BIO 234 Final

Pataasin ang iyong marka sa homework at exams ngayon gamit ang Quizwiz!

Disseminated Intravascular Coagulation causes a drop in circulating clotting factors. T or F?

True

Endothelial dysfunction describes potentially reversible changes in endothelial function that occur in response to environmental stimuli. T or F?

True

Improper lead placement for an ECG can significantly change the QRS morphology. T or F?

True

Non-Hodgkin disease is a type of lymphoma that originates at extranodal sites and spreads to anatomically contiguous nodes. T or F?

True

Surgical correction of heart defects in children may cause heart failure. T or F?

True

The electrocardiogram is a reflection of cardiac muscle contraction. You can directly diagnose specific defects in muscle activity. T or F?

True

Transmural Infarcts involve the full thickness of the ventricular wall. T or F?

True

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

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

P wave

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

Pallor, pulselessness, and pain

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

What is the most common identifiable cause of secondary cardiomyopathy?

Alcohol abuse

Anticoagulant drugs prevent thromboembolic 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

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

"Aspirin will help prevent blood clotting."

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."

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? Select all that apply.

"Do you get up often during the night to urinate?" "Do you easily get tired?" "Do you have swelling in your ankles?" "Are you feeling depressed?"

While taking a history on a pediatric client who appears to have Burkitt lymphoma, which question to the client and/or the family is likely to correlate with this diagnosis?

"Have you recently been diagnosed with Epstein-Barr virus (EBV)?"

A client diagnosed with type 2 diabetes has been instructed about managing his condition with diet. Which statements by the client indicate a need for additional education? Select all that apply.

"I must avoid all candies and cookies, but can eat unlimited amounts of pasta and breads." "I need to carefully limit my protein consumption."

The nurse is caring for of a 6-month-old infant diagnosed with iron deficiency anemia. The nurse determines further teaching is necessary when the mother states:

"I must stop breast-feeding my baby because of the anemia."

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."

The mother of a 2-year-old newly diagnosed with type 1 diabetes asks why insulin has to be given by injection. The best response by the nurse is:

"Insulin is destroyed by the stomach contents and has to be administered by injection."

A client who will be undergoing a Holter monitor examination would be given which instruction?

"Keep a diary of your activities and symptoms throughout the examination."

When assessing the mouth of a client receiving chemotherapy, which of the following should the nurse interpret as a possible indicator of neutropenia?

Stomatitis

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

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

A client with thrombotic thrombocytopenic purpura (TTP) is signing consent for plasmapheresis. The client asks, "What is this procedure and why do I need it?" Which response by the health care provider is most accurate?

"The laboratory will remove plasma from the withdrawn blood and replace it with fresh-frozen plasma."

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

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

140/90

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

15% blood volume loss Severe dehydration Severe burns

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:

20 mL/hour

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

Accounting for age, illness, and risk factors, a transfusion is recommended when the hemoglobin is at which level?

<7 g/dL (<70 g/L)

The signs and symptoms of abrupt cessation of pharmacologic glucocorticoids closely resemble those of: A. Addison disease B. Cushing disease C. Graves disease D. Cushing syndrome

A

Which statement best describes a secondary disorder of endocrine function?

The disorder occurs when the target organ is normal, but stimulating hormones alter its function.

The nurse is working in a pediatric clinic. Which child would the nurse recognize as having isosexual precocious puberty?

A 5-year-old black female with developing breasts and pubic hair

Which client is at greatest risk for orthostatic hypotension?

A 66-year-old postoperative client on bed rest

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

A rate between 60 and 100 beats per minute Constant R to R intervals A "P" before every QRS wave

A person with type A blood who exhibits the D antigen would be considered to have which blood type?

A+

A child has Down syndrome and has been experiencing unexplained nose bleeds for the past several months. His blood tests identify blast cells in the peripheral smear. In addition to nose bleeds, his acute leukemia will typically manifest which of the following signs/symptoms? Select all that apply. A. Fatigue due to RBC deficiency B. Bleeding due to thrombocytopenia C. Infections due to neutropenia D. Hypogammaglobulinemia due to progressive infiltration of the bone marrow and lymphoid tissues E. Palpation of solid tumors on the kidneys

A, B, C

A person newly diagnosed with Kawasaki disease in the acute phase will likely have which of the following clinical manifestations? Select all that apply. A. Bilateral conjunctivitis B. Fever C. Edematous hands and feet D. Irritability and lability of mood E. Peeling of the skin of the fingers and toes

A, B, C

Loss of pituitary function can result in deficiencies/loss of which of the following hormones' secretions? Select all that apply. A. Prolactin B. Follicle-stimulating hormone C. Luteinizing hormone D. Growth Hormone E. Corticotropin-releasing hormone

A, B, C, D

A client is admitted in the ICU with diagnosis of hyperglycemic hyperosmolar state (HHS). The nurse caring for the client knows that the client's elevated serum osmolality has pulled water out of this brain cells based on which of the following assessment findings? Select all that apply. A. Weakness one side of the body B. After the sole of the foot has been firmly stroked, the toes flex and flare out C. Unable to respond verbally to questions D. Increase in urine output in proportion to the increase in blood glucose E. Uncontrollable twitching of a muscle group

A, B, C, E

The health care provider is reviewing diurnal variation pattern in adrenocorticotropic (ACTH) levels. Select the typical diurnal variation pattern in adrenocorticotropic (ACTH) levels.

ACTH peaks in the morning and declines throughout the day.

The nurse is caring for a client with chronic myelogenous leukemia (CML) 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 the administration of a blood transfusion, the client suddenly reports chills and fever. After stopping the transfusion, which treatment is recommended for this common blood transfusion reaction?

Acetaminophen

A client 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 48-year-old male client diagnosed with type 2 diabetes presents with the following: • Blood glucose level of 46 mg/dL (2.55 mmol/L) • Very lethargic • Has cool, clammy skin. Select the most appropriate intervention.

Administer injectable glucagon

Which client is most likely to have a workup to rule out Hodgkin lymphoma?

Adult client concerned about an enlarged lymph node in the axilla

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

Advanced age Ethnicity

Two months following a myocardial infarction (MI), a client visits the health care provider with reports 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 health care provider consider prescribing for this client? Select all that apply.

Antiarrhythmics Anticoagulants

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

Antihypertensives Psychotropics Diuretics

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

Apply sequential pneumatic compression devices to lower extremities.

_______________ thrombi are associated with conditions that produce turbulent blood flow and platelet adherence.

Arterial

Paroxysmal supraventricular tachycardia arises from which form of reentry?

Arterioventricular (AV) nodal

How does low-dose aspirin therapy impact clot formation?

Aspirin is a platelet aggregation inhibitor.

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

Assess the client's history

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 cardiac disorder?

Atrial fibrillation

A client with heart failure asks, "Why am I taking a 'water pill' when it's my heart that is having a problem?" While educating the client about the Frank-Starling mechanism, which of the following explanations is most appropriate to share? A. "You must be drinking way too many liquids. Your kidneys cannot filter all that you are drinking during the day." B. "Since your heart is not pumping efficiently, the kidneys are getting less blood flow; therefore, the kidneys are holding on to sodium and water." C. "Since your heart function is impaired, the lungs are not able to oxygenate the blood and your kidneys are wearing out." D. "Your heart muscle is overstretched, so it's not able to pump all the blood out. The prescribed 'water pills' help by decreasing your weight."

B

A nurse is preparing her client for a blood transfusion. She knows that a client with type A blood is said to have which type of antibodies?

B

Which of the following disease etiologies may be directly related to dietary insufficiencies? A. Sickle cell anemia B. Iron deficiency anemia C. Polycythemia vera D. Erythroblastosis fetalis

B

DIC is associated with which of the following? Select all that apply. A. Increase in C-reactive protein B. Activation of factor X C. Release of tissue factor D. Endothelial damage E. Increase in sedimentation rate

B, C, D

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

Beta-adrenergic blockers

The nurse reviews the lab results of a client who has a thrombocyte count of 60 ×103/μL (60 ×109/L). The client is at risk for:

Bleeding

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

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

Blood vessel occlusion Chronic hemolytic anemia

What is the first symptom of multiple myeloma that a client typically presents with on a visit to the primary care provider?

Bone pain

Which clinical manifestations are associated with acute leukemia? Select all that apply.

Bone pain Fever Epistaxis Bleeding gums

The health care provider is teaching a client about the metabolic effect of cortisol. The most appropriate information to provide would be:

Breakdown of proteins and fats

A client with a diagnosis of chronic renal failure secondary to diabetes has seen a gradual increase in her blood pressure over the past several months, culminating in a diagnosis of secondary hypertension. Which of the following has most likely resulted in the client's increased blood pressure? A. Increased levels of adrenocortical hormones B. Increased sympathetic stimulation by the autonomic nervous system (ANS) C. Activation of the renin-angiotensin-aldosterone mechanism D. Coarctation of the client's aorta

C

A nurse is performing client health education with a 68-year-old man who has recently been diagnosed with heart failure. Which of the following statements demonstrates an accurate understanding of his new diagnosis? A. "I'll be sure to take my beta blocker whenever I feel short of breath." B. "I know it's healthy to drink a lot of water, and I'm going to make sure I do this from now on." C. "I'm trying to think of ways that I can cut down the amount of salt that I usually eat." D. "I'm going to avoid as much physical activity as I can so that I preserve my strength."

C

A nursing student asks her instructor, "I don't understand this coagulation system. When we donate blood, what keeps it from clotting in the bag?" The instructor responds: A. "The blood bank adds heparin to every bag prior to actually collecting the blood from the donor." B. "Calcium gluconate is added to the bag to keep it from clotting." C. "Citrate is added to the blood bag, which prevents it from clotting." D. "If the blood is used within 24 hours from retrieval, there will be no clot formation yet."

C

DVTs may be the direct result of _______________. A. hypercholesterolemia B. hypersensitivity reaction C. bed rest D. smoking

C

Thrombocytopenia may be caused by all of the following except: A. Bacterial infections that decrease platelet production B. Drug hypersensitivities C. Viral stimulation of platelet production D. Auto antibodies

C

While working on the med-surg floor, the nurse has a client who is experiencing an insulin reaction. The client is conscious and can follow directions. The most appropriate intervention would be: A. Skip the oral glucose tablets and go directly to giving intramuscular glucagon. Repeat the glucagon in 15 minutes if the blood glucose level is not within a normal range. B. Start pushing 50% glucose solution slowly and do not stop pushing until the client's repeat blood glucose level is above 100 mg/dL. C. Immediately administer 15 g of glucose (preferably via oral route if the client is alert enough to swallow) and wait for 15 minutes. Then repeat this if necessary. D. Call the physician and wait for him or her to respond to give you orders of what he or she prefers you do for this client.

C

Which of the following children may be considered high risk for developing hypertension? Select all that apply. A. Has a history of epilepsy with weekly seizures B. Has a history of frequent sinus infections treated with antibiotics C. Recent scan showing a pheochromocytoma D. Diagnosed with coarctation of the aorta as an infant E. Takes cyclosporine daily since a kidney transplant

C, D, E

Which complication of acromegaly can be life threatening?

Cardiac structures increase in size

_____________________ is the result of restricted movement of the muscle and will inhibit ventricular contraction. The conduction is intact, but there will be little or no SV.

Cardiac tamponade

Which types of leukemias originate from the B cells? Select all that apply.

Chronic lymphocytic leukemia Acute lymphocytic leukemia

In which conditions are Bence Jones proteins not found in the lab analysis? Select all that apply.

Chronic myelogenous leukemia Hodgkin lymphoma Chronic lymphocytic leukemia

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

Class III

Which individual is at greatest risk for developing a venous thrombosis resulting from venous stasis?

Client on bed rest

A nurse is teaching a client about nutritional components needed for erythropoiesis. Which vitamin/mineral is essential for DNA synthesis and nuclear maturation of a red blood cell?

Cobalamin

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

Congenital defects are a risk factor. Inotropic agents such as digoxin may be used in children. Symptoms include tachypnea and tachycardia.

Which disorder is a result of excess cortisol?

Cushing syndrome

A 16-year-old girl has been brought to her primary care provider by her mother due to the daughter's recent malaise and lethargy. Which of the following assessments should the clinician perform in an effort to confirm or rule out infectious mononucleosis? A. Assessing the client's cranial nerve reflexes B. Assessing the client for bone pain C. Auscultating the client's lungs D. Palpating the client's lymph nodes

D

A client's primary care provider has added 20 mg of Lasix (furosemide) to his medication regimen to treat his primary hypertension. How does this agent achieve its therapeutic effect? A. By blocking the release of antidiuretic hormone from the posterior pituitary B. By inhibiting the conversion of angiotensin I to angiotensin II C. By inhibiting the movement of calcium into arterial smooth muscle cells D. By decreasing vascular volume by increasing sodium and water excretion

D

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? A. Lymphocyte—phagocytosis B. Monocytes—release heparin C. Basophils—engulf antigens D. Eosinophils—allergic reactions

D

Sinus arrhythmias will have a greater affect on the total heart than atrial arrhythmias because________. A. the sinus node will directly cause a fibrillation B. they will not be different, and each is equally harmful C. the sinus node will not activate the atrioventricular node D. the sinus node will stimulate the rest of the heart directly into a new rhythm

D

The client is an average-sized adult and has abnormal microcytic hypochromic red blood cells due to a long-term, chronic disease. Which of the following complete blood count (CBC) results is characteristic of her type of anemia? A. Band cells 3000/mL B. Reticulocytes 1.5% C. Hematocrit 44% D. Hemoglobin 8 g/dL

D

Which of the following clients is most susceptible to experiencing the effects of inadequate erythropoiesis? A client: A. Who recently experienced an ischemic stroke and who remains bedridden B. Whose heavy alcohol use has culminated in a diagnosis of pancreatitis C. Whose estimated blood loss during recent surgery was 700 mL D. Who has developed renal failure as a result of long-standing hypertension

D

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 occurence? Select all that apply.

Decreased diastolic pressure Increased systolic pressure Widened pulse pressure

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

Diastolic dysfunction

A week after starting atorvastatin for high cholestrol, the client returns reporting bleeding from the mouth (mucous membranes) and nose. What priority intervention should the health care provider perform?

Discontinue the atorvastatin immediately.

A client has been diagnosed with runs of intermittent ventricular tachycardia where the client loses consciousness and needs to be stimulated to recovery. Knowing this history, the nurse will educate the client about which treatment intervention/procedure that will depolarize the heart to allow the sinoatrial node to regain control of the heart?

Education involving automatic implantable cardioverter-defibrillators implantation

Which are primary treatment options for a client with acute venous thrombosis? Select all that apply.

Elastic support Application of heat Bed rest

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

Management of hyperthyroidism would include which interventions? Select all that apply.

Eradication of the gland with radioactive iodine Drug therapy directed toward decreasing the gland's function Surgical removal of part of the gland or the entire gland

Manifestations of anemia are dependent upon the causative factor in the initiation of the disease. T or F?

F

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

Factor V gene mutation

An excessive amount of TSH released by the pituitary can cause a primary disorder of the thyroid gland.

False

Atrial fibrillation is a benign condition. T or F?

False

Each hemoglobin protein binds to one oxygen. T or F?

False

Electronic pacemakers permanently replace the heart's conduction system. T or F?

False

Orthostatic hypertension is an abnormal drop in blood pressure on assumption of the standing position. T or F?

False

Platelets originate in the spleen as megakaryocytes. T or F?

False

Scurvy causes bleeding disorders via protein wasting. T or F?

False

The percentage of reticulocytes (normally approximately 10%) provides an index of the rate of red cell production. T or F?

False

Thrombocytopenia results from a decrease in platelet production, increased sequestration of platelets in the spleen, or increased platelet survival. T or F?

False

Venous stasis is one of many risk factors for atherosclerosis. T or F?

False

A 25-year-old female client exhibits exophthalmos of both eyes. The health care provider recognizes this as a manifestation of:

Graves disease

What is the most important factor in myocardial oxygen demand?

Heart rate

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

Select the option that best describes the pathogenesis of the anemia in a client with beta-thalassemia.

Heinz bodies impair DNA synthesis and damage the red blood cell (RBC) membrane.

___________ measures the volume of red cell mass in 100 mL of plasma volume.

Hematocrit

The nurse is studying hemostasis. She knows that which statements are true? Select all that apply.

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

The pathologist notes that the client has Reed-Sternberg cells. He knows that these cells are a diagnostic hallmark for which disorder?

Hodgkin lymphoma

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

Hypertension

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

Hyperthyroidism Fever Pain Blood loss

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

Hypotension

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? Select all that apply.

Hypovolemia Obstruction of blood flow Maldistribution of blood flow

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

Immediate defibrillation

The nurse is reviewing hospital discharge instructions with a client who has been diagnosed with secondary thrombocytosis and who also suffers from chronic ulcerative colitis, making anticoagulation inadvisable. The nurse stresses that the client should avoid: Select all that apply.

Immobilization Smoking Oral contraceptives

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

In the morning before arising from bed

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.

Inactive lifestyle High salt consumption Obesity

In which atrioventricular (AV) conduction disorder 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

Select the most appropriate intervention for the nurse to teach a client diagnosed with distal symmetric neuropathy related to diabetes.

Inspect the feet for blisters daily

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

The diagnosis of type 1 diabetes would be confirmed by which principle?

Insulin is not available for use by the body.

Which therapies are part of the treatment for acute lymphocytic leukemia (ALL)? Select all that apply.

Intensification Maintenance Induction

A neonatal nurse is caring for a newborn that has been prescribed an injection of vitamin K to prevent possible bleeding. Lack of which physiologic finding in a newborn makes it necessary for the neonate to be given vitamin K?

Intestinal bacteria

A client who has had a right total knee replacement has experienced a moderate, non-life-threatening loss of blood during the procedure. Which type of blood replacement would be beneficial?

Intraoperative blood salvage

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

Iron

Which statement describes the greatest diagnostic limitation of an electrocardiogram (ECG)?

It documents only current cardiac function.

The nurse conducting a community education program on mononucleosis determines the participants are understanding the information when they make which statement? Select all that apply.

It is a self-limiting disorder. It is caused by the Epstein-Barr virus.

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

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

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 to which part of the body?

Left side of the heart to the right side of the heart

_____________________ is a genetic condition that results in rapid bone growth and late/absence of epiphyseal capping.

Marfan syndrome

The nurse is reviewing the client's laboratory data showing an increased mean corpuscular volume (MCV) and a normal mean corpuscular hemoglobin concentration (MCHC). The client most likely has which type of anemia?

Megaloblastic anemia

A 26-year-old female client has a neutrophil count of 750/μL (0.75 x 109/L). Which description best correlates with the neutrophil count?

Moderate neutropenia

______________________ involves an increase in serum levels of a single monoclonal immunoglobulin or its fragments.

Multiple myeloma

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

_______________ is inflammation of the heart muscle and conduction system without evidence of myocardial infarction.

Myocarditis

A nurse is teaching a client with newly diagnosed type 1 diabetes about the importance of blood glucose control to decrease the risk of which potential chronic complications of diabetes? Select all that apply.

Neuropathy Nephropathy Retinopathy Gastroparesis

Which manifestations regarding hypothyroidism are accurate? Select all that apply.

Onset of symptoms is gradual Anorexia Weight gain

Which interventions would be included in the plan of care for a client experiencing myxedema coma? Select all that apply.

Oxygen therapy to support ineffective respirations Reversal of hypoglycemia Initiation of thyroid replacement therapy Frequent monitoring of cardiac functions

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

Pericardial effusion

_____________ is pinpoint purplish-red spots.

Petechiae

________________ are important structural constituents of lipoproteins, blood clotting components, the myelin sheath, and cell membranes.

Phospholipids

The coagulation cascade is the third component of the hemostatic process. The other two are:

Platelet aggregation Vessel spasm

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 K+ moves outward across the cell membrane

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.

A client experiencing a sinus arrest would demonstrate which symptom or finding?

Prolonged periods of asystole demonstrated on an electrocardiogram

The nurse is conducting the initial assessment on a client with newly diagnosed Hodgkin lymphoma. Which symptoms should the nurse interpret as manifestation of the disease process? Select all that apply.

Pruritus Night sweats Weight loss

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 client presents to the emergency department reporting bilateral cyanosis and pallor of the fingers after being out in the cold weather for 5 minutes. The toes are of normal color. What is a potential diagnosis for this client?

Raynaud disease

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

Recency of onset Etiology Persistence of dysrhythmia

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

Septic Neurogenic Anaphylactic

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

Sinoatrial (SA) node

A client's history and physical documents the presence of an indolent lymphoma. The nurse plans care for which type of lymphoma?

Slow-growing

If you take insulin before bed but still wake up with high blood sugar levels, you have experienced the ___________________

Somogyi effect

The nurse is assessing a female client with a diagnosis of primary adrenal cortical insufficiency. Which manifestation should the nurse anticipate?

Sparse axillary and pubic hair

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

Staphylococcus aureus

The student is studying the body's lymphatic system. Which of the following is true of this system?

T lymphocytes travel to the thymus to complete the differentiation process.

The nurse is admitting a client who is documented to be in the terminal blast crisis phase of chronic myelogenous leukemia (CML). What interpretation should the nurse make, given this information?

The CML has evolved to acute leukemia.

Which clients are at risk for impaired normal red blood cell (RBC) destruction? Select all that apply.

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

A client is managing his type 2 diabetes with exercise and diet. He has a fasting blood sugar level (FBS) of 80 mg/dL (4.44 mmol/L) and a hemoglobin A1C of 5% (.05). Based on these findings, which of the following can the nurse assume?

The client is achieving normal glycemic control.

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

The nurse is educating a newly diagnosed client with Hashimoto thyroiditis who is to be discharged from the acute care facility. What should the nurse be sure to include in the education to prevent complications?

The client should be informed about the signs and symptoms of severe hypothyroidism and the need for early intervention.

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 newborn's signs and symptoms.

The inability of the immature liver to conjugate bilirubin

A nurse is monitoring a premature infant diagnosed with hyperbilirubinemia with a current bilirubin level of 200 μmol/L. What assessment finding would suggest to the nurse that the infant may be developing kernicterus?

The infant's muscle tone is rigid and she has lost interest in breast-feeding.

When it is determined that a client's red blood cells (RBCs) have a biconcave shape, what will be the nurse's reaction?

The nurse will be pleased, as that shape allows for increased oxygen diffusion.

Administration of Rh immune globulin has been ordered for a pregnant client who is at 28 weeks' gestation. The nurse should draw what conclusion from these data?

The risk of hemolytic disease of the newborn will be reduced.

Which degree of "heart block" results in decreased cardiac output and fainting?

Third-degree

What is the reason why bed rest and analgesics are expected treatments for infectious mononucleosis?

To relieve fever, headache, and sore throat

Which serum biomarker is highly specific for myocardial tissue?

Troponin

All cells of the heart are capable of setting conduction rhythm. T or F?

True

Clot retraction and clot dissolution are significant to hemostasis. T or F?

True

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

Uteroplacental insufficiency Recurrent fetal loss Pregnancy loss before the 10th week Hypertension during pregnancy

The nurse is caring for a client with chronic heart failure. Which drug category may be pescribed for acute heart failure to improve heart performance by decreasing preload?

Vasodilator drugs like nitroprusside

Which dysrhythmia is considered to be the most fatal and requires immediate treatment?

Ventricular fibrillation

Which medication is known to interfere with the body's ability to control bleeding? Select all that apply.

Warfarin Heparin NSAIDs

When RBCs are destroyed, the heme molecule is converted to __________ and transported to the liver.

bilirubin

The nurse evaluating the blood work of a client with chronic lymphocytic leukemia (CLL) notes the following: white blood count 22,000/μL (22 x 109/L); lymphocytes 90% (0.90); and hemoglobin 6 g/dL (60 g/L). The nurse should:

communicate to the physician an unexpected low hemoglobin.

In hematology neutropenia, granulocytopenia and others refer to ____________ circulating cells.

decreased

The manifestations of untreated congenital hyperthyroidism are referred to as cretinism. T or F?

false

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.

WBCs are formed from hematopoietic stem cells that differentiate into committed _____________________.

progenitor cells

A preventive measure to decrease the risk of developing rheumatic heart disease includes:

prompt diagnosis of streptococcal infections with a throat culture.

Cardiac arrhythmias develop in the ______________ period.

supernormal excitatory

β-adrenergic-blocking drugs act by blunting the effect of _______________ nervous system stimulation on the heart.

sympathetic

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.

Coagulation activated by the extrinsic pathway is initiated when:

there is release of thromboplastin from the injured vessel wall.

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

unconjugated bilirubin levels are not successfully reduced.


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