The practical nurse (PN) reviews the laboratory results of an elderly female client who is one day postoperative for a right total hip replacement (THR).

Which serum value result has the greatest implication for client safety?

Reference ranges

Hemoglobin (Hgb) [12 to 16 g/dL (120 to 160 g/L)]

Potassium (K+) [3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L)]

Sodium [136 to 145 mEq/L (136 to 145 mmol/L)]

Blood Urea Nitrogen (BUN) [10 to 20 mg/dL (3.6 to 7.1 mmol/L)]

Sodium 130 mEq/L.

Hemoglobin 8.9 grams/dL.

Potassium 3.4 mEq/L

Blood urea nitrogen 20 mg/dL.

Answer and Explanation

The Correct Answer is B

A.   Sodium level of 130 mEq/L is slightly below the lower limit of the reference range but might not have as immediate an impact on safety as a critically low hemoglobin level.
B.   Hemoglobin of 8.9 grams/dL is significantly below the normal range and indicates a substantial drop in red blood cells, which can lead to impaired oxygen transport and potentially severe postoperative complications like inadequate tissue perfusion and oxygenation.
C.   Potassium level of 3.4 mEq/L is slightly below the lower limit of the reference range but might not pose an immediate threat compared to a critically low hemoglobin level.
D.   Blood urea nitrogen (BUN) of 20 mg/dL is at the upper limit of the reference range but might not have an immediate implication for client safety compared to a critically low hemoglobin level.

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Correct Answer is D

Explanation

A. Allowing the client to go to the bathroom independently may pose a safety risk, particularly if the labor progresses rapidly or if she experiences increased discomfort.
B. Assisting the client to the bathroom might not be advisable if she is in active labor, as her condition can change quickly, and she may need immediate access to care.
C. Offering the client a bedpan or urinal would allow for bladder emptying but may not address the urgency of her desire to ambulate.
D. Encouraging the client to hold off until she is further dilated is appropriate, as a full bladder can impede labor progression and lead to complications. This allows for monitoring and assessment of her condition, ensuring that she remains safe and that labor can continue effectively.

A. Call the charge nurse to the room. B. Observe the appearance of the injection site. C. Cleanse the finger with soap and water. D. Explain the occurrence to the client.

Correct Answer is C

Explanation

A. Calling the charge nurse might be necessary, but the immediate action after a needlestick injury is to cleanse the affected area to minimize the risk of infection.
B. Observing the appearance of the injection site is important but not the first action following a needlestick injury.
C. Cleaning the finger with soap and water is the initial action to reduce the risk of infection following a needlestick injury.
D. Explaining the occurrence to the client is important but comes after taking care of the nurse's immediate health following a needlestick injury.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

The practical nurse (PN) administers an injection using a syringe with a retractable needle. After the needle is removed from the client's skin, the needle does not retract, and the PN gets stuck in the finger with the used needle. What action should the PN take first?

Correct Answer is C

Explanation

The practical nurse (PN) is caring for a newborn whose mother has poorly controlled type 1 diabetes mellitus and observes the newborn is grunting with mild sternal retractions. The PN should recognize the newborn is exhibiting signs of which condition?

The practical nurse (PN) observes a client's mouth and lips as seen in the picture. Which follow-up action is most important for the PN to take?

The practical nurse (PN) is caring for a client with fractured metatarsals after slamming a hand in the car door. After administering the prescribed hydrocodone/acetaminophen for pain, which intervention should the PN include in the client's care?

The practical nurse (PN) is administering a saline enema to a client who was admitted because of a fever of unknown origin and is now constipated. Which techniques should the PN use? (Select all that apply.)

What factors are important in determining the level of hypoxemia that the child may have experienced during the submersion? Select all that apply.

The practical nurse (PN) administers an antibiotic to a client with a respiratory tract infection. To evaluate the medication's effectiveness, which laboratory values should the PN monitor? (Select all that apply.)

After a successful cardioversion, a male client with a new onset of atrial fibrillation receives a prescription for an anticoagulant. What instruction should the practical nurse (PN) reinforce with the client?