{"id":1694,"date":"2022-11-16T18:40:00","date_gmt":"2022-11-16T18:40:00","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=1694"},"modified":"2026-03-20T13:51:44","modified_gmt":"2026-03-20T21:51:44","slug":"nclex-question-of-the-day-altered-mental-state-with-high-white-blood-count","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/nclex-question-of-the-day-altered-mental-state-with-high-white-blood-count","title":{"rendered":"NCLEX-RN\u00ae Question of the Day: Altered mental state with high white blood count"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_80 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/nclex-question-of-the-day-altered-mental-state-with-high-white-blood-count\/#The_correct_answer_to_todays_NCLEX-RN%C2%AE_Question_is%E2%80%A6\" >The correct answer to today&#8217;s NCLEX-RN\u00ae Question is&#8230;<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/nclex-question-of-the-day-altered-mental-state-with-high-white-blood-count\/#A_Administer_the_prescribed_antibiotic\" >A. Administer the prescribed antibiotic<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/nclex-question-of-the-day-altered-mental-state-with-high-white-blood-count\/#Major_Takeaway\" >Major Takeaway<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/nclex-question-of-the-day-altered-mental-state-with-high-white-blood-count\/#Incorrect_answer_explanations\" >Incorrect answer explanations<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.osmosis.org\/blog\/nclex-question-of-the-day-altered-mental-state-with-high-white-blood-count\/#B_Prepare_the_client_for_the_operating_room\" >B. Prepare the client for the operating room<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.osmosis.org\/blog\/nclex-question-of-the-day-altered-mental-state-with-high-white-blood-count\/#C_Contact_the_on-call_urologist\" >C. Contact the on-call urologist<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/www.osmosis.org\/blog\/nclex-question-of-the-day-altered-mental-state-with-high-white-blood-count\/#D_Insert_an_indwelling_catheter\" >D. Insert an indwelling catheter<\/a><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><strong><em>Today&#8217;s NCLEX-RN\u00ae question of the day focuses on a nurse&#8217;s best response about a 91-year-old client who arrives at the emergency department for altered mental status. Can you figure it out?<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 91-year-old client arrives at the emergency department for altered mental status. The client\u2019s blood pressure is 82\/48 mmHg and heart rate is 118\/min. A urine sample is obtained and shows a white blood cell count of &gt;60 WBC\/hpf. Which intervention should the nurse perform first?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Administer the prescribed antibiotic<br><br>B. Prepare the client for the operating room<br><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Contact the on-call urologist<\/strong><strong>D. Insert an indwelling catheter<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Scroll down for the correct answer!<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_correct_answer_to_todays_NCLEX-RN%C2%AE_Question_is%E2%80%A6\"><\/span>The correct answer to today&#8217;s NCLEX-RN\u00ae Question is&#8230;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"A_Administer_the_prescribed_antibiotic\"><\/span><strong>A. Administer the prescribed antibiotic<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Rationale:&nbsp;<\/strong>The normal range of white blood cells in the urine is 2-5 WBCs\/hpf or less so this result indicates the client has a UTI. This client also has symptoms indicating sepsis, such as hypotension and tachycardia. Therefore, the nurse should administer the ordered antibiotic as soon as possible to treat the infection.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Major_Takeaway\"><\/span>Major Takeaway<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The normal range of white blood cells in the urine is 2-5 WBCs\/hpf or less. This lab result indicates the client has a urinary tract infection (UTI) and their vital signs indicate possible sepsis, or a systemic infection. Since the client displays hemodynamic instability, such as hypotension and tachycardia, the nurse should administer the prescribed antibiotic first to treat the infection. The additional interventions for clients with UTIs typically include intravenous hydration, client education, and possible surgical intervention or follow-up with a urologist if required.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Incorrect_answer_explanations\"><\/span>Incorrect answer explanations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"B_Prepare_the_client_for_the_operating_room\"><\/span>B. Prepare the client for the operating room<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Rationale:<\/strong>&nbsp;In certain cases, clients with recurrent UTIs require urological surgery. This is most frequently the case when there are calculi present along the urinary tract, an enlarged prostate, or anatomical abnormalities. However, there is nothing indicating this client requires surgical intervention at this time.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"C_Contact_the_on-call_urologist\"><\/span>C. Contact the on-call urologist<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Rationale:&nbsp;<\/strong>Urology clinicians may be involved in the care of clients with a UTI. Although the on-call urologist may be consulted, this is not the highest priority intervention for the nurse.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"D_Insert_an_indwelling_catheter\"><\/span>D. Insert an indwelling catheter<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Rationale:\u00a0<\/strong>This client may require urinary catheterization if they are retaining urine; however, in this client\u2019s case, another intervention should take priority. In addition, indwelling catheters can introduce additional bacteria to the urinary tract. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em><strong><em>Try Osmosis today! Access your\u00a0<a href=\"https:\/\/www.osmosis.org\/login?type=create\" target=\"_blank\" rel=\"noreferrer noopener\">free trial<\/a>\u00a0and find out why millions of current and future clinicians and caregivers love learning with us.<\/em><\/strong><\/em><\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><a href=\"https:\/\/www.osmosis.org\/plans\/rn?source_cta=navbar\"><img loading=\"lazy\" decoding=\"async\" width=\"994\" height=\"356\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_04dd2b.png\" alt=\"\" class=\"wp-image-1696\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_04dd2b.png 994w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_04dd2b.png?resize=300,107 300w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_04dd2b.png?resize=768,275 768w\" sizes=\"auto, (max-width: 994px) 100vw, 994px\" \/><\/a><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><em><strong><em><a href=\"https:\/\/www.osmosis.org\/plans\/rn?source_cta=navbar\" target=\"_blank\" rel=\"noreferrer noopener\"><\/a><a href=\"https:\/\/www.osmosis.org\/plans\/rn?source_cta=navbar\" target=\"_blank\" rel=\"noreferrer noopener\"><\/a><\/em><\/strong><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Today&#8217;s NCLEX-RN\u00ae question of the day focuses on a nurse&#8217;s best response about a 91-year-old client who arrives at the emergency department for altered mental status. Can you figure it out? A 91-year-old client arrives at the emergency department for altered mental status. The client\u2019s blood pressure is 82\/48 mmHg and heart rate is 118\/min. [&hellip;]<\/p>\n","protected":false},"author":279,"featured_media":1695,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[20,29,1367,32],"tags":[],"class_list":["post-1694","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-exam-prep","category-nclex","category-nclex-rn","category-nursing"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>NCLEX-RN\u00ae Question of the Day: Altered mental state with high white blood count - Osmosis Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.osmosis.org\/blog\/nclex-question-of-the-day-altered-mental-state-with-high-white-blood-count\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"NCLEX-RN\u00ae Question of the Day: Altered mental state with high white blood count - Osmosis Blog\" \/>\n<meta property=\"og:description\" content=\"Today&#8217;s NCLEX-RN\u00ae question of the day focuses on a nurse&#8217;s best response about a 91-year-old client who arrives at the emergency department for altered mental status. Can you figure it out? A 91-year-old client arrives at the emergency department for altered mental status. The client\u2019s blood pressure is 82\/48 mmHg and heart rate is 118\/min. 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