TEST 1 PATHO (MODULES 1&2)

A nurse working in an emergency department is assigned to triage the following patients. Which of the following patients should the nurse evaluate first?

Patient who has chemotherapy-induced neutropenia and a temperature of 101.2.

Exudate in the pericardial cavity is a characteristic of which cardiac condition?

Pericardial effusion

How does low-dose aspirin therapy impact clot formation?

Aspirin is a platelet aggregation inhibitor

Low output failure

(impair pumping of heart), ischemic heart disease, cardiomyopathy, marked reductions in SV, narrowed pulse pressure, cold pale and cyanotic extremities

A client with a history of acute coronary syndrome asks why she needs to take aspirin 81mg every day. The most appropriate response by the nurse would be...

Aspirin will help prevent blood clotting

A client presents with sinus bradycardia. What is the nurse's best action?

Assess the client's history (Can be normal depending on the patient)

The nurse knows that the main objective of the management of hypertension is to achieve a sustainable level of blood pressure below which of the following?

140/90 (120/80-140/90 = prehypertension)

The nurse is monitoring hourly urine output of a client diagnosed with hypovolemic shock. The nurse is most concerned if the client's output is...

20ml/hr (indicates inadequate renal perfusion)

Normal EF

55-70%

The physician's order states, "calculate the pulse pressure of the client's B/P." The blood pressure reading is as follows: systolic pressure of 146 mm Hg and a diastolic pressure of 82 mm Hg. The pulse pressure would be...

64 mm Hg (The difference between the systolic and diastolic pressures is the pulse pressure: systolic - diastolic = pulse pressure)

Which client is most likely to be experiencing vasodilation?

A 51-year-old man with a history of hypertension who is taking a medication that blocks the effect of the renin-angiotensin-aldosterone system. (Angiotensin is a vasoconstrictor)

Which of the following patients is at greatest risk for orthostatic hypotension?

A 66-year-old post surgery patient on bedrest (immobility)

Stages of heart failure

A = high risk for development B = presence of structural disease but no signs or symptoms C = Current or prior symptoms with structural heart disease D = Advanced structural heart disease and symptoms of HF at rest on max therapy

The nurse is assessing a client said to be in sinus rhythm. What does the nurse expect to find when evaluating the electrocardiogram?

A P wave before every QRS wave, a rate between 60 and 100 beats per minute, and constant R to R intervals.

Natriuretic peptides

ANP (atrial cells) BNP (ventricules) heart muscle produces and secretes. Promote diuresis

The nurse is preparing to auscultate for a mitral valve stenosis murmur. Where is the best location to place the stethoscope?

At the apex of the heart

The purpose of a cardioversion device is the treatment of which of the following cardiac disorders?

Atrial fibrillation

Diastolic Dysfunction

Abnormal relaxation, decreases CO due to abnormal filling, ventricular pressures elevated, pulmonary and systemic congestion. Influenced by heart rate

The nurse is caring for a client with chronic myelogenous leukemia and notes that the client has splenomegaly, and an increased basophil count as well as night sweats, bone pain, and a low grade fever. The nurse interprets the symptoms as indicating that the client is in which phase of the clinical course of CML?

Accelerated

During administration of a blood transfusion, a child complains of chills, headache, and nausea. Which action should the nurse implement?

Acetaminophen

Which of the following neurotransmitters is associated with the parasympathetic nervous system?

Acetylcholine

A patient diagnosed with systemic lupus erythematosus (SLE) has been experiencing a low neutrophil count. How would this type of neutropenia be classified?

Acquired, autoimmune secondary neutropenia

A student makes the statement to a colleague, "Blood plasma is essentially just a carrier for the formed cells like red blood cells and white blood cells." What would be the most accurate response to this statement?

Actually, plasma plays a significant role in nutrient and waste transport

Hypovolemic shock occurs as a result of..

Acute intravascular volume loss (can also result from internal hemorrhage or third spacing, manifestations of tachycardia and vasoconstriction are possible)

Which types of leukemias originate from the B cells?

Acute lymphocytic leukemia, chronic lymphocytic leukemia (Chronic myelogenous leukemia = myeloid cells, Acute myelogenous leukemia = myeloid precursor cells in bone marrow)

The pathophysiology of heart failure involves an interaction between decreased pumping ability and the ________ to maintain cardiac output.

Adaptive mechanisms

The nurse is caring for a client with sickle cell disease. The most important treatment for the nurse to provide would be

Aggressive intravenous hydration and morphine (goal is to manage symptoms through pain control, hydration, and prevention of complications)

What is the most common identifiable cause of secondary cardiomyopathy?

Alcohol abuse

Anticoagulant drugs prevent thromboembolitic disorders. How does Warfarin, one of the anticoagulant drugs, act on the body?

Alters vitamin K, reducing its ability to participate in the coagulation of the blood

When a patient experiences the Cushing reflex, what occurs with the body?

An increase in arterial pressure above the intracranial pressure. (re-establishes blood flow)

High output failure

Anemia, thyrotoxicosis, arteriovenous shunting, paget disease (excessive need for CO)

Two months following a myocardial infarction (MI), a client visits their healthcare provider with complaints of severe fatigue, shortness of breath, and frequent episodes of palpitations. A 12-lead ECG reveals the client has atrial fibrillation with a heart rate of 120. Which medications should the healthcare provider consider prescribing for this client?

Antiarrhythmics, Anticoagulants

The nurse is reviewing the laboratory results of a newborn. The infant has anemia, thrombocytopenia, and granulocytopenia (pancytopenia). Based on these results, the nurse anticipates the diagnosis of which type of anemia?

Aplastic anemia

Which are primary treatment options for a client with acute venous thrombosis?

Application of heat, bed rest, elastic support

The nurse is developing a plan of care for a postsurgical client. A major goal is to prevent the formation of deep vein thrombosis (DVT). The most important intervention for the nurse to implement would be...

Apply SCD's (sequential pneumatic compression devices) to lower extremities

Paroxysmal supraventricular tachycardia arises from which form of reentry?

Arterioventricular (AV) node

A nurse is reviewing an echocardiogram for a client with a congenital defect in the papillary muscles of the heart. Based on this result, which of the following assessments should the nurse complete?

Auscultate for a murmur caused by the backward expulsion of blood through the atrioventricular valves.

The father of a 2-year-old boy recently diagnosed with hemophilia A asks the nurse how to prevent complications for his son. The best response would be...

Avoid administering aspirin and nonsteroidal anti-inflammatory drugs (also prevent trauma)

Which of the following types of lymphocyte is involved with humoral-mediated immunity?

B Lymphocytes (T lymphocytes, or helper T cells, are cell-mediated immunity, natural killer cells are innate/natural immunity)

Which of the following types of white blood cells are related to the connective tissue mast cells and respond in allergic and hypersensitivity reactions?

Basophils

The health care provider is reviewing the results of a client's magnetic resonance imaging (MRI). The results indicate a small spherical dilation at the circle of Willis. The provider would interpret this as...

Berry Aneurysm

Which of the following cardiac drug classifications decreases sympathetic outflow to the heart and is the cornerstone of therapy for catecholaminergic polymorphic ventricular tachycardia (CPVT)?

Beta-Adrenergic Blockers (Beta Blockers) (olol's - metoprolol, carvedilol, etc.)

A client's echocardiogram identified a narrowed valve that has resulted in a decreased blood flow between the left atria and left ventricle. The nurse would interpret this as the:

Bicuspid (mitral) valve

A pregnant female client is at risk for the development of preeclampsia-eclampsia. Select the most important data to assess.

Blood pressure 160/100 mm Hg and proteinuria during the 30th week of pregnancy (developing after 20 weeks gestation)

Cardiac output is the ______ each minute.

Blood pumped

Which of the following is the first symptom of multiple myeloma that a patient typically presents with on a visit to the primary care provider?

Bone pain (also easy bruising and fatigue)

Causes of heart failure

CAD, DCM, Hypertension, Valvular heart disease

Inflammatory mediators

CRP can equal heart failure

Which of the following blood vessels function without the benefit of having walls comprised of three muscular layers?

Capillaries (Arteries, veins, and arterioles have the tunica externa, tunica media, and tunica intima)

Select the correct sequence of blood return to the heart.

Capillaries, venules, veins, right atrium

Megaloblastic anemia

Caused by impaired DNA synthesis that results in enlarged red cells (increased MCV, normal MCHC)

Which statements regarding heart failure in older adults are true?

Causes of heart failure in older adults include coronary heart disease and mitral valve dysfunction, sensitivity of beta adrenergic receptors decreases resulting in decreased ventricular contractility

The practitioner knows the client has sickle cell disease associated with hemoglobin S. The practitioner explains to the client that which major consequences can occur with this disorder?

Chronic hemolytic anemia and blood vessel occlusion

Leukocytes consist of three categories of cells that have different roles in the inflammatory and immune responses. Which of the following leukocytes is correctly matched with its function?

Eosinophils; allergic reactions

Heart failure classifications

Class I = Known heart disease without symptoms during ordinary activity Class II = heart disease with slight limitations but not extreme fatigue, palpitations, dyspnea, or angina during regular activity Class III = heart disease who are comfortable at rest, but ordinary activity does result in fatigue and other symptoms Class IV = marked progressive cardiac disease and are not comfortable at rest or minimal activity

A patient with a history of heart failure has no symptoms while at rest but has developed dyspnea when active. According to The New York Heart Association guidelines, this patient would be designated...

Class II

Which of the following classes of cardiac antiarrhythmic drugs extends the action potential and refractoriness of the heart's contraction?

Class III (amiodarone, bretylium, sotalol) (Classes 1-4)

Which is needed for erythropoiesis?

Cobalamin

Regulation of blood cells is thought to be controlled in part by which of the following hormonelike growth factors?

Cytokines

Systolic dysfunction

Decrease in contractility, EF less than 40, EF declines which leads to increase in end-diastolic volume, ventricular dilation, increase in wall tension, rise in end pressure. Causes increased preload - accumulation of blood in the atria and venous system causing pulmonary or peripheral edema

While intubated for surgery, a patient has inadvertently had his vagus nerve stimulated. What effect would the surgical team expect to observe?

Decreased heart rate as a result of parasympathetic innervation of the heart.

Which condition decreases preload?

Dehydration

A client has developed constrictive pericarditis and myocardial hypertrophy. Select the most likely cause.

Diastolic dysfunction (causes of diastolic dysfunction are those that impede expansion of the ventricles (pericarditis), those that increase ventricular wall thickness and reduce chamber size (myocardial hypertrophy), and those that delay diastolic relaxation (aging).

Pharmacological treatment of heart failure

Diuretics, ACE inhibitors, Beta Blockers, Digitalis, Vasodilators

A client is diagnosed with orthostatic hypotension. The nurse knows that which drugs can predispose the client to orthostasis?

Diuretics, Antihypertensives, Psychotropics

A 75-year-old client is being evaluated for heart failure. Which questions will the nurse ask to confirm common signs and symptoms observed in older adults experiencing heart failure?

Do you easily get tired? Do you have swelling in your ankles? Are you feeling depressed? Do you get up often during the night to urinate? (anorexia and decreased appetite are also symptoms)

Which diagnostic lab test is used to diagnose the presence of inflammation?

ESR = Erythrocyte sedimentation rate.

The inner most layer of the heart is the..

Endocardium

A nurse is evaluating laboratory results of a patient diagnosed with a parasitic infection. The tests reveal a large group of cells that are membrane bound with granules in their cytoplasm that are aiding in the destruction of the parasite. Which of the following cells is the nurse evaluating?

Eosinophil

A 16-year-old boy has enlarged lymph nodes and a sore throat. His girlfriend was recently diagnosed with infectious mononucleosis. While educating this teenager, the nurse emphasizes that infectious mononucleosis is caused by which pathogen and usually transmitted via...

Epstein-Barr virus; saliva

A child diagnosed with acute lymphocytic leukemia undergoes aggressive high-dose chemotherapy and is scheduled for an autologous stem cell transplant. Which treatments would the nurse anticipate administering?

Erythropoietin to stimulate red blood cell production, granulocyte colony stimulating factor to promote the proliferation of all neutrophils, thrombopoietin to stimulate platelet development, and macrophage colony stimulating factor to increase macrophage colonies

The nurse is discussing risk factors for hypertension with a client. Which factors are nonmodifiable risk factors for development of hypertension?

Ethnicity, advanced age

A client has been diagnosed with inherited hypercoagulability. Select the most likely cause

Factor V gene mutation

Aplastic anemia is the result of which of the following conditions?

Failure of multipotent stem cells to grow

Which clinical manifestations are associated with acute leukemia?

Fever, epistaxis, bleeding gums, bone pain

A client admitted to the emergency department is experiencing sinus tachycardia. What can cause this dysrhythmia that the nurse should monitor for?

Fever, pain, blood loss, hyperthyroid (also anxiety, exercise, and sympathetic stimulation)

Diagnosis of heart failure

H&P, Labs, ECG, CXR, ECHO, hemodynamic monitoring

What is the most important factor in myocardial oxygen demand?

Heart rate (as heart rate increases, oxygen demand increases)

The nurse is providing education to a client diagnosed with varicose veins. The nurse determines that teaching has been effective when the client states that which activity is most likely the cause of the varicosities?

Heavy lifting (prolonged standing and increased abdominal pressure)

The nurse is studying hemostasis. She knows that which of the following are true?

Hemostasis refers to the body's ability to control bleeding. Vessel constriction or spasm is a factor in effective hemostasis. Hemostasis results in the formation of a platelet plug. Hemostasis occurs in established stages.

Which of the following medications are known to interfere with the body's ability to control bleeding?

Heparin, Warfarin, NSAIDS

The health care provider is teaching a client about modifiable risk factors for atherosclerosis. The most appropriate information to provide would be...

Hypertension (other modifiable factors include smoking, obesity, HLD, elevated LDL, and diabetes)

Causes of L. Ventricular dysfunction

Hypertension, MI, Aortic stenosis/regurg, mitral stenosis/regurg, DCM

A child has down syndrome and has recently experienced unexplained nose bleeds. His blood tests identify blast cells in the peripheral smear. In addition to nose bleeds, his acute leukemia will typically manifest all of the following except....

Hypogammaglobulinemia (This is common with chronic lymphocytic leukemia. Infections, fatigue, and bleeding are seen in all patients with acute leukemias and chronic leukemias).

An elderly patient is prescribed a vasodilator for hypertension. Which adverse effect is of greatest concern for an older adult taking this class of drug?

Hypotension

The nurse is assisting a patient who had a myocardial infarction 2 days ago during a bath. The patient suddenly lost consciousness and the nurse was unable to feel a pulse. Cardiopulmonary resuscitation was begun and the patient was connected to the monitor with a gross disorganization without identifiable waveforms or intervals observed. Which of the following is a priority intervention at this time?

Immediate defibrillation (patient is in V-fib)

Causes of systolic dysfunction

Impaired contractile heart (ischemic heart disease and cardiomyopathy), produce volume overload (valve insufficient and anemia), and pressure overload (hypertension and valvular stenosis)

Left Ventricular dysfunction

Impairs movement from low pressure pulm system to high pressure arterial side of sytemic circulation, increase in pulm venous pressure due to blood in left atrium/pulm circulation, shift of intravascular fluid into interstitial lungs = pulm edema

Causes of R ventricular dysfunction

Impede blood flow to lungs, compromise pumping of right ventricle (L. V failure, pulm HTN, pulm disease, tricuspid stenosis or regurg, right ventricular infarct, congenital heart defects

Causes of diastolic dysfunction

Impede ventricle expansion (pericardial effusion, pericarditis), increase wall thickness/reduce chamber size (HCM, Hypertrophy), Delay diastolic relaxation (aging, ischemic heart disease)

The health care team is developing a plan of care for a client diagnosed with congestive heart failure (CHF). The primary treatment goal would be...

Improving quality of life by relieving symptoms

When will the nurse plan to assess a patient's blood pressure to confirm the possible diagnosis of orthostatic hypotension?.

In the morning before arising from bed

Frank Starling Mechanism

Increase in preload, increase in CO, increased ventricular wall tension, leads to ischemia and impairs contractility, no longer compensatory and causes heart failure to worsen

Considering how hydrostatic forces affect capillaries, which of the following would increase capillary hydrostatic pressure most?

Increase in venous pressure

A 65-year-old male client is diagnosed with systolic hypertension. The nurse educates the client about how the aging process and development of stiff, large arteries can result in which physiologic occurrence?

Increased systolic pressure, decreased diastolic pressure, widened pulse pressure

Which therapies are part of the treatment for acute lymphocytic leukemia? (And acute myelogenous leukemia)

Induction, Intensification, and Maintenance

The mother of a newborn infant questions why her baby needs a vitamin K injection immediately after birth. The best response by the nurse would be...

Infants are not born with the normal intestinal bacteria that synthesize vitamin K for clotting

Kernicterus

Infants muscle tone is rigid and she has lost interest in breast feeding (worsening of jaundice/increased bilirubin levels) Accumulation of unconjugated bilirubin in brain cells - lethargy, poor feeding, short term behavioral changes. Severe manifestations include rigidity, tremors, ataxia, and hearing loss

Which situations would the nurse associate with an increase a client's risk for developing secondary thrombocytosis?

Inflammatory bowel disease, cardiopulmonary bypass surgery, lung cancer, rheumatoid arthritis

Sympathetic nervous system compensatory

Initially helps to maintain perfusion by direct stimulation of HR and contractility, regulation of vascular tone, and enhancement of renal sodium and water retention - can however lead to tachycardia, vasoconstriction, and cardiac arrhythmias - increased myocardial oxygen consumption

A child is suspected to have heart failure. The nurse knows that which statements regarding heart failure in children are most accurate?

Inotropic agents such as digoxin may be used in children, congenital defects are a risk factor, symptoms include tachypnea and tachycardia (Causes in children include congenital abnormalities and genetic cardiomyopathy. Signs and symptoms include fatigue, effort intolerance, cough, anorexia, abdominal pain, and impaired growth, as well as tachypnea and tachycardia. Surgery can correct some effects, digoxin and diuretics are good for medical management, active lifestyle is supported.

The nurse is assessing a client diagnosed with anemia and notes that the client's skin and mucous membranes are pale. The nurse interprets this as...

Insufficient hemoglobin (pallor of skin, mucous membranes, conjunctiva, and nail beds)

Leukemias are classified according to the predominant cell type. The myelogenous cell type of leukemia can...

Interfere with thrombocyte cell maturation (Interferes with all blood cells).

Which cytokines support the proliferation of stem cells in the human body?

Interleukins, interferons, and tumor necrosis factor

A patient who has had a RTK has experienced a moderate, non-life threatening loss of blood during the procedure. Which of the following types of blood replacement would be beneficial?

Intraoperative blood salvage (autologous transfusion)

The rate at which hemoglobin is synthesized depends on availability of which of the following?

Iron

A 72-year-old woman with complaints of increasing fatigue has completed a series of fecal occult blood tests that indicate the presence of blood in her stool. Which of the following health problems is likely to accompany this patient's gastrointestinal bleed?

Iron-deficiency anemia (resulting from the chronic blood loss of the GI bleed)

Which of the following is the greatest diagnostic limitation of an electrocardiogram?

It documents only current cardiac function

Which of the following is true regarding pulmonary circulation?

It is a low-pressure system that allows for improved gas exchange. (Right side of heart, pulmonary artery, capillaries, veins. Smaller of systems, lower pressure to assist with gas exchange)

Secondary hepatitis from mono...

It resolves without causing permanent liver damage

A patient who will be undergoing a holter monitor examination would be given which of the following instructions?

Keep a diary of your activities and symptoms throughout the examination (48 hour exam)

The parents are ready to take their child with newly diagnosed hemophilia A home. Which teaching aspects should the nurse discuss with them prior to discharge?

Keep the child away from contact sports like football and wrestling. Administration of factor VIII at home when bleeding occurs

What type of macrophages are found in the liver?

Kupffer Cells

Which of the following blood flow patterns reduces friction, allowing the blood layers to slide smoothly over one another?

Laminar (turbulent disrupts this flow)

Atherosclerotic plaque is most likely to be unstable and vulnerable to rupture when the plaque has a thin fibrous cap over a..

Large lipid core

The nurse has just completed teaching a client about acyanotic congenital heart disease. The nurse determines that teaching was effective when the client states the blood is shunted where to which part of the body

Left side of the heart to the right side of the heart (acyanotic disorders do not compromise oxygenation of blood in the pulmonary circulation)

What level should a blood transfusion be considered with hemoglobin?

Less than 7

Which organs has larger capillary pores to allow the exchange of gases, nutrients, and/or waste products?

Liver (kidney does filtration, not large capillaries)

renin-angiotensin-aldosterone system

Low CO - reduction in renal blood flow - sodium and water retention - increased renin/angiotension II - vasoconstriction - aldosterone - increases reabsorption of sodium and water - increased fluids = ventricular dilation and increased wall tension

A patient has been diagnosed with non-Hodgkin lymphoma (NHL), a form of malignancy that most likely originated in which of the following sites?

Lymph nodes

Which of the following related circulatory complications can result from surgical treatment for metastatic breast cancer?

Lymphedema in the affected arm.

Which of the following statements accurately describes a component of the hematopoietic system?

Lymphocytes lack cytoplasmic granules

When an acute event occurs and the circulatory system can no longer provide the body with adequate perfusion of its tissues and organs, cellular hypoxia occurs and the body goes into shock. What are the causes of shock in the human body?

Maldistribution of blood flow, hypovolemia, and obstruction of blood flow

Which valvular heart diseases are most common in adults?

Mitral valve regurgitation and aortic stenosis.

Which of the following individuals is at greatest risk for developing a venous thrombosis resulting from venous stasis?

Patient on bed rest

The nurse is developing a plan of care for a client diagnosed with stable angina . Select the most important goal for this client.

Myocardial infarction prevention

In distributive shock, there are abnormalities in vascular resistance. Which types of shock display the same distributive pattern?

Neurogenic, Septic, Anaphylactic (extreme vasodilation occurs in these shocks)

A patient is admitted to the hospital with an elevated temperature and flank pain. When reviewing the complete blood count, which of the following levels is the most important for the nurse to communicate to the health care provider?

Neutrophils 85% (first cells to go to an area of tissue damage - elevation indicates an acute infection such as pyelonephritis)

Manifestations of Hodgkin's lymphoma

Night sweats, Pruritus, chills, weight loss, cough, dyspnea

A teenager is diagnosed with hypertension. The nurse knows that risk factors for hypertension in children and adolescents include which of these? Select all that apply.

Obesity, High salt consumption, Inactive lifestyle

The nurse is reviewing hospital discharge instructions with a patient who has been diagnosed with secondary thrombocytosis and who also suffers from chronic ulcerative colitis, making anticoagulation inadvisable. The nurse stresses to the patient that the patient should avoid which of the following?

Oral contraceptives, smoking, immobilization

Considering the PQRST complex of an electrocardiogram (ECG), which of the following letter designations represents atrial depolarization?

P wave

Which of the following are characteristic signs of acute arterial embolism?

Pallor, Pulselessness, and Pain. (Seven P's: pistol shot, pallor, polar, pulselessness, pain, paresthesia, and paralysis)

A client tells the nurse that the doctor told her she has too many red blood cells accompanied by elevated white cells and platelet counts. The nurse recognizes this as...

Polycythemia vera

Which of the following occurs during repolarization?

Positively charged potassium (K+) moves outward across the cell membrane

Which of the following factors represents the amount of blood that the heart must pump with each beat and is determined by the stretch of the cardiac muscle fibers and the actions of the heart prior to cardiac contraction?

Preload

A nurse is teaching the client the correct technique for taking an arterial pulse. The nurse explains that the pulsations are:

Pressure pulses

A 62-year-old female client presents to the emergency department and is diagnosed with acute heart failure syndrome. Which assessment finding would the nurse expect?

Productive cough with frothy sputum (other symptoms include shortness of breath, respiratory manifestations, exertional dyspnea, orthopnea, fatigue, limited exercise tolerance, fluid retention, edema, cachexia, malnutrition, and cyanosis. Acute pulmonary edema is the most dramatic symptom. Increased heart rate would be present)

In contrast to acute leukemias, chronic leukemias are malignancies involving abnormal ________ blood cells in the marrow.

Proliferation of well-differentiated

A patient experiencing a sinus arrest would demonstrate which of the following symptoms or findings?

Prolonged periods of asystole demonstrated on an electrocardiogram

A preventative measure to decrease the risk of developing rheumatic heart disease includes which of the following?

Prompt diagnosis of streptococcal infections with a throat culture.

Manifestations of Hodgkin lymphoma that distinguish it from non-Hodgkin lymphoma include....

Pruritus and night fevers

A nurse is caring for a client with right heart failure caused by pulmonary hypertension. Which hemodynamic parameter is most appropriate for the nurse to monitor?

Pulmonary Arterial Pressure (PAP) (main source of afterload work on the right heart)

A client has been diagnosed with deep vein thrombosis (DVT). The nurse is planning care and recognizes that the client is most at risk for...

Pulmonary embolism

A patient presents to the emergency department with complaints of bilateral cyanosis and pallor of the fingers after being out in the cold weather for 5 minutes. The toes are of normal color. Which of the following is a potential diagnosis for this patient?

Raynaud's disease

Atrial fibrillation is the most common chronic arrhythmia whose incidence increases with age. Atrial fibrillation may present as asymptomatic to severe symptomatology. What is the treatment of atrial fibrillation dependent on?

Recency of onset, etiology, and persistence of arrhythmia

A female client has been diagnosed with antiphospholipid syndrome. The nurse would anticipate the client has a health history that may include which disorders?

Recurrent fetal loss, hypertension during pregnancy, uteroplacental insufficiency, pregnancy loss before the 10th week (ischemia and thrombosis of the placental vessels can happen)

Right ventricular dysfunction

Reduces blood moving forward in pulm circulation - congestion of blood in systemic circulation, peripheral edema, hepatic veins engorged/liver, GI congestion = anorexia/abdominal bloating, jugular veins engorged

Cytokines that affect hematopoiesis in bone marrow are called colony-stimulating factors (CSF's) based on their ability to...

Regulate blood cells

Coagulation activated by the extrinsic pathway is initiated when:

Release of thromboplastin from the injured vessel wall

Treating heart failure

Relieve symptoms, improve quality of life, reduce/eliminate factors, slowing halting or reversing cardiac dysfunction

The electrical activity of the heart is recorded on the ECG. What does the T wave on the ECG represent?

Repolarization of the ventricles (P wave = depolarization of the atria or SA node, QRS = depolarization of the ventricles and repolarization of the atria)

A client has had an acute myocardial infarction. The brother of the client has a history of angina. The client asks how they will know if the brother's pain is angina or if the brother is actually having an MI. Which statement is correct?

Rest and intake of nitroglycerin relieve chest pain with angina; they do not relieve chest pain with an MI.

Clinical manifestations of heart failure

SOB, Dyspnea, Orthopnea, nocturnal dyspnea, nonproductive dry cough, acute pulm edema, fatigue, weakness, mental confusion, fluid retention/edema, cachexia and malnutrition, cyanosis

The diagnosis is hypovolemic shock. The nurse knows that causes of hypovolemic shock include which of the following?

Severe burns, fifteen percent blood volume loss, severe dehydration (another cause is shifting of extracellular fluid from the circulatory system to interstitial spaces)

Which of the following is called the pacemaker of the heart?

Sinoatrial (SA) node

Hemostatic process main 3 steps

Spasm of the blood vessel, Platelet aggregation, Coagulation cascasde

A client with a known history of intravenous drug abuse had been diagnosed with infective endocarditis. Select the most likely cause of infection.

Staphylococcus aureus

A client diagnosed with pancytopenia due to aplastic anemia is scheduled for which of the following treatments that can correct bone marrow deficiencies?

Stem cell transplant

Sign of neutropenia in the mouth?

Stomatitis

A client has been diagnosed with a dissecting aortic aneurysm. It is most important for the nurse to assess the client for...

Tearing or ripping type pain in the chest or back

A client refuses to take the 81mg of aspirin ordered by the physician, stating, "I do not have any pain." The best response by the nurse would be...

The 81mg of aspirin daily will help protect you from a stroke or a heart attack

Myocardial contractility

The ability of the heart muscle to contract.

Which clients are at risk for impaired normal red blood cell destruction?

The client whose spleen was damaged in an automobile accident, the client diagnosed with chronic cirrhosis of the liver, the client whose biopsy revealed cancer cells in numerous lymph nodes

A nurse is preparing a client for CABG the following week and asks the client to discontinue their daily aspirin. Which response is best to explain the effect aspirin has on the platelets and potential bleeding problems?

The effect is not reversible for the life of the platelet. (platelet life 8-12 days, lasts that whole time)

Afterload

The force or resistance against which the heart pumps.

The nurse is caring for a 2-day old newborn infant who appears lethargic and has a yellowish tint to the skin. Select the most likely cause of this newborns signs and symptoms.

The inability of the immature liver to conjugate bilirubin

A 42-year-old male client recently diagnosed with liver cancer is noted as at high risk for bleeding abnormalities. The nurse recognizes this risk as a result of...

The reduction of clotting factors synthesized in the liver

Which of the following heart block results in decreased cardiac output and fainting?

Third Degree

In which of the following atrioventricular (AV) conduction disorders does the link between the atria and ventricles get lost, resulting in atrial and ventricular depolarization being controlled by separate pacemakers?

Third-degree AV block (first degree = AV conduction delayed but still conducted, second degree = some impulses get through while others do not)

A client has an impaired platelet function that may have developed from inheritance, drugs, disease, or extracorporeal circulation. The health care provider would document this as...

Thrombocytopathia

Which of the following parts of the body are considered to be parts of the lymphatic system?

Thymus and Spleen (Also lymphatic vessels, lymphoid tissue, and lymph nodes).

Bed rest and analgesics treatment for mono?

To relieve fever, headache, and sore throat

Which type of pacing involves the placement of large patch electrodes on the anterior and posterior chest wall that can be connected by a cable to an external pulse generator?

Transcutaneous

Which serum biomarker is highly specific for myocardial tissue?

Troponin

Anaphylactic shock is directly associated with..

Type 1 hypersensitivity response (Histamine = vasodilator)

A client diagnosed with autosomal dominant von Willebrand factor disease (vWF) is experiencing mild to moderate bleeding. The health care provider would classify the diagnosis as...

Type 2

Myocardial Hypertrophy

Types: Symmetric = increase in muscle length and width athletes, Concentric = wall thickness increase HTN, Eccentric = disproportionate increase in muscle length DCM

A neonate has been diagnosed with hyperbilirubinemia and begun phototherapy. The infant's risk of encephalopathy will increase if:

Unconjugated bilirubin levels are not successfully reduced

Endothelins

Vasoconstrictors, anti-natriuretic effects on kidneys

Which of the following arrhythmias is considered to be the most fatal and requires immediate treatment?

Ventricular fibrillation

In right sided heart failure, the peripheral edema accumulation is evidenced by...

Weight gain (left heart failure = shortness of breath and decreased renal perfusion/output)

Which statements are correct regarding normal hematopoiesis?

White blood cells result from hematopoietic stem cells, hematopoietic stem cells differentiate into committed progenitor cells, committed progenitor cells develop into myelogenous and lymphocytic lineages, and stem cell reproduction is controlled by colony-stimulating factors (CSFs)

Iron deficiency anemia treatments (for a baby)

cereals with fortified iron, decrease intake of whole milk, good nutrition

Treatments of heart failure

exercise, sodium and fluid restriction, weight management, counseling, health coaching

Indolent lymphoma...

is slow growing

Preload

volume of blood in ventricles at end of diastole, determined by venous return