Page 2617 - Saunders Comprehensive Review For NCLEX-RN

transmission of tuberculosis to direct you to the correct option. Remember, three
negative sputum cultures are required.
Level of Cognitive Ability: Applying
Client Needs: Safe and Effective Care Environment
Integrated Process: Teaching and Learning
Content Area: Foundations of Care: Infection Control
Health Problem: Adult Health: Respiratory: Tuberculosis
Priority Concepts: Infection; Safety
Reference: Ignatavicius, Workman, Rebar (2018), p. 609.

940. Answer: 3

Rationale: This client is in a severe state of anxiety. When a client is in a severe or
panic state of anxiety, it is crucial for the nurse to remain with the client. The client in
a severe state of anxiety would be unable to learn relaxation techniques. Discussing
the assault at this point would increase the client’s level of anxiety further. Placing
the client in a quiet room alone may also increase the anxiety level.
Test-Taking Strategy: Note the strategic word, priority. The priority action in this
situation is to remain with the client.
Level of Cognitive Ability: Applying
Client Needs: Safe and Effective Care Environment
Integrated Process: Nursing Process—Implementation
Content Area: Mental Health
Health Problem: Mental Health: Anxiety disorder
Priority Concepts: Anxiety; Caregiving
Reference: Varcarolis (2017), p. 134.

941. Answer: 2

Rationale: Laboratory findings do not establish the diagnosis of appendicitis, but
there is often an elevation of the white blood cell count (leukocytosis) with a shift to
the left (an increased number of immature white blood cells). Options 1, 3, and 4 are
incorrect because they are not associated findings in acute appendicitis.
Test-Taking Strategy: Focus on the subject, appendicitis. Knowledge that an
inflammatory process causes an increase in the white blood cell count will assist you
in eliminating options 1 and 3. From the remaining options, it is necessary to
understand the significance of a shift to the left.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Adult Health: Gastrointestinal
Health Problem: Adult Health: Gastrointestinal: GI Accessory organs
Priority Concepts: Cellular Regulation; Inflammation
Reference: Ignatavicius, Workman, Rebar (2018), pp. 1147-1148.

942. Answer: 3

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