ATI Learning System RN 3.0 Med Surg Cardiovascular and Hematology Dynamic Quiz

A solution of 5 mL heparin 1,000 units/mL has been prepared

A charge nurse is observing a newly licensed nurse administer an IV medication to a client who has an implanted venous access port. Which of the following observations requires intervention by the charge nurse?

Hypertension Diabetes mellitus Hyperlipidemia Tobacco smoking

A nurse completing an assessment on a client. Which of the following findings should the nurse identify as a risk factor for CAD?

Dry, pale skin with minimal body hair

A nurse in a clinic is assessing the lower extremities and ankles of a client who has a history of peripheral arterial disease. Which of the following findings should the nurse expect?

Elevate the affected leg

A nurse is caring for a client who has femoral thrombophlebitis and a prescription for enoxaparin. Which of the following actions should the nurse take?

Prepare for replacement of the missing clotting factor.

A nurse is caring for a client who has hemophilia. The client reports pain and swelling in a joint following an injury. Which of the following actions should the nurse take?

Vitamin B12 deficiency

A nurse is caring for a client who has pernicious anemia. Which of the following factors should the nurse identify with this condition?

Vitamin C

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?

Epistaxis

A nurse is caring for a client who has severely elevated blood pressure. Which of the following findings should the nurse identify as a manifestation of HTN?

Apply lateral pressure to the client's nose for 10 min

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

Nausea

A nurse is caring for a client who is having a possible MI. Which of the following findings should the nurse identify as an associated manifestation of an MI?

0.9% NaCl

A nurse is caring for a client who is in hypovolemia shock. While waiting for a unit of blood, the nurse should administer which of the following IV solutions?

Position the client supine with his legs elevated when in bed

A nurse is caring for a client who is postop following vein ligation and stripping for varicose veins. Which of the following actions should the nurse take?

Stop the medication infusion

A nurse is caring for a client who is receiving IV ampicillin and develops urticaria and dyspnea. Which of the following actions should the nurse take first?

"Your body has a process called fibrinolysis that will eventually dissolve the clot."

A nurse is caring for a client who is undergoing conservative treatment for DVT. The client asks the nurse what will happen to the clot. Which of the following responses should the nurse make?

"I would never have believed I could get used to enjoying my food without the salt."

A nurse is caring for a client who is undergoing treatment for HTN. Which of the following statements indicates that the client is adhering to the treatment plan?

Check the affected extremity for warmth and redness

A nurse is caring for a client who reports calf pain. What is the first action the nurse should take?

Witness the informed consent document

A nurse is preparing to transfuse a unit of packed RBCs for a client who has anemia. Which of the following actions should the nurse take first?

Prothrombin time

A nurse is reviewing a client's repeat lab results 4 hr after administering fresh frozen plasma (FFP). Which of the following lab results should the nurse review?

Eggs

A nurse is teaching a client who has pernicious anemia. The nurse should encourage the client to increase consumption of which of the following foods?

Atrial rate of 300 bpm with QRS complex of 80 bpm

A nurse on a telemetry unit is caring for a client who has an irregular radial pulse. Which of the following ECG abnormalities should the nurse recognize as atrial flutter?

10 ggt/min

Math question

Give the client a written record of his BP to bring to his provider

While participating in a community health fair, a nurse is providing info to a client who has a BP of 150/90 during screening. Which of the following actions should the nurse take?

"Platelets plug breaks down in blood vessels."

A client who has thrombocytopenia asks the nurse why platelets are so important. Which of the following responses should the nurse make?

Hardening along the blood vessel. Tenderness in the calf. Increased leg circumference.

A nurse is assessing a client who has DVT in her left calf. Which of the following manifestations should the nurse expect to find?

Report of sudden, severe back pain

A nurse is assessing a client who has an abdominal aortic aneurysm (AAA). Which of the following findings indicates that the AAA is expanding?

Lower back discomfort

A nurse is assessing a client who has an abdominal aortic aneurysm. Which of the following manifestations should the nurse expect?

Auscultate blood pressure for pulsus paradoxus

A nurse is assessing a client who has coronary artery bypass grafts for cardiac tamponade. Which of the following actions should the nurse take?

Jugular vein distension Moist crackles Increased heart rate

A nurse is assessing a client who has fluid volume overload from a cardiovascular disorder. Which of the following manifestations should the nurse expect?

Hypokalemia

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?

Increased hematocrit level

A nurse is assessing a client who has isotonic dehydration. Which of the following findings should the nurse expect?

Weight gain of 1 kg in 1 day

A nurse is assessing a client who has late-stage heart failure and is experiencing fluid volume overload. Which of the following findings should the nurse expect?

Crackles in the lung bases

A nurse is assessing a client who has left sided heart failure. Which of the following findings should the nurse expect?

Dyspnea with hiccups

A nurse is assessing a client who has pericarditis. Which of the following manifestations should the nurse expect?

Ankle swelling

A nurse is assessing a client who has peripheral vascular disease and a venous ulcer on the right ankle. Which of the following findings should the nurse expect in the client's affected extremity?

Paresthesias in the hands and feet

A nurse is assessing a client who has pernicious anemia. Which of the following findings should the nurse expect?

Dependent edema

A nurse is assessing a client who has right sided heart failure. Which of the following findings should the nurse expect?

Acute confusion

A nurse is assessing a client who is 85 years old. Which of the following findings should the nurse identify as a manifestation of myocardial infarction?

Coarse crackles

A nurse is caring for a client who had myocardial infarction 5 days ago. The client has a sudden onset of SOB and begins coughing frothy, pink sputum. The nurse auscultates loud, bubbly sounds on inspiration. Which of the following adventitious breath sounds should the nurse document?

Impaired circulation

A nurse is caring for a client who has PVD and ulcers on the toes. Which of the following findings of PVD is a risk factor for ulceration of the extremities?

Elevated Hct

A nurse is caring for a client who has a major burn injury and is experiencing third spacing. Which of the following fluid or electrolyte imbalances should the nurse expect?

Appearance of Q waves

A nurse is monitoring a client for reperfusion following thrombolytic therapy to treat acute MI. Which of the following indicators should the nurse identify to confirm reperfusion?

Ventricular dysrhythmias

A nurse is monitoring a client who had a MI. For which of the following complications should the nurse monitor in the first 24 hr?

Increased pulmonary congestion

A nurse is monitoring for a client who has heart failure related to mitral stenosis. The client reports SOB on exertion. Which of the following conditions should the nurse expect?

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

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?

"I will not drink coffee 4 hr prior to my test."

A nurse is providing info to a client who scheduled an exercise ECG test. Which of the following client statements indicates an understanding of the teaching?

"Before taking my medication, I will count my radial pulse rate."

A nurse is providing teaching about lifestyle changes to a client who experienced a MI and has a new prescription for a beta blocker. Which of the following client statements indicates an understanding of the teaching?

Iron toxicity

A nurse is reviewing lab values for an adult client who has sickle cell anemia and a history of receiving blood transfusions. For which of the following complications should the nurse monitor?

Decreased albumin

A nurse is reviewing the lab findings of a client who has protein-calorie malnutrition. Which of the following findings should the nurse expect?

Erythropoietin

A nurse is reviewing the lab 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?

BNP of 200 pg/mL

A nurse is reviewing the medical record of a client who has heart failure. Which of the following findings should the nurse expect?

Turkey on whole-wheat bread

A nurse is reviewing the menu selections of a client who has heart failure and anticipates discharge to home the following day. Which of the following lunch choices should the nurse identify as an indication that the client understands his dietary instructions?

The heart rate times the stroke volume

A nurse is reviewing the progress notes for a client who has heart failure. The provider noted some improvement in the client's cardiac output. The nurse should understand that cardiac output reflects which of the following physiologic parameters?

Acidosis

A nurse is rewarming a client following CABG surgery. For which of the following complications of the rewarming process should the nurse monitor for the client?

Superior vena cava

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?

"My coronary artery disease is a risk factor for heart failure."

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?

Grilled chicken salad with fresh tomatoes

A nurse is teaching a client about dietary modifications to control blood pressure. Which of the following food choices should the nurse identify as an indication that the client understands the instructions?

N + v Diaphoresis and dizziness Anxiety and feelings of doom

A nurse is teaching a client who has CAD about the difference between angina pectoris and MI. Which of the following manifestations should the nurse identify as indications of MI?

Beef liver

A nurse is teaching a client who has iron-deficiency anemia. The nurse should encourage the client to increase consumption of which of the following foods?

Lentils

A nurse is teaching a client who has iron-deficiency anemia. The nurse should encourage the client to increase her consumption of which of the following foods?

"Elevate your legs when sitting."

A nurse is teaching a client who has polycythemia vera about self-care measures. Which of the following interventions should the nurse include?

"I should remove the skin from poultry before eating it."

A nurse is teaching a client with heart disease about a low-cholesterol diet. Which of the following client statements indicates the teaching was effective?

Chicken breast and corn on the cob

A nurse is teaching about a low-cholesterol diet to a client who had a MI. Which of the following meal selections by the client indicates an understanding of the teaching?

Remove the unit of plasma immediately and start an IV infusion of normal saline solution

A nurse is transfusing a unit of B-positive fresh frozen plasma to a client whose blood type is O negative. Which of the following actions should the nurse take?

Use a transfusion pump to regulate and maintain the transfusion at a slower rate

A nurse observes tachycardia, dyspnea, a cough, and distended neck veins in a client who is receiving a transfusion of packed RBCs. Which of the following interventions should the nurse use to prevent these manifestations with the client's next transfusion?

"Variant angina can cause changes on your ECG."

A client who just learned that he has variant (Prinzmetal's) angina asks the nurse how this type of angina compares with stable angina. Which of the following replies should the nurse make?

A client who is a vegetarian. A client who is pregnant. A toddler who is overweight.

A nurse in a provider's office is reviewing the medical record of a group of clients. Which of the following clients is at risk for iron deficiency?

Stop the infusion of blood

A nurse is administering a unit of packed RBCs to a client who is postop. The client reports itching and hives 30 min after the infusion begins. Which of the following actions should the nurse take first?

Ample hydration

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?

Petechiae and ecchymosis

A nurse is assessing a client for manifestations of aplastic anemia. Which of the following findings should the nurse expect?

Sudden olgiuria

A nurse is assessing a client who is receiving a transfusion of packed RBCs. Which of the following findings should the nurse identify as an indication of an acute intravascular hemolytic reaction?

Low back pain

A nurse is assessing a client who is receiving a unit of whole blood. Which of the following findings should the nurse identify as a manifestation of a hemolytic transfusion reaction?

Bleeding at the venipuncture site. Petechiae on the chest and arms. Abdominal distension.

A nurse is assessing for DIC in a client who has septic shock secondary to an untreated foot wound. Which of the following findings should the nurse expect?

Absence of hair on the legs

A nurse is assessing the hematologic system of an older adult client. The nurse should report which of the following findings to the provider as a possible indication of a hematologic disorder?

Keep the client NPO

A nurse is caring for a client following a stroke. Which of the following actions should the nurse take first?

Flush the line with sterile 0.9% NaCl before and after medication administration. Access the PICC for blood sampling. Perform a heparin flush of the line at least daily when not in use.

A nurse is caring for a client who has a PICC in place. Which of the following actions should the nurse take when handling this central venous access device?

Telemetry monitoring showing QRS complexes occurring at a rate of 74 bpm with no pacing spikes

A nurse is caring for a client who has a demand pacemaker inserted with a set rate of 72 bpm. Which of the following findings should the nurse expect?

Vitamin B12

A nurse is caring for a client who has a new diagnosis of pernicious anemia. The nurse should expect the client's provider to prescribe which of the following medications for this client?

Apply pressure to the catheter removal site for 5 min

A nurse is caring for a client who has a platelet count of 50,000. After discontinuing the client's peripheral IV site, which of the following actions should the nurse take?

Hgb 6.5 g/dL

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 lab results, which of the following values should the nurse identify as contributing to the client's fatigue and pallor?

Administer anti-HTN medication for BP.

A nurse is caring for a client who has an abdominal aortic aneurysm and is scheduled for surgery. The client's vital signs are BP 160/98, HR 102 bpm, RR 22 bpm, and SpO2 95%. Which of the following actions should the nurse take?

Assess and document the client's vital signs. Verify with another nurse the blood type and Rh of the packed RBCs. Change IV tubing to a set that has a filter.

A nurse is caring for a client who has an upper GI bleed and a hematocrit of 24%. Prior to initiating a transfusion of packed RBCs, which of the following actions should the nurse take?

Hyperkalemia

A nurse is caring for a client who has emphysema and chronic respiratory acidosis. The nurse should monitor for which of the following electrolyte imbalances?

Potassium 2.8 mEq/L

A nurse is caring for a client with heart failure whose telemetry reading displays a flattening of the T wave. Which of the following laboratory results should the nurse anticipate as the cause of this ECG change?

Elevated LDL levels

A nurse is caring for an adult male client who is undergoing screening tests for atherosclerosis. Which of the following findings should the nurse identify as an increased risk for this disorder?

Peripheral vascular resistance increases

A nurse is caring for an older adult client who had an acute MI. When assessing this client, the nurse should identify that older adults are prone to complications of MI from poor tissue perfusion because of which of the following age-related factors?

1. Palpate the blood pressure and inflate the cuff above the systolic pressure. 2. Deflate the cuff slowly and listen for the first audible sounds. 3. Identify the first BP sounds audible on expiration and then on inspiration. 4. Subtract the inspiratory pressure from the expiratory pressure. 5. Inspect for jugular venous distention and notify the provider.

A nurse is checking paradoxical blood pressure of a client who has a possible cardiac tamponade. In what order should the nurse complete the following steps?

Omega 3 fatty acids

A nurse is completing a medication history for a client who reports using fish oil as a dietary supplement. Which of the following substances in fish oil should the nurse recognize as a health benefit to the client?

Chest pain lasts longer than 15 min

A nurse is completing an assessment for a client who has a history of unstable angina. Which of the following findings should the nurse expect?

"I can have yogurt as a dessert."

A nurse is completing dietary teaching with a client who has heart failure and is prescribed a 2 g sodium diet. Which of the following statements by the client indicates an understanding of the teaching?

Much greater amplitude than the usual QRS complexes

A nurse is examining the ECG of a client who has frequent ventricular contractions (PVCs). Which of the following changes should the nurse expect to see on the client's ECG?

Elevated ST segments

A nurse is examining the ECG of a client who has hyperkalemia. Which of the following ECG changes should the nurse expect?

Necrosis

A nurse is examining the ECG of a client who is having an acute MI. The nurse should identify that the elevated ST segments on the ECG indicate which of the following alterations?

Prolonged QT intervals

A nurse is monitoring the ECG of a client who has hypocalcemia. Which of the following findings should the nurse expect?

Encourage increased fluid intake

A nurse is planning care for a client during sickle cell crisis. Which of the following interventions should the nurse include in the client's plan of care?

Avoid MI injections.

A nurse is planning care for a client who has acute myelogenous leukemia and a platelet count of 48000. Which of the following interventions should the nurse include?

Initiate weekly injections of vitamin B12

A nurse is planning care for a client who has pernicious anemia. Which of the following interventions should the nurse include in the plan?

Measure the client's abdominal girth daily

A nurse is planning care for a client who has thrombocytopenia. Which of the following interventions should the nurse include in the plan of care?

Monitor for bleeding

A nurse is planning care for a client who is having a PTCA with stent placement. Which of the following actions should the nurse anticipate in the post-procedure plan of care?

"You'll feel a painful, pulling sensation when the doctor withdraws the marrow."

A nurse is preparing a client for a bone-marrow biopsy. Which of the following pieces of info should the nurse include in the preoperative teaching?

"You'll have to lie flat for several hours after the procedure." "You'll receive medication to relax you before the procedure." "You'll have to keep your leg straight after the procedure."

A nurse is preparing a client for cardiac catheterization. Which of the following pieces of information should the nurse give the client before the procedure?

Apply the defibrillator pads to the client's chest

A nurse is preparing an AED for a client receiving CPR after a cardiac arrest. Which of the following actions should the nurse perform first?

Dysrhythmias

A nurse is preparing an in-service about the management of MI. Death following MI is often a result of which of the following complications?

Substernal chest pain

A nurse is preparing an in-service presentation about assessing clients who are having an acute MI. What is the most common assessment finding with acute MI?

Tissue hypoxia

A nurse is preparing an in-service presentation about the basics of hematology. Which of the following factors provides a stimulus for the production of RBCs?

Check to determine the packed RBCs are less than 1 week old. Ask another nurse to check the packed RBCs' label against the medical record. Prime the transfusion tubing with 0.9% sodium chloride.

A nurse is preparing to administer packed RBCs to a client who is anemic. Which of the following actions should the nurse take?

"I'll stick with soft foods for now."

A nurse is providing discharge teaching for a client who had a bone marrow transplant and has thrombocytopenia. Which of the following statements indicates that the client understands the precautions he must take at home?

"Keep your cell phone 6 inches away from your pacemaker when making a call."

A nurse is providing discharge teaching for a client who has a newly inserted permanent pacemaker. Which of the following instructions should the nurse include in the teaching?

"Physical activity is good for me, but I need to avoid overexertion."

A nurse is providing discharge teaching to a client who had a sickle cell crisis. Which of the following statements indicates that the client understand the instructions?

"I should check my heart rate at the same time each day."

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?

"I should eliminate uncooked foods from my diet for now."

A nurse is providing discharge teaching to a client who has aplastic anemia. Which of the following statements indicates that the client understands the instructions?

"I can snack on fresh fruit."

A nurse is providing teaching for a client who has a prescription for a low-sodium diet to manage HTN. Which of the following statements by the client indicates an understanding of the teaching?

HTN is a common adverse effect of this medication

A nurse is providing teaching to a client who has anemia and a new prescription for epoetin alfa. Which of the following pieces of info should the nurse include in the teaching?