NUR 452 EAQ 1 Cardiovascular, Hematologic, and
Lymphatic Systems Questions With Complete Solutions
A client just had a total hip replacement and is experiencing
restlessness and changes in mentation. Which complication
would the nurse consider the client may be experiencing based
on these responses?
1
Bladder spasms
2
Polycythemia vera
3
Hypovolemic shock
4
Pulmonary hypertension Correct Answers These signs occur
with hypovolemic shock because less blood is being circulated
to vital centers in the brain. A large loss of blood may occur
during and after orthopedic surgery. Urinary retention, not
bladder spasms, may occur after general anesthesia. Anemia and
deep vein thrombosis, not an increase in the total red blood cells
(polycythemia vera), tend to occur after a total hip replacement.
Atelectasis and pneumonia are possible complications of general
anesthesia, but pulmonary hypertension is a not a postoperative
complication.
A client who has multiple myeloma tells the nurse about plans
for airline travel to visit family members. Which topic will the
nurse include in discharge planning?
1
Avoidance of travel to prevent fatigue
2
,Need to restrict fluid intake when flying
3
Ways to prevent infection during travel
4
How to fill prescriptions away from home Correct Answers
Ways to prevent infection during travel
Prevention of infection is important in this client with impaired
bone marrow production of leukocytes and immunoglobulins.
Fatigue is a concern with multiple myeloma, but travel can be
managed with careful planning and use of rest periods. Increased
fluid intake is needed with airline travel, because dehydration
should be avoided due to the risk for kidney stones and renal
failure with multiple myeloma. The nurse would assist the client
to be sure all prescriptions were filled before leaving home,
because it can be difficult to fill prescriptions when traveling to
different states or countries.
A client with a diagnosis of myocardial infarction asks the
nurse, "What is causing the pain I am having?" Which
explanation would the nurse give?
1
Compression of the heart muscle
2
Release of myocardial isoenzymes
3
Rapid vasodilation of the coronary arteries
4
Inadequate oxygenation of the myocardium Correct Answers
Cessation of the blood flow that normally carries oxygen to the
myocardium results in pain because of ischemia of myocardial
, tissue. Myocardial infarction does not involve compression of
the heart. The release of myocardial isoenzymes is an indication
of myocardial damage; this does not cause myocardial pain.
Vasodilation will increase perfusion and contribute to pain
relief, not cause myocardial pain.
A client with type 1 diabetes asks what causes several brown
spots on the skin. What would be the best response by the nurse?
1
"The brown spots reflect the accumulation of blood fats in the
skin; they should disappear."
2
"Those spots indicate a high glucose content in the skin that may
get infected if left untreated."
3
"They are the result of diseased small vessels in the shins and
may spread if not treated soon."
4
"Those brown spots result from small blood vessel damage; the
blood contains iron, which leaves a brown spot." Correct
Answers "Those brown spots result from small blood vessel
damage; the blood contains iron, which leaves a brown spot" is
an accurate explanation for the client's concern; brown spots are
caused by the deposit of hemosiderin in the tissue. Brown spots
reflecting the accumulation of blood fats in the skin and
disappearing is the definition of a xanthoma. A high glucose
content in the skin that has become infected is not the cause of
brown spots on the skin; increased glucose in the skin is not
observable by inspection. Brown spots result from the
deposition of hemosiderin. Blood vessels may become diseased
with diabetes, but this does not cause brown spots.Test-Taking
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