NCLEX-PN® ExaminationReduction of Risk PotentialMedium
A client is admitted to the emergency department with severe abdominal pain, nausea, and vomiting. Initial lab results show a white blood cell (WBC) count of 18,000/µL. Which action should the LPN anticipate next?
- AAdministering oral antiemetics to relieve nausea.
- BPreparing the client for an abdominal ultrasound or CT scan.
- CDischarging the client with instructions for rest and fluids.
- DProviding a high-fiber diet to promote bowel regularity.
Show answer & explanationAnswer & explanation
Correct answer: B. Preparing the client for an abdominal ultrasound or CT scan.
A WBC count of 18,000/µL is significantly elevated, indicating an active inflammatory or infectious process. Coupled with severe abdominal pain, nausea, and vomiting, this strongly suggests an acute abdominal condition like appendicitis or pancreatitis, requiring further diagnostic imaging to identify the cause.
Why the other options are wrong
- A. Antiemetics may be given, but they address symptoms, not the underlying severe cause indicated by the high WBC count and pain.
- C. Discharging a client with severe abdominal pain, vomiting, and a significantly elevated WBC count would be unsafe and negligent.
- D. A high-fiber diet is inappropriate for acute abdominal pain and nausea/vomiting, especially with an elevated WBC count.
Elevated WBC Count
A white blood cell (WBC) count above the normal range (typically >10,000/µL), indicating an inflammatory or infectious process in the body.
- Normal range: 4,500-10,000/µL
- Can be caused by infection, inflammation, stress, trauma, or certain medications
- Requires further assessment to determine the underlying cause
Memory trick: WBC High? Worry, But Check Context!