The practical nurse (PN) reviews the laboratory results of an older adult client who is one day postoperative for a right total hip replacement. 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)]
Hemoglobin 8.9 grams/dL (89 g/L).
Potassium 3.4 mEq/L (3.4 mmol/L).
Sodium 130 mEq/L (130 mmol/L).
Blood urea nitrogen 20 mg/dL (7.14 mmol/L).
The Correct Answer is A
Rationale:
A. Hemoglobin 8.9 grams/dL (89 g/L): This value is significantly below the normal range of 12–16 g/dL, indicating anemia, likely from perioperative blood loss. Low hemoglobin can compromise oxygen delivery to tissues, increase risk for hypoxia, and cause tachycardia, hypotension, or dizziness, which are critical safety concerns for a postoperative client.
B. Potassium 3.4 mEq/L (3.4 mmol/L): This is slightly below the normal range of 3.5–5.0 mEq/L, indicating mild hypokalemia. While important for cardiac and neuromuscular function, the degree of deviation is less immediately life-threatening than severe anemia in the early postoperative period.
C. Sodium 130 mEq/L (130 mmol/L): Hyponatremia below the normal range of 136–145 mEq/L can lead to neurological changes such as confusion or seizures. However, in the context of immediate postoperative safety, the oxygen-carrying deficit from low hemoglobin has a more direct impact on vital organ perfusion.
D. Blood urea nitrogen 20 mg/dL (7.14 mmol/L): This value is at the upper limit of the normal range (10–20 mg/dL) and may reflect mild renal stress or dehydration but does not pose an immediate safety risk compared with severe anemia post-surgery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Continue by stroking down the medial side of the sole of the foot: Further stroking is unnecessary if the initial test elicited a normal plantar flexion response. Additional stimulation is not required to confirm a normal response and may cause discomfort to the client.
B. Repeat the same motion with the flat portion of the reflex hammer: Using the flat portion is not indicated for testing the plantar reflex. The pointed end is the standard tool for eliciting this response, and repeating the motion is unnecessary when the initial response is normal.
C. Notify the healthcare provider of the presence of a positive Babinski reflex: A positive Babinski reflex is indicated by dorsiflexion of the big toe and fanning of the other toes, which is abnormal in adults. In this patient, the toes curl downward, indicating a normal plantar flexion response; no abnormal finding exists to report.
D. Record the normal response of plantar flexion in the record: The observed downward curling of the toes represents a normal plantar reflex in an adult. Accurate documentation of this normal neurologic finding is the appropriate next step, ensuring continuity of care and baseline assessment for future comparison.
Correct Answer is D
Explanation
Rationale:
A. Inspect the urethral meatus for discharge: Examining the urethral meatus is primarily indicated when infection or inflammation, such as urethritis, is suspected. While discharge could indicate a problem, the client’s main concern involves urinary hesitancy and nocturia, making this assessment less directly relevant.
B. Observe the scrotum for swelling: Scrotal inspection is important for conditions such as hydrocele or testicular masses. These findings are not typically associated with nocturia or difficulty initiating urination in older males, so this assessment would not provide focused information for the client’s current urinary symptoms.
C. Palpate the inguinal area for a bulge: Assessing the inguinal area can detect hernias, which may cause discomfort or urinary issues indirectly, but it does not address the primary complaints of urinary hesitancy and frequency, and is therefore not the most pertinent assessment.
D. Question client about urinary dribbling and frequency: Asking about urinary dribbling, frequency, and stream characteristics directly evaluates symptoms associated with benign prostatic hyperplasia or lower urinary tract obstruction. This focused history provides critical information to guide further assessment and intervention for the client’s nocturia and difficulty initiating urination.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.