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Exhibits

Which laboratory tests would be helpful in determining the plan of care for this client? Select all that apply.

Coagulation studies

Type and screen

Urine osmolality

Complete blood count

Blood culture

Lipid panel

Arterial blood gas

Electrolytes

Answer and Explanation

Correct Answer : A,B,D,G,H

A. Coagulation Studies: This client has liver and spleen lacerations with blood noted in the peritoneum, increasing the risk of coagulopathy due to active bleeding. The liver is responsible for producing clotting factors, and an injury may impair coagulation. The client also has a low hemoglobin (9.3 g/dL) and hematocrit (30%), suggesting ongoing blood loss. Monitoring prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (aPTT) can guide transfusion therapy (e.g., fresh frozen plasma or platelets).
B. Type and Screen: This client has evidence of hemorrhagic shock (tachycardia, narrow pulse pressure, low hemoglobin/hematocrit) and may require blood transfusion. Type and screen determines ABO blood type and Rh factor to ensure availability of compatible blood products. If bleeding worsens, crossmatching blood would be necessary for transfusion.
C. Urine osmolality: Not a priority in this trauma case. Urine osmolality assesses kidney function and hydration status but does not provide urgent information about blood loss, shock, or ventilation status.
D. Complete Blood Count (CBC): Provides serial hemoglobin and hematocrit (H&H) monitoring to assess for ongoing internal bleeding. White blood cell (WBC) count helps detect infection or inflammation post-operatively. Platelets are critical for clotting and must be monitored, especially in trauma patients at risk for coagulopathy.
E. Blood culture: Used to detect bloodstream infections (sepsis), which is not an immediate concern in this trauma patient. While infection risk is relevant postoperatively, it is not a priority test for acute trauma care.
F. Lipid panel: Lipid panels evaluate cholesterol and triglyceride levels, which are irrelevant in acute trauma management.
G. Arterial Blood Gas (ABG): This client is intubated and ventilated, making ABG analysis essential for evaluating: Oxygenation (PaO₂, SaO₂) and ventilation (PaCO₂), Acid-base balance (pH, bicarbonate levels). Early detection of metabolic acidosis, which may indicate shock or inadequate perfusion.
H. Electrolytes: Trauma and fluid resuscitation can cause electrolyte imbalances, leading to cardiac arrhythmias, fluid shifts, and metabolic disturbances. Potassium (K⁺) is Essential to monitor due to IV fluids with potassium chloride infusion. Sodium (Na⁺), chloride (Cl⁻), and bicarbonate (HCO₃⁻) are crucial in assessing fluid status and acid-base balance. Lactate levels (part of a metabolic panel) can indicate tissue hypoxia and worsening shock.

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Correct Answer is ["A","B","C"]

Explanation

A. Anti-cyclic citrullinated peptide (anti-CCP) antibodies are highly specific for rheumatoid arthritis (RA). A positive result supports the diagnosis of RA.
B. C-reactive protein is an inflammatory marker that is elevated in active RA, reflecting inflammation in the body.
C. Sedimentation rate (ESR) is also an inflammatory marker and is often elevated in RA, indicating active inflammation.
D. D-Dimer is a test that assesses for the presence of clot formation and breakdown. It is not used for diagnosing RA.
E. White blood cell count may be slightly elevated in RA due to inflammation, but it is not specific for RA and is less helpful in the diagnosis compared to the other tests.

A. Monitor the client's white blood cell count. B. Institute contact precautions for staff and visitors. C. Send wound drainage for culture and sensitivity. D. Explain the purpose of a low bacteria diet. E. Use standard precautions and wear a mask.

Correct Answer is ["A","B","C"]

Explanation

A. Monitor the client's white blood cell count. WBC count is a key indicator of infection and helps monitor the severity of the infection.

B. Institute contact precautions for staff and visitors. MRSA is highly contagious and can be spread through direct contact, so contact precautions are necessary to prevent transmission.

C. Send wound drainage for culture and sensitivity. This is essential to identify the specific pathogen and determine the appropriate antibiotic treatment.

D. Explain the purpose of a low bacteria diet. While a low-bacteria diet is often recommended for immunocompromised patients, it is not a priority in this scenario, where infection management and isolation precautions are more urgent.

E. Use standard precautions and wear a mask. Standard precautions should always be used, but a mask is not necessary unless the client has respiratory symptoms, which is not indicated in this case.

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Exhibits Which laboratory tests would be helpful in determining the plan of care for this client? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","B","C"]

Explanation

A client with osteomyelitis from a compound fracture of the left tibia has an open draining wound and is admitted with possible methicillin- resistant Staphylococcus aureus (MRSA) infection. Which interventions should the nurse include in the plan of care? Select all that apply.

Correct Answer is ["A","B","C"]

Explanation

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Exhibits

Which laboratory tests would be helpful in determining the plan of care for this client? Select all that apply.