitus and an HbA1c of 8% (less than 7%):

An HbA1c level of 8% in a child with diabetes mellitus indicates poor glycemic control and may increase the risk of long-term complications. While it requires attention and adjustment of the treatment plan, it is not an urgent or critical condition requiring immediate intervention.

C. A toddler who has moderate dehydration and an RBC count of 5.6/mm3 (4 to 5.5/mm3):

Moderate dehydration in a toddler is a concerning finding that requires prompt intervention to restore fluid balance and prevent complications. However, the RBC count of 5.6/mm3 is within the normal range and does not indicate an urgent or critical condition.

D. A preschooler who has cystic fibrosis-related diabetes and a WBC count of 15,000/mm3 (5,000 to 10,000/mm3):

A WBC count of 15,000/mm3 in a preschooler with cystic fibrosis-related diabetes may indicate an infection or inflammatory process. Elevated WBC count warrants further assessment and possible intervention to identify and treat the underlying cause, making this the priority.

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Correct Answer is A

Explanation

A. Obtain a daily weight:

This is an appropriate action. Monitoring daily weights can help assess fluid balance and detect fluid retention, which is common in children with kidney disorders like acute glomerulonephritis. Sudden weight gain or fluid overload may indicate worsening kidney function and the need for intervention.

B. Strain the urine:

Straining the urine may be indicated to monitor for the presence of blood or protein, which are common findings in acute glomerulonephritis. Straining the urine is not necessary, as hematuria is a common finding and does not indicate kidney damage.

C. Monitor blood glucose level every 4 hr:

Monitoring blood glucose levels every 4 hours is not directly related to the care of a child with acute glomerulonephritis. Blood glucose monitoring is more relevant in conditions such as diabetes mellitus. However, monitoring electrolyte levels, including blood glucose, may be part of routine laboratory testing in children with kidney disorders.

D. Recommend strict bed rest:

Strict bed rest is not typically recommended for children with acute glomerulonephritis unless there are specific complications or severe symptoms requiring immobilization. While some activity restriction may be recommended during the acute phase of the illness, strict bed rest may lead to complications such as deconditioning and venous thromboembolism.

A. "Seal nonwashable items in a plastic bag for 2 days." B. "Soak hair brushes in boiling water for 10 minutes." C. "Apply permethrin 1 percent cream rinse every day for 5 days." D. "After washing bed linens, place them in a dryer on a cool setting for 30 minutes."

Correct Answer is B

Explanation

A. "Seal nonwashable items in a plastic bag for 2 days."

This instruction is incorrect. Items that cannot be laundered may be dry-cleaned or sealed in a plastic bag for two weeks

B. "Soak hair brushes in boiling water for 10 minutes."This is correct. According to CDC, combs and brushes should be soaked in hot water (at least 130 degrees fahrenheit) to help avoid re-infestation.

C. "Apply permethrin 1 percent cream rinse every day for 5 days."

This instruction is incorrect. Permethrin 1 percent cream rinse is a medication used to treat head lice infestations, but it is typically applied only once and then rinsed out after a specified period of time (usually 10 minutes). Repeated daily application for five days is not recommended and may lead to unnecessary exposure to the medication.

D. "After washing bed linens, place them in a dryer on a cool setting for 30 minutes."

This instruction is incorrect. To effectively kill lice and nits on bed linens, they should be washed in hot water (at least 130°F or 54°C) and then dried on a hot setting in the dryer. A cool setting may not be sufficient to kill lice and nits.

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A nurse on a pediatric unit is reviewing the laboratory results for a group of clients. Which of the following results should the nurse identify as the priority?

Nursing Test Bank

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