A nurse is caring for four clients. After reviewing today's laboratory results, which client would the nurse assess first?

Correct Answer: C

Rationale: The correct answer is C because a prothrombin time (PT) of 28 seconds indicates potential issues with blood clotting and can be a sign of bleeding disorders or liver dysfunction, requiring immediate assessment and intervention to prevent complications. Choice A (INR of 2.8) is within the therapeutic range for clients on anticoagulant therapy, so it's not an immediate concern. Choice B (platelet count of 128,000/mm3) is low but not critically low, so it doesn't require immediate assessment. Choice D (red blood cell count of 5.1 million/mcl) is within the normal range and doesn't indicate urgent issues. In summary, the nurse should assess the client with a PT of 28 seconds first due to the potential risk of bleeding or clotting disorders, while the other choices are not as urgent.

Correct Answer: C

Rationale: The correct answer is C: Tapeworm infestation. The symptoms described suggest vitamin B12 deficiency, which can lead to macrocytic anemia. Chronic atrophic gastritis can cause decreased intrinsic factor production, leading to impaired B12 absorption. Ileal resection can also affect B12 absorption as it is the site where B12 is absorbed. Alcoholism can lead to poor dietary intake and impaired B12 absorption. However, tapeworm infestation does not directly affect B12 absorption and would not be a likely cause of the described symptoms.

Correct Answer: D

Rationale: The correct answer is D: Monocytosis. In chronic bacterial infections, there is a prolonged immune response leading to an increased production of monocytes to help combat the infection. Neutrophilia (choice A) is more characteristic of acute bacterial infections. Basophilia (choice B) is associated with allergic reactions or certain blood disorders, not typically seen in bacterial infections. Lymphocytosis (choice C) is more common in viral infections or certain immune responses, not specific to chronic bacterial infections.

Correct Answer: A

Rationale: The correct answer is A: Filovirus. Filoviruses, such as Ebola and Marburg viruses, are known to cause viral hemorrhagic fevers and are commonly found in Africa. The symptoms presented by the patient align with those of filovirus infections. Togavirus (choice B) and Bunyavirus (choice D) are not typically associated with viral hemorrhagic fevers. Adenovirus (choice C) can cause respiratory and gastrointestinal infections but is not known to cause viral hemorrhagic fevers.

Correct Answer: D

Rationale: The correct answer is D: Glucose 6-phosphate dehydrogenase deficiency (G6PD). G6PD deficiency can cause hemolysis in response to oxidative stress, such as medications like sulfonamides. The decrease in hemoglobin levels after sulfonamide treatment indicates hemolysis, which is a common manifestation of G6PD deficiency. Sickle cell disease (A), thalassemia minor (B), and hereditary spherocytosis (C) do not typically present with hemolysis triggered by sulfonamides. G6PD deficiency is the most likely cause in this scenario due to the timing of hemolysis after the drug exposure and the characteristic response of G6PD-deficient red blood cells to oxidative stress.