Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
While changing a client's postoperative dressing, the nurse observes purulent drainage at the wound. Before reporting this finding to the healthcare provider, the nurse should note which of the client's laboratory values?
A. Hematocrit.
B. Platelet count.
C. Creatinine level.
D. White blood cell (WBC) count.
The presence of purulent drainage at the wound indicates a potential infection, and monitoring the client's WBC count is an important laboratory value to assess for signs of infection. An elevated WBC count, specifically an increase in the neutrophil count (neutrophilia), can indicate an active infection and provide important information for the healthcare provider when evaluating the wound. While hematocrit, platelet count, and creatinine level are essential laboratory values to assess the client's overall condition, they may not provide specific information regarding the presence of infection or purulent drainage at the wound site.
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Full Explanation
The presence of purulent drainage at the wound indicates a potential infection, and monitoring the client's WBC count is an important laboratory value to assess for signs of infection. An elevated WBC count, specifically an increase in the neutrophil count (neutrophilia), can indicate an active infection and provide important information for the healthcare provider when evaluating the wound.
While hematocrit, platelet count, and creatinine level are essential laboratory values to assess the client's overall condition, they may not provide specific information regarding the presence of infection or purulent drainage at the wound site.
Similar Questions
An S3 heart sound is auscultated in a client in her third trimester of pregnancy. What intervention should the nurse take?
A. Document in the client's record.
An S3 heart sound can be a normal finding during pregnancy due to increased blood volume and changes in cardiac output. It is known as a physiological S3 and is considered a benign finding in the absence of other concerning symptoms or signs. In this case, there is no immediate need for intervention or concern regarding the S3 heart sound. It is not necessary to prepare the client for an echocardiogram or limit the client's fluids based solely on the presence of an S3 heart sound in the absence of other significant symptoms or complications.
B. Prepare the client for an echocardiogram.
C. Notify the healthcare provider.
D. Limit the client's fluids.
Full Explanation
An S3 heart sound can be a normal finding during pregnancy due to increased blood volume and changes in cardiac output. It is known as a physiological S3 and is considered a benign finding in the absence of other concerning symptoms or signs.
In this case, there is no immediate need for intervention or concern regarding the S3 heart sound. It is not necessary to prepare the client for an echocardiogram or limit the client's fluids based solely on the presence of an S3 heart sound in the absence of other significant symptoms or complications.
The nurse-manager is involved in agency restructuring. During this re-engineering process, it is most important for the nurse to address which employee concern?
A. Potential changes in employee benefits.
B. Changes in job descriptions.
C. New management's expectations.
D. Employees' job security.
Agency restructuring can be a time of significant stress and uncertainty for employees, particularly if they feel that their jobs may be at risk. Addressing employees' job security concerns and providing clear and timely communication regarding the restructuring process can help to alleviate anxiety and maintain morale within the workplace. While changes in employee benefits, job descriptions, and management expectations are important considerations, they may be secondary to employees' immediate concerns about their job security. Once job security concerns have been addressed, it may be appropriate to provide additional information and support regarding changes in other areas. Ultimately, maintaining a positive and supportive work environment during agency restructuring can help to minimize disruption and maintain employee satisfaction and engagement.
A client receives a prescription for a fluid bolus of 0.9% sodium chloride, USP 200 mL to be infused in 30 minutes. How many mL/hr should the nurse program the infusion pump to deliver?
(Enter numerical value only.)
Full Explanation
To calculate the mL/hr rate for the infusion pump, we can use the following formula: mL/hr = (Total volume to be infused in mL) / (Time in hours)
In this case, the total volume to be infused is 200 mL, and the infusion time is 30 minutes, which is equal to 0.5 hours.
mL/hr = 200 mL / 0.5 hours mL/hr = 400 mL/hr
Therefore, the nurse should program the infusion pump to deliver 400 mL/hr.