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Med-Surg_ Cardiovascular and Hematology - 2024 with complete solutions/ latest update (stuvia 5 stars rating) $7.50   Add to cart

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Med-Surg_ Cardiovascular and Hematology - 2024 with complete solutions/ latest update (stuvia 5 stars rating)

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Med-Surg_ Cardiovascular and Hematology - 2024 with complete solutions/ latest update (stuvia 5 stars rating)

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  • July 20, 2024
  • 38
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers
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‭ TI Med-Surg: Cardiovascular and Hematology‬
A
‭Questions‬
‭A nurse is admitting a client who is in sickle cell crisis. Besides pain management, which of the following‬

‭interventions should the nurse include in the client's plan of care?‬



‭A. Flexion of the extremities‬

‭B. Therapeutic hypothermia‬

‭C. Upright positioning‬

‭D. Ample hydration - CORRECT ANSWER-D. Ample hydration‬



‭A client who is in sickle cell crisis needs ample hydration (either IV, oral, or both) to shorten the duration‬

‭of painful episodes. The nurse should plan to offer the client water, juice, or a favorite beverage that does‬

‭not contain caffeine.‬



‭A nurse is teaching a 70-year-old client about risk factors for heart failure. The client has mild asthma,‬

‭diabetes mellitus, and coronary artery disease. Which of the following statements by the client indicates‬

‭an understanding of the teaching?‬



‭A. My diabetes will not increase my risk of heart failure‬

‭B. My asthma makes it more likely for me to have heart failure‬

‭C. My age does not increase my risk of heart failure‬

‭D. My coronary artery disease is a risk factor for heart failure - CORRECT ANSWER-D. My coronary‬

‭artery disease is a risk factor for heart failure‬



‭Coronary artery disease is a primary risk factor for the development of heart failure. Other risk factors‬

‭include hypertension, cardiomyopathy, tobacco use, family history, and hyperthyroidism. Diabetes‬

‭mellitus and an increased age also can increase the risk of heart failure.‬

,‭A nurse is planning care for a client who is having a percutaneous transluminal coronary angioplasty‬

‭(PTCA) with stent placement. Which of the following actions should the nurse anticipate in the‬

‭post-procedure plan of care?‬



‭A. Instruct the client about a long-term cardiac conditioning program‬

‭B. Administer scheduled doses of acetaminophen‬

‭C. Check for peak laboratory markers of myocardial damage‬

‭D. Monitor for bleeding - CORRECT ANSWER-D. Monitor for bleeding‬



‭Bleeding is a post-procedure complication of PTCA because the administration of heparin during the‬

‭procedure and the removal of the femoral (or brachial) sheath. Manual pressure or a closure device is‬

‭used to obtain hemostasis to the site. The client should remain on bed rest until hemostasis is assured.‬



‭A nurse is assessing a client who has heart failure and is taking daily furosemide. The client's apical‬

‭pulse is weak and irregular. The nurse should identify these findings as manifestations of which of the‬

‭following electrolyte imbalances?‬



‭A. Hypokalemia‬

‭B. Hypophosphatemia‬

‭C. Hypercalcemia‬

‭D. Hypermagnesemia - CORRECT ANSWER-A. Hypokalemia‬



‭Furosemide can cause the loss of potassium, sodium, calcium, and magnesium. Manifestations of‬

‭hypokalemia can include shallow respirations, muscle weakness, leathery, and ectopic heartbeats.‬



‭A nurse is caring for a client who has thrombocytopenia and develops epistaxis. Which of the following‬

‭actions should the nurse take?‬



‭A. Have the client gently blow clots from the nose every 5 min‬

‭B. Instruct the client to sit with his head hyperextended‬

,‭C. Apply ice compresses to the back of the client's neck‬

‭D. Apply lateral pressure to the client's nose for 10 min - CORRECT ANSWER-D. Apply lateral pressure‬

‭to the client's nose for 10 min‬



‭The nurse should apply direct, lateral pressure to the nose for 10 minutes to control epistaxis. If after 10‬

‭minutes the epistaxis continues, the client might require nasal packing or other interventions.‬



‭A nurse is caring for a client who has acute lymphocytic leukemia and reports a fever, chills, fatigue, and‬

‭pallor over the past week. When checking the client's laboratory results, which of the following values‬

‭should the nurse identify as contributing to the client's fatigue and pallor?‬



‭A. Magnesium 2.0 mEq/L‬

‭B. Hgb 6.5 g/dL‬

‭C. WBC count 9.6/mm3‬

‭D. Creatinine 0.8 mg/dL - CORRECT ANSWER-B. Hgb 6.5 g/dL‬



‭The expected reference range of Hgb is 14-18 for men and 12-16 for women. Therefore, a client who has‬

‭an Hgb level of 6.5 has anemia. Typical manifestations of a low Hgb level include fatigue, headaches,‬

‭pallor, dizziness, and tachycardia.‬



‭A nurse is caring for a client who has pernicious anemia. Which of the following factors should the nurse‬

‭identify with this condition?‬



‭A. Iron deficiency‬

‭B. Hemolytic blood loss‬

‭C. Folic acid deficiency‬

‭D. Vitamin B12 deficiency - CORRECT ANSWER-D. Vitamin B12 deficiency‬



‭A client who has pernicious anemia is deficient in vitamin B12 due to a deficiency in an intrinsic factor‬

‭normally supplied by the gastric mucosa that is essential for the absorption of vitamin B12.‬

, ‭- A: Iron deficiency can be a result of blood loss, poor absorption or iron, or poor nutrition in the diet. This‬

‭condition is called iron-deficiency anemia.‬

‭- B: Hemolytic blood loss is a result of hemorrhage, not pernicious anemia‬

‭- C: Folic acid deficiency is caused by poor nutrition related to a lack of green leafy vegetables, citrus‬

‭fruits, and nuts in the diet. Folic acid is essential for the absorption of vitamin B12.‬



‭A nurse is providing discharge teaching to an adult female client who has infective endocarditis about‬

‭how to prevent recurrence. Which of the following statements by the client indicates an understanding of‬

‭the teaching?‬



‭A. I will ask my provider to change my contraception to an intrauterine device‬

‭B. I will notify my doctor before I have dental procedures‬

‭C. I will avoid using antiseptic mouthwash for oral care‬

‭D. I will wear a mask when I go out in public - CORRECT ANSWER-B. I will notify my doctor before I‬

‭have dental procedures‬



‭The client should notify the provider prior to invasive or dental procedures due to the need for‬

‭prophylactic antibiotic therapy to reduce the risk of a streptococcal infection.‬



‭A nurse is planning care for a client who has acute myelogenous leukemia and a platelet count of‬

‭48,000/mm^3. Which of the following interventions should the nurse take?‬



‭A. Avoid IM injections‬

‭B. Assess the client for ecchymosis once per shift‬

‭C. Do not allow the client to have visitors‬

‭D. Encourage daily flossing between teeth - CORRECT ANSWER-A. Avoid IM injections‬



‭The client's platelet count of 48,000/mm^3 indicates thrombocytopenia; therefore, the nurse should avoid‬

‭invasive procedures such as an IM injection which can increase the client's risk of bleeding.‬

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