Client with white blood cell count 7,000/mm3 (7 x 109/L).
This client is stable. The normal white blood cell (WBC) count for an adult is 4,500 to 11,000/mm3 (4.5 to 11 x 109/L). The normal WBC for a child is 5,000 to 13,000/mm3 (5 to 13 x 109/L).
Client with hemoglobin 6 g/dL (60 g/L).
This client is not stable because the hemoglobin is critically low. The client will require close monitoring by the nurse and a blood transfusion. Normal values are:
Client with blood urea nitrogen 80 mg/dL (28.56 mmol/L).
This client is not stable because the blood urea nitrogen (BUN) is markedly elevated, a sign of decreased renal perfusion. This finding indicates either hypovolemia or kidney failure. The normal range is 10 to 20 mg/dL (3.6 to 7.1 mmol/L).
Client with prothrombin time 10 seconds.
This client is stable. The normal prothrombin time (PT) is 9.5 to 12 seconds (depending on the reagent and instrumentation used).
Client with a fasting glucose 130 mg/dL (7.21 mmol/L).
This client is stable. The blood glucose is only mildly elevated, and there is no indication that this client is unstable. The normal fasting glucose range is 70 to 99 mg/dL (3.89 to 5.49 mmol/L).
Client with platelet count 22,000/mm3 (22 x 109/L.)
This client is not stable because of a critically low platelet count, which suggests severe thrombocytopenia. The client will require close observation for bleeding by the nurse and platelet transfusions. The normal platelet count is 150,000 to 450,000/mm3 (150 to 450 x 109/L)
Decision Tree:
This walk-through provides test-taking strategies to determine the correct answer for the different types of questions you will encounter on the NCLEX-RN exam. These strategies are based on the Kaplan Decision Tree (DT) algorithm, a technique that provides a process to determine the correct answer for NCLEX-style questions.
This is a Select All That Apply Question.
This type of question may also be referred to as multiple-select, multiple-response, or SATA. Multiple-select questions have 5 or 6 answer options. At least one option, or as many as all of the options, will be correct. Use these steps, based on the Kaplan Decision Tree, to determine the correct answer.
STEP 1: Can you identify the topic of the question?
- Unstable clients inappropriate for LPN/LVN assignment.
STEPS 2-4:These steps are not relevant to this type of question because you do not need to use the rules for Select All That Apply questions. Move to Step 5.
STEP 5: What is the outcome of each of each answer choice?
Read each answer choice, adding the topic in front. Example: If the identified topic of the question is negligence, read it as, ?Is it negligent if.... [insert the answer choice].?
- Is the answer choice true? If yes, keep it.
- Is answer choice false? If yes, eliminate it.
Evaluate the outcomes
1. Client with white blood cell count 7,000/mm3 (7 x 109/L). Incorrect. This stable client with a normal WBC is an appropriate assignment for an LPN/LVN. Eliminate.
2. Client with hemoglobin 6 g/dL (60 g/L). Correct. This client is unstable due to a markedly low hemoglobin, which suggests severe anemia. Assigning this client to an LPN/LVN would be inappropriate and considered professionally negligent.
3. Client with blood urea nitrogen 80 mg/dL (28.56 mmol/L). Correct. This client is unstable due to a markedly elevated BUN, which suggests either hypovolemia or kidney failure. Assigning this client to an LPN/LVN would be inappropriate and considered professionally negligent.
4. Client with prothrombin time 10 seconds. Incorrect. This stable client with a normal PT is an appropriate assignment for an LPN/LVN. Eliminate.
5. Client with a fasting glucose 130 mg/dL (7.21 mmol/L). Incorrect. This stable client has a mildly elevated glucose level and is an appropriate assignment for an LPN/LVN. Eliminate.
6. Client with platelet count 22,000/mm3 (22 x 109/L.) Correct. This client is unstable due to a markedly low platelet count, which suggests severe thrombocytopenia and a high risk for bleeding. Assigning this client to an LPN/LVN would be inappropriate and considered professionally negligent.
Select the best choice:
Are #2, 3, and 6 the correct answers? Yes. These clients are unstable with unexpected outcomes and require care by the nurse.
Do #2, 3, and 6 make sense? Yes. These unstable clients with unexpected outcomes must be cared for by the nurse. The LPN/LVN cares for stable clients with expected outcomes.
