ATI DYNAMIC QUIZ-PHARM, CARDIOLOGY, HEMATOLOGY, CIRULATORY-REVIEW QUESTIONS

A nurse is rewarming a client following coronary artery bypass graft (CABG) surgery. For which of the following complications of the rewarming process should the nurse monitor the client? A. Acidosis B. Infection C. Hypertension D. Cardiac tamponade

A. Acidosis Metabolic acidosis associated with hypoxia can occur if a client is rewarmed too quickly. Acidosis develops after the client starts to shiver and increases myocardial oxygen consumption. Rewarming of the client after CABG should occur at a rate no faster than 1°C (1.8°F) per hour.

A nurse is teaching about a low-cholesterol diet to a client who had a myocardial infarction. Which of the following meal selections by the client indicates an understanding of the teaching? A. Chicken breast and corn on the cob B. Shrimp and rice C. Cheese omelet and turkey bacon D. Liver and onions

A. Chicken breast and corn on the cob The nurse should identify that chicken breast is low in cholesterol, and all vegetables, including corn, are cholesterol-free; therefore, this food selection by the client indicates an understanding of the teaching.

A nurse is examining the ECG of a client who has hyperkalemia. Which of the following ECG changes should the nurse expect? A. Elevated ST segments B. Absent P waves C. Depressed ST segments D. Varying PP intervals

A. Elevated ST segments Elevated ST segments can indicate hyperkalemia and pericarditis.

A nurse is reviewing the laboratory results of a client who has end-stage renal disease and reports fatigue. The client's hemoglobin level is 8 g/dL. The nurse should expect a prescription for which of the following medications? A. Erythropoietin B. Erythromycin C. Filgrastim D. Calcitriol

A. Erythropoietin Erythropoietin stimulates the production of RBCs and is used to treat anemia associated with chronic renal failure.

A nurse is assessing a client who has fluid volume overload from a cardiovascular disorder. Which of the following manifestations should the nurse expect? (Select all that apply.) A. Jugular vein distension B. Moist crackles C. Postural hypotension D. Increased heart rate E. Fever

A. Jugular vein distension B. Moist crackles D. Increased heart rate The increased venous pressure due to excessive circulating blood volume results in neck vein distension. Moist crackles are an indicator of pulmonary edema that can quickly lead to death. Fluid volume excess (hypervolemia) is an expansion of fluid volume in the extracellular fluid compartment, which results in an increased heart rate and bounding pulses.

A nurse is providing teaching to a newly licensed nurse about administering morphine via IV bolus to a client. Which of the following pieces of information should the nurse include in the teaching? A.Respiratory depression can occur 7 min after the morphine is administered. B. The morphine will peak in 10 min. C. Withhold the morphine if the client has a respiratory rate of <16/min. D. Administer the morphine over 2 min.

A. Respiratory depression can occur 7 min after the morphine is administered. Respiratory depression can occur within 7 minutes of the administration of IV bolus morphine. The nurse should monitor the client's respirations and have naloxone available to reverse the effects of the morphine.

A nurse is providing discharge teaching to a client who has a new permanent pacemaker. Which of the following statements by the client indicates an understanding of the teaching? A. "I should check my heart rate at the same time each day." B."I don't have to take my antihypertensive medications now that I have a pacemaker." C."I should keep a pressure dressing over the generator until the incision is healed." D."I cannot stand in front of our new microwave oven when it is on."

A."I should check my heart rate at the same time each day." The nurse should instruct the client to check the heart rate at the same time each day and to document the rate in a log for reporting to the provider.

A nurse is caring for a client who has a platelet count of 50,000/mm^3. After discontinuing the client's peripheral IV site, which of the following actions should the nurse take? A. Apply warm compresses B. Apply pressure to the catheter removal site for 5 min C. Place the affected arm in a dependent position D. Clean the insertion site with alcohol

B. Apply pressure to the catheter removal site for 5 min A platelet count below 100,000/mm^3 indicates thrombocytopenia, which puts the client at an increased risk of bleeding. By applying pressure to the site for at least 5 minutes, the nurse promotes coagulation and prevents additional blood loss.

A nurse is preparing to administer packed RBCs to a client who is anemic. Which of the following actions should the nurse take? (Select all that apply.) A. Insert a 23-gauge angiocatheter with an IV adaptor B. Check to determine the packed RBCs are less than 1 week old C. Administer the packed RBCs over a 6-hr period D. Ask another nurse to check the packed RBCs' label against the medical record E. Prime the transfusion tubing with 0.9% sodium chloride

B. Check to determine the packed RBCs are less than 1 week old D. Ask another nurse to check the packed RBCs' label against the medical record E. Prime the transfusion tubing with 0.9% sodium chloride The nurse should check to determine that the packed RBCs are less than 1 week old; if the blood is older, the RBCs become fragile, break easily, and release potassium into the blood steam. In addition, the nurse should ask another nurse to check the packed RBCs label against the medical record for safety verification. The nurse should ensure that the client's complete name and identification number match and that the blood group name and number are correct. If there is any type of discrepancy, the nurse should not infuse the blood and should notify the blood bank. Finally, the nurse should prime the transfusion tubing with 0.9% sodium chloride. Other solutions such as Ringer's lactate and dextrose in water can cause clotting or hemolysis of the packed RBCs.

A nurse is reviewing the laboratory data for a client who has Alzheimer's disease and a new prescription for memantine. The nurse should identify that which of the following findings increases the client's risk for reduced clearance of the medication? A. Alanine aminotransferase (ALT) 60 international units/L B. Creatinine clearance 35 mL/min C. HbA1c 5% D. BMI 31

B. Creatinine clearance 35 mL/min Creatinine clearance is an estimate of the glomerular filtration rate (GFR) and the kidneys' ability to filter waste. A creatinine clearance of 35 mL/min is below the expected reference range of 87 to 139 mL/min and indicates moderate renal impairment. Memantine is excreted by the kidneys, and decreased clearance occurs with moderate renal impairment.

A nurse is caring for a client who has a new prescription for ergotamine. The nurse should recognize that ergotamine is administered to treat which of the following conditions? A. Raynaud's phenomenon B. Migraine headaches C. Ulcerative colitis D. Anemia

B. Migraine headaches Ergotamine prevents or stops a migraine headache by blocking alpha-adrenergic receptors in the cranial peripheral vascular smooth muscle, which causes vasoconstriction of dilated cerebral blood vessels.

A nurse is administering an enteric-coated tablet to a client and explaining the pharmaceutical preparation. Which of the following statements should the nurse make? A."This coated tablet dissolves better in your stomach and intestines." B."You are less likely to have an upset stomach with this pill because of the coating on the tablet." C."The coating on the tablet improves the absorption of the medication." D. "The coating on the tablet allows a gradual release of the medication."

B."You are less likely to have an upset stomach with this pill because of the coating on the tablet." Enteric-coated preparations have an outside coating of a substance that dissolves in the intestines instead of in the stomach. This protects the medication from acids and enzymes in the stomach and protects the stomach from ingredients in the medication that can cause gastric upset.

A nurse is assessing a client who had coronary artery bypass grafts for cardiac tamponade. Which of the following actions should the nurse take? A. Check for hypertension B. Auscultate for loud, bounding heart sounds C. Auscultate blood pressure for pulsus paradoxus D. Check for a pulse deficit

C. Auscultate blood pressure for pulsus paradoxus The client who has cardiac tamponade will have pulsus paradoxus when the systolic blood pressure is at least 10 mmHg higher on expiration than on inspiration. This occurs because of the sudden decrease in cardiac output from the fluid compressing the atria and ventricles.

A nurse is caring for a client who has a prescription for chlorothiazide to treat hypertension. The nurse should plan to monitor the client for which of the following adverse effects? A. Thrombophlebitis B. Hyperactive reflexes C. Muscle weakness D. Hypoglycemia

C. Muscle weakness Chlorothiazide is a thiazide diuretic used to treat hypertension and congestive heart failure. It promotes the excretion of water, sodium, and potassium and can cause hypokalemia. Manifestations of hypokalemia include muscle weakness, muscle cramps, and dysrhythmias.

A nurse is caring for a client who has scurvy. Which of the following vitamin deficiencies should the nurse identify as the cause of this disease? A. Vitamin A B. Vitamin B3 C. Vitamin C D. Vitamin D

C. Vitamin C Vitamin C deficiency produces symptoms of scurvy such as delayed wound healing and capillary fragility.

A nurse is preparing a client for a bone-marrow biopsy. Which of the following pieces of information should the nurse include in preoperative teaching? A. "You'll receive heavy sedation, so you might even sleep during the procedure." B. "You'll have to lie on your back throughout the procedure." C. "You'll feel a painful, pulling sensation when the doctor withdraws the marrow." D. "Expect the procedure to take about an hour."

C."You'll feel a painful, pulling sensation when the doctor withdraws the marrow." The nurse should prepare the client to expect a painful, pulling sensation when the provider aspirates the marrow as well as some discomfort from the rotation of the needle into the bone.

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

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 planning to administer diphenhydramine 50 mg via IV bolus to a client who is having an allergic reaction. The client has an IV infusion containing a medication that is incompatible with diphenhydramine in solution. Which of the following actions should the nurse take? A. Choose an IV port for IV bolus injection of diphenhydramine as near as possible to the client's hanging IV bag B. Flush the IV tubing with 2 mL of 0.9% sodium chloride before and after administering diphenhydramine C. Allow the IV infusion to keep running while administering the diphenhydramine via IV bolus D. Aspirate to check for IV patency before administering the diphenhydramine

D. Aspirate to check for IV patency before administering the diphenhydramine It is important to confirm IV patency prior to administering an IV bolus. Some medications cause severe tissue damage when inadvertently administered into tissue rather than into a vein.

A nurse is caring for a client following a stroke. Which of the following actions should the nurse take first? A.Obtain coagulation laboratory studies from the client B. Apply pneumatic compression boots to the client C. Request a referral for a speech-language pathologist D. Keep the client NPO

D. Keep the client NPO The first action the nurse should take when using the airway, breathing, and circulation (ABC) approach to client care is to keep the client NPO due to the risk of aspiration as a result of the stroke. The client should be screened for the ability to swallow and should not receive anything by mouth until this has been completed. A client who has experienced a cerebrovascular accident is at risk for dysphagia, which increases the change of life-threating aspiration.

A nurse is assessing a client who has an abdominal aortic aneurysm. Which of the following manifestations should the nurse expect? A. Midsternal chest pain B. Thrill C. Pitting edema in lower extremities D. Lower back discomfort

D. Lower back discomfort An abdominal aortic aneurysm involves a widening, stretching, or ballooning of the aorta. Back pain and abdominal pain indicate that the aneurysm is extending downward and pressing on lumbar spinal nerve roots, causing pain.

A nurse is showing a client who has right-sided heart failure an illustration of the heart. Which of the following blood vessels carry deoxygenated blood to the right atrium? A. Right coronary artery B. Left carotid artery C. Aorta D. Superior vena cava

D. Superior vena cava The nurse should identify that the superior and inferior vena cava carry deoxygenated blood to the right atrium.