Page 330 - Saunders Comprehensive Review For NCLEX-RN

combined. From the remaining options, it is necessary to remember that toxicity can
result if NSAIDs are combined with calcium channel blockers. Also note that options
4 and 5 are comparable or alike and are antilipemic medications. This will assist in
eliminating these options.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Implementation
Content Area: Skills: Vital Signs
Health Problem: Adult Health: Neurological: Pain
Priority Concepts: Clinical Judgment; Safety
Reference: Lewis et al. (2017), p. 111.

72. Answer: 4

Rationale: The normal reference range for the glycosylated hemoglobin A is less
1c
than 6.0%. This test measures the amount of glucose that has become permanently
bound to the red blood cells from circulating glucose. Erythrocytes live for about 120
days, giving feedback about blood glucose for the past 120 days. Elevations in the
blood glucose level will cause elevations in the amount of glycosylation. Thus, the
test is useful in identifying clients who have periods of hyperglycemia that are
undetected in other ways. The estimated average glucose for a glycosylated
hemoglobin A of 8% is 205 mg/dL (11.42 mmol/L). Elevations indicate continued
1c
need for teaching related to the prevention of hyperglycemic episodes.
Test-Taking Strategy: Focus on the subject, a glycosylated hemoglobin A level
1c
of 8%. Recalling the normal value and that an elevated value indicates
hyperglycemia will assist in directing you to the correct option.
Level of Cognitive Ability: Applying
Client Needs: Health Promotion and Maintenance
Integrated Process: Teaching and Learning
Content Area: Foundations of Care: Laboratory Tests
Health Problem: Adult Health: Endocrine: Diabetes Mellitus
Priority Concepts: Client Education; Glucose Regulation
Reference: Lewis et al. (2017), p. 1118.

73. Answer: 1

3
Rationale: The normal WBC count ranges from 5000 to 10,000 mm (5 to 10 ×
9
10 /L). The client who has a decrease in the number of circulating WBCs is
immunosuppressed. The nurse implements neutropenic precautions when the
client’s values fall sufficiently below the normal level. The specific value for
implementing neutropenic precautions usually is determined by agency policy. The
remaining options are normal values.
Test-Taking Strategy: Focus on the subject, the need to implement neutropenic
3
precautions. Recalling that the normal WBC count is 5000 to 10,000 mm (5 to 10 ×
9
10 /L) will direct you to the correct option.
Level of Cognitive Ability: Applying

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