a nurse reviews the laboratory findings of a client with a urinary tract infection the laboratory report notes a shift to the left in a clients white
Logo

Nursing Elites

HESI RN

HESI Medical Surgical Practice Quiz

1. A nurse reviews the laboratory findings of a client with a urinary tract infection. The laboratory report notes a “shift to the left” in the client’s white blood cell count. Which action should the nurse take?

Correct answer: B

Rationale: A “shift to the left” in a white blood cell count indicates an increase in band cells, which is typically associated with urosepsis. In this scenario, the nurse should notify the provider and initiate IV antibiotics as a left shift is often seen in severe infections like urosepsis. Requesting a differential analysis on white blood cells would not be the immediate action needed in response to a left shift. Collaborating to strain urine for renal calculi is unrelated to the situation of a left shift in white blood cells due to urosepsis. Assessing for allergic reactions and anaphylactic shock is not the priority as a left shift is not indicative of an allergic response; it is associated with an increase in band cells, not eosinophils.

2. How can a nurse best help a client undergoing a bone marrow aspiration and biopsy, along with two upset family members, manage anxiety during the procedure?

Correct answer: C

Rationale: Encouraging the client to take slow, deep breaths is an effective way for the nurse to help the client manage anxiety during the bone marrow aspiration and biopsy procedure. Slow, deep breathing can promote relaxation and help reduce anxiety levels. Choice A, allowing the client's family to stay for emotional support, may provide comfort but does not address a direct intervention to help manage anxiety. Choice B, staying with the client silently, may not actively help the client address their anxiety. Choice D, allowing the client to express feelings, is important but may not directly address anxiety management during the procedure.

3. The healthcare provider is unable to palpate the client's left pedal pulses. Which of the following actions should the healthcare provider take next?

Correct answer: C

Rationale: When pedal pulses are not palpable, using a Doppler ultrasound device is the appropriate next step to locate the pulse. Auscultating the pulses with a stethoscope (Choice A) is used for assessing blood flow in arteries above the clavicle, not for pedal pulses. Calling the physician (Choice B) may be necessary at a later stage, but initially, using a Doppler ultrasound device to locate the pulse is more appropriate. Inspecting the lower left extremity (Choice D) can provide visual information but will not help in locating the pedal pulses, making it a less suitable option.

4. A client with renal insufficiency and a low red blood cell count asks, 'Is my anemia related to the renal insufficiency?' How should the nurse respond?

Correct answer: C

Rationale: The correct answer is C. Erythropoietin is produced in the kidney and is released in response to decreased oxygen tension in the renal blood supply. Erythropoietin stimulates red blood cell production in the bone marrow. Anemia in renal insufficiency is often due to decreased erythropoietin production. Anemia and renal insufficiency are not manifestations of vitamin D deficiency as stated in choice B. Choice A is incorrect as erythropoietin does not increase blood flow to the kidneys. Choice D is incorrect because kidney insufficiency does not inhibit active transportation of red blood cells throughout the blood; rather, it affects erythropoietin production and subsequent red blood cell formation.

5. A female patient will receive doxycycline to treat a sexually transmitted infection (STI). What information will the nurse include when teaching this patient about this medication?

Correct answer: D

Rationale: The correct answer is D. The desired action of oral contraceptives can be reduced when taken with tetracyclines like doxycycline. Therefore, patients on oral contraceptives should be advised to use a backup contraception method while taking doxycycline. Choice A is incorrect because nausea and vomiting are common adverse effects of doxycycline. Choice B is incorrect because doxycycline is not known for causing teratogenic effects. Choice C is incorrect because dairy products can interfere with the absorption of doxycycline, so they should be avoided when taking this medication.

Similar Questions

During a paracentesis procedure on a client with abdominal ascites, into which position would the nurse assist the client?
A nurse has a prescription to insert a nasogastric tube into the stomach of an assigned client. Which action should the nurse take to insert the tube safely and easily?
A client is returning home after arthroscopy of the shoulder. The nurse should tell the client:
After checking the client’s gag reflex following an esophagogastroduodenoscopy (EGD), which action should the nurse take?
A client is to have a transsphenoidal hypophysectomy to remove a large, invasive pituitary tumor. The nurse should instruct the client that the surgery will be performed through an incision in the:

Access More Features

HESI RN Basic
$89/ 30 days

  • 5,000 Questions with answers
  • All HESI courses Coverage
  • 30 days access

HESI RN Premium
$149.99/ 90 days

  • 5,000 Questions with answers
  • All HESI courses Coverage
  • 30 days access

Other Courses