A nurse working in the acute care setting has just received laboratory data results. Which of the following clients should the nurse assess first?

A client recently diagnosed with rheumatoid arthritis whose platelet count is 148,000/mm3 (150,000 to 400,000/mm3)

A client who has hypothyroidism and whose magnesium level is 2.9 mEq/L (1.3 to 2.1 mEq/L)

A client who reported chest pain over the night whose potassium level is 5.9 mEq/L (3.5 to 5 mEq/()

A client who has a urinary tract infection whose white blood cell count is 14,000/mm2 (5,000 to 10,000/mm3)

Answer and Explanation

The Correct Answer is C

A. Platelet count of 148,000/mm³ is slightly below normal but not immediately life-threatening.
B. Magnesium level of 2.9 mEq/L is elevated but usually not critical unless very high or symptomatic.
C. Potassium level of 5.9 mEq/L is critically high and can cause life-threatening cardiac arrhythmias, especially in a client with recent chest pain—this client requires immediate assessment.
D. WBC count of 14,000/mm³ indicates infection but is not as immediately urgent as the hyperkalemia in option C.

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Correct Answer is A

Explanation

A. Drinking 4 to 6 ounces of juice (such as orange juice) is a fast-acting carbohydrate source recommended to quickly raise blood glucose levels during a hypoglycemic episode. This is part of the standard 15/15 rule: give 15 grams of fast-acting carbohydrate, then recheck blood glucose in 15 minutes.
B. 1 teaspoon of glucose gel is typically insufficient; usually, 1 tablespoon or more is required to deliver 15 grams of carbohydrate.
C. Two glucose tablets may be too little, depending on the brand; most tablets contain only 4 grams each, and 15 grams is typically required. Also, waiting 1 hour to recheck blood glucose is too long—blood glucose should be checked after 15 minutes.
D. Peanut butter with crackers is a slower-acting carbohydrate and fat combination, better for preventing future episodes after blood sugar is stabilized—not for initial treatment of acute hypoglycemia.

A. Keep client's affected heel on the bed. B. Perform internal and external rotation exercises of hip C. Use an elevated toilet seat D. Log roll the client onto the operative side

Correct Answer is C

Explanation

A. The affected heel should not rest directly on the bed as it increases the risk for pressure injuries. A pillow or heel protector should be used to elevate the heel off the bed.
B. Internal and external rotation of the hip is contraindicated after a hip replacement, as it can lead to dislocation of the prosthesis.
C. Using an elevated toilet seat prevents excessive hip flexion (>90 degrees), which reduces the risk of hip dislocation after surgery.
D. The client should not be turned onto the operative side immediately after surgery; instead, the client should be log rolled onto the non-operative side with an abduction pillow in place to maintain proper alignment.

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A nurse working in the acute care setting has just received laboratory data results. Which of the following clients should the nurse assess first?

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Naxlex Comprehensive Predictor Exams

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