CEA Nursing Practice Exam

In a patient with elevated WBC, fever, chills, and malaise, which of the following is not likely the cause of the elevated WBC?

1. Sepsis

2. Diabetes Mellitus Type 2

3. Leukemia

4. Recent oral corticosteroid therapy

The correct answer is: Diabetes Mellitus Type 2

In assessing a patient with elevated white blood cells (WBC), fever, chills, and malaise, it's important to recognize the potential causes behind these clinical signs. A significant elevation in WBC is often a response to infection or inflammation. Sepsis is a systemic infection that leads to a dramatic increase in WBC as the body attempts to combat the infection. In patients experiencing sepsis, the immune response is heightened, resulting in elevated WBC counts. Leukemia, a type of cancer affecting blood and bone marrow, is characterized by the uncontrolled production of abnormal white blood cells. This condition typically presents with significantly elevated WBC counts, so it's a clear cause for the elevated levels in this context. Recent oral corticosteroid therapy can also lead to increased WBC counts, particularly neutrophils, due to the demargination of white cells from blood vessel walls. Corticosteroids can induce stress leukogram, which may falsely elevate WBC counts despite the lack of infection. In contrast, while diabetes mellitus can influence the body’s response to infections, it is not a direct cause of elevated WBC counts. Patients with diabetes may have a more tempered immune response, making the elevation of WBC less likely in the absence of an active infection