A nurse is assessing a client with a temperature of 38.5°C (101.3°F) and a white blood cell count of 15,000/mm³. Which condition is the client most likely experiencing?
Bacterial infection.
Viral infection.
Fungal infection.
Parasitic infection.
The Correct Answer is A
Choice A rationale
Bacterial infection often leads to an elevated white blood cell count (15,000/mm³) and fever (38.5°C). The body’s immune response to bacterial pathogens results in these clinical manifestations.
Choice B rationale
Viral infections can cause fever, but they typically do not lead to a significant increase in white blood cell count.
Choice C rationale
Fungal infections can cause fever and elevated white blood cell count, but they are less common and usually occur in immunocompromised individuals.
Choice D rationale
Parasitic infections can cause fever and elevated white blood cell count, but they are less common and usually present with other specific symptoms.
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Correct Answer is C
Explanation
Choice A rationale
Urine specific gravity of 1.029 indicates concentrated urine, which is common in dehydration but not specific to prerenal AKI. It reflects the kidney’s ability to concentrate urine in response to fluid deficit.
Choice B rationale
BUN of 28 mg/dL can indicate dehydration or renal impairment. However, it is not as specific as creatinine in diagnosing prerenal AKI. BUN can be elevated due to other factors like high protein intake or gastrointestinal bleeding.
Choice C rationale
Creatinine of 2.4 mg/dL is a critical indicator of kidney function. Elevated creatinine levels are more specific to renal impairment, including prerenal AKI, as they reflect the kidney’s ability to filter waste products.
Choice D rationale
Dry mucous membranes are a sign of dehydration but are not specific to prerenal AKI. They indicate fluid volume deficit but do not directly reflect kidney function.
Correct Answer is B
Explanation
Choice A rationale
Administering vitamin B12 to increase RBC size is not appropriate in this scenario. The elevated MCV indicates macrocytic anemia, which is often due to vitamin B12 deficiency. The goal is to restore normal RBC maturation, not to increase RBC size.
Choice B rationale
Administering vitamin B12 to restore normal RBC maturation is the appropriate action. The elevated MCV indicates macrocytic anemia, which is often due to vitamin B12 deficiency. Administering vitamin B12 will help restore normal RBC maturation and correct the anemia.
Choice C rationale
Administering medication to decrease RBC size is not appropriate in this scenario. The elevated MCV indicates macrocytic anemia, which is often due to vitamin B12 deficiency. The goal is to restore normal RBC maturation, not to decrease RBC size.
Choice D rationale
Administering iron to increase the formation of hemoglobin molecules is not appropriate in this scenario. The elevated MCV indicates macrocytic anemia, which is often due to vitamin B12 deficiency. Iron supplementation is typically used for microcytic anemia, not macrocytic anemia.