Cardio final

What should the nurse see first

Dvt or loc?

A patient's complete blood count shows a hemoglobin of 20 and a hematocrit of 54%. Which question should the nurse asked to determine possible causes of this finding?

Do you have any history of lung disease?

A client who has a chronic vitamin B 12 deficiency is admitted to the hospital. When obtaining the clients health history, which priority question does a nurse assess client?

Do you notice any changes in your memory?

Which patient statement to the nurse indicates a need for additional instruction about taking oral ferrous sulfate?

"I will call my health care provider if my stools turn black."

An older adult client with heart failure asks if she should get a flu shot. Which is the nurses best response?

"Yes, because of your heart failure you are at greater risk for complications."

The nurse is discussing immediate postoperative communication strategies with a client scheduled for a total laryngectomy. What information will the nurse include?

"You can use writing or a communication board to communicate."

A nurse teaches a client who has chronic obstructive pulmonary disease. Which statement related to nutrition should the nurse include in the clients teaching? Select all that apply.

1. Avoid drinking fluids just before and during meals. 2. Rest before meals if you have Dyspnea 3. Have about six small meals a day.

The nurse explains to a patient on a mechanical ventilator, that it is set on assist control mode, which means that the machine will: select all that apply

1. Deliver a set tidal volume. 2. Deliver a set number of breaths if the patient rates fall.

The nurse makes a visual aid differentiating between mild, moderate and severe anemia. Which signs and symptoms are manifestations of mild anemia? Select all that apply.

1. Palpitations. 2. Dyspnea on exertion.

What medical history information is significant to potential bleeding problems? Select all that apply.

1. Takes nonsteroidal anti-inflammatory drugs for the relief of arthritic pain four times a day. 2. Has hepatitis B. 3. Had a cardiac valve replaced six months earlier.

In assessing several patients at the outpatient clinic, the nurse identifies a patient who is at the greatest risk for cancer as

45 year old farmer from Texas, who has worked on his families cotton farm since the age of 12

Counting ventricular rate, and atrial rate

80 atrial, 60 ventricular

The nurse is teaching a client about his fenestrated tracheostomy tube. Which statement by the client indicates an accurate understanding of the tube?

A -"I'm glad I will still be able to talk with this tube in place."

After receiving the change of shift report which client will you assess first?

A 20 year old, with possible acute myelogenous leukemia who has just arrived on the medical unit

Which client does the nurse caution to avoid taking over the counter decongestions for manifestations of a cold or flu?

A middle-aged woman with hypertension

The nurse is caring for a patient with crushing injuries from an automobile accident is horrified to find the patient bleeding profusely from the nose, mouth and rectum, as well as from the injuries. The nurse assesses this emergency situation as:

Disseminated intravascular coagulation (DIC)

Patient has been admitted to the emergency department for a suspected drug overdose. His respirations are shallow with an irregular pattern with a rate of 12 per minute. The nurse interprets this respiration pattern as which of the following.

ANS: Hypoventilation

The client is ordered to be treated with Singulair. The nurse anticipates the client will experience what type of change in her laboratory values?

Abnormal liver function tests

Which lab test will the nurse use to determine whether the prescribed filgrastim (neupogen) is effective and treatment of a patient who is receiving chemotherapy for acute lymphocytic leukemia?

Absolute neutrophil count

Which laboratory result will the nurse expect to show a decreased value with a patient develops heparin induced thrombocytopenia

Activated partial thromboplastin time

A patient age 23 is admitted with enlarged lymph nodes, decreased production of RBCs thrombocytopenia, and a severe increase in his WBC count. A bone marrow aspiration shows abnormal lymphocytes present. These abnormalities are present in which disease?

Acute leukemia

Which of the following nursing actions included in the care plan for a patient with neutropenia is appropriate for the RN to delegate to an LPN?

Administering the ordered subcutaneous filgrastim injection

Which factors will the nurse consider when calculating the curb 65 score for a patient with pneumonia? Select all that apply.

Age Blood pressure Respiratory rate Presence of confusion Blood urea nitrogen (BUN) level

A nurse is assessing a client who has suffered a nasal fracture which assessment should the nurse perform first?

Airway patency

A client has COPD. In reviewing this client's laboratory values, the nurse would not be surprised to see.

An elevated RBC count

The nurse taking care of her patient who has been diagnosed with severe iron deficiency. She is aware that the patient will show signs of.

Anorexia, tachycardia, systolic murmur, hypotension, and tinnitus

The nurse is caring for a client with a complete heart block, also known as a third- degree AV block. What is the nurses priority intervention?

Begin external pacing

A client has heparin-induced thrombocytopenia (HIT). The student nurse asks how this is treated. About what drugs does the nurse instructor teach? (Select all that apply.)

Argatroban (Argatroban) Bivalirudin (Angiomax) Lepirudin (Refludan)

The nurse is caring for a patient with the chest of understands that which statement about Chest tube removal is correct

Ask the patient to perform the Valsalva maneuver as the practitioner remove the two

When assessing a patient with chronic lung disease, the nurse finds a sudden onset of agitation and confusion. Which action should the nurse take first?

Assess oxygenation using pulse oximetry.

A client has mucositis. What actions by the nurse will improve the client's nutrition? (Select all that apply.)

Assist with rinsing the mouth with saline frequently. Encourage the client to eat room-temperature foods. Provide local anesthetic medications to swish and spit. Remind the client to brush teeth gently after each meal.

The nurse setting up the environment for tracheal section on newly postop tracheostomy. Patient will: select all that apply.

Auscultate lungs for retained secretions. Wash hands and open Sterile suction kit. Don sterile gloves and prepare solutions from Kit. Perform section with sterile supplies.

The nurse is planning discharge teaching for a client who has acute myelogenous leukemia. Which instruction does the nurse include in the clients discharge plan?

Avoid contact sports

A patient who has just been admitted with pneumococcal pneumonia, has a temperature of 101.6° with a frequent cough and is complaining of severe pleuritic chest pain. Which of these prescribed medication should the nurse give first?

Azithromycin, Zithromax, macrolide

Miss Dauss is receiving a PEEP level of six while the mandatory frequency is turned off. Since the patient is breathing spontaneously, she is essentially on.

CPAP

Strip showing first-degree heart block, what do you do?

Cardiac work up

Atrial flutter? Give what medication?

Cardizem

The nurse assesses a client with pneumonia and notes Decrease lung sounds on the left side and decreased long expansion. What is the nurses best action?

Check oxygen saturation and notify the healthcare provider

An anemia, from dietary deficiency is most likely related to what condition?

Chronic alcoholism

Explain decreased surfactant

Collapse and compliance Alveoli will collapse, and lungs won't function properly

An older adult is admitted to the emergency department with respiratory symptoms. Which client symptoms requires the nurse to intervene immediately?

Confusion

The nurse is caring for a client with a new tracheostomy which assessment finding requires the nurses immediate action

Crackling sensation around the neck when skin is palpated.

Four hours after mechanical ventilation is initiated a patient ABG results include a pH of 7.51, PA 02 of 82, PaCO2 of 26, and HCO3 of 23. The nurse will anticipate the need to.

Decrease the respiratory rate

Which of the following are risk factors associated with acute leukemia?

Exposure to radiation Exposure to benzene Drugs like alkylating agents

A patient who's been receiving a heparin infusion and warfarin for a DVT is diagnosed with heparin induced thrombocytopenia. Which action would the nurse include in the plan of care?

Flush all intermittent IV lines using normal saline

A patient who is receiving methotrexate develops a megaloblastic anemia. The nurse will anticipate teaching a patient about increasing oral intake of

Folic acid

A nurse is teaching a client with B12 deficiency anemia to eat a diet high in this vitamin which meal selected by the client indicates that the client correctly understands that prescribe diet

Fried liver and onions, orange juice, spinach salad

The nurse is a obtaining a Health history from a client on an annual physical exam. Which documentation should be brought to the physicians attention?

Hoarseness for 2 weeks

Something about Epstein bar virus can cause

Hodgkin's

A nurse is educating high school students about avoiding risk factors for different diseases. When a teenager laughs off a recent infection with mononucleosis as a silly kissing disease, the nurse cautions him that mononucleosis is a risk factor for.

Hodgkin's disease

A 67-year-old client who is receiving chemotherapy for lung cancer is admitted to the hospital with thrombocytopenia. While you were taking the admission history, the client makes these statements. Which statement is the most concern?

I take one aspirin every morning because of my history of angina

The nurse is caring for a patient immediately Post operative after a left pneumonectomy. How should the nurse position the patient?

In a left sided lying position

The nurse assessing the CBC of a patient with chronic bronchitis, a.k.a. COPD identifies a typical feature of this disease, which is

Increase red blood cells

The nurse counsels a client with idiopathic thrombocytopenic purpura that if medication therapy is not effective the surgical procedure most likely to be used in the treatment is

Splenectomy

Atrial flutter select all that apply

Lidocaine Amiodarone. Hemodynamic monitoring. Cardiologist consult.

The nurse is performing a medication, history on a patient who reports long-term use of Singulair and an albuterol inhaler. The nurse will contact the provider to discuss an order for which laboratory test.

Liver function tests, and serum glucose

During care of the patient with multiple myeloma, it is important nursing intervention to

Maintain a fluid intake of 3 to 4 L a day

A patient who is lethargic and exhibits deep rapid, respirations has the following arterial blood gas results: pH 7.32, PaO2 88, PaCO2, 37, and HCO3 16. How should the nurse interpret these results?

Metabolic acidosis

The nurse administer his prescribed therapies for a patient with cor pulmonale and right sided heart failure. Which assessment could be used to evaluate the effectiveness of the therapies?

Observe for distended neck veins

The nursing intervention that will enhance the nutritional status of a patient with COPD is

Offering small, frequent meals

Which person is at greatest risk for developing a community acquired pneumonia?

Older adult who smokes and has a substance abuse problem

Which menu choice indicates that the patient understands the nurse is teaching about the best dietary choices for iron deficiency, anemia?

Omelette and whole wheat toast

A patient with chronic bronchitis who has a new prescription for Advair discus ask the nurse the purpose of using to drugs. The nurse explains that.

One drug decreases inflammation, and the other is a bronchodilator

Which statement by the nurse when explaining the purpose of positive end-expiratory pressure to the patient's caregiver is accurate?

PEEP prevents the lung air sacs from collapsing during exhalation

The nurses in the emergency department receive arterial blood gas results for four recently admitted patients with obstructive pulmonary disease. The results for which patient will require the most rapid action by the nurse?

PH 7.28 PaCO2 50 PaO2, 58

Which clinical manifestations will the nurse expect to find when assessing a patient with oral mucositis? select all that apply

Pain. Irritation. Ulceration.

You're making a room assignment for a newly arrived patient who's laboratory test results indicate pancytopenia. Which patient will be the best roommate for this new patient.

Patient with digoxin toxicity

When assessing the patient with thrombocytopenia, the nurse observes for

Petechiae on the skin and bleeding gums

A home healthcare nurse makes an initial call on a newly diagnosed Hispanic tuberculosis. Patient who lives at home with his wife and child would give special instruction for infection control to? Select all that apply.

Play contaminated tissues in sealable plastic bag Take prescribed drugs as directed without fail. Wash hands frequently Wear mask when in crowds

Which collaborative problem will the nurse include in a care plan for a patient admitted to the hospital with idiopathic aplastic anemia

Potential complication: infection

When teaching a client who has multiple myeloma about self-care in the home, the nurse should advise the client and family take appropriate precautions to

Prevent fractures

Your client is status post total laryngectomy, and cannot talk. What intervention should you make to help this client communicate?

Provide alternative methods of communication.

What is the best way for the nurse to decrease the risk of ventilator associated pneumonia and a ventilator dependent client? Select all that apply.

Provide frequent oral care. Keep the head of the bed elevated. Maintain good hand hygiene.

In preparing discharge plans for a patient recently diagnosed with pernicious anemia, the nurse must include information regarding

Providing sufficient rest periods Throughout the day.

During a teaching session for a patient who will be receiving a new prescription for Singulair, the nurse will tell the patient that the drug has had which therapeutic effect?

Reduces inflammation in the air way

The nurse is caring for a patient who is taking radiation treatments. The patient has a platelet count of 100,000. Which action is most important for the nurse to add to the patient's care plan?

Remove the clutter from the patient's room

A patient who has a right sided chest tube, following a thoracotomy has continuous bubbling in the suction control chamber of the collection device. The most appropriate action by the nurse is to.

Take no further action or continue monitoring device

The patient is admitted to the emergency department with establishing to the right chest. Eric can be heard entering his chest with each inspiration. To decrease the possibility of a tension pneumothorax in a patient the nurse should.

Tape, a non-porous dressing on three sides over the chest wound

A 64-year-old patient with newly diagnosed acute myelogenous leukemia who is undergoing induction therapy with chemotherapeutic agents tells the nurse: I feel so sick that I don't know if the treatment is worth completing. The nurses best response to the patient is.

The chemotherapy is difficult, but it is necessary to put the disease into remission and give you time to make choices about your life

In the preoperative teaching plan for a client scheduled for total laryngectomy and radical neck resection the nurse would give highest priority to

The client not being able to speak normally again

A client has Folick acid deficiency anemia. Which information in the nursing history would be of concern to the nurse?

The client takes metformin

The patient with sleep apnea is fitted with a CPAP mask and ask the nurse how This device will help. How should the nurse respond?

The device delivers constant positive pressure to keep your airway open

The unlicensed assistive personnel ask the primary nurse how does someone get hemophilia a? Which statement would be the nurses best response?

The mother carries the gene and gives it to the sOn

Which assessment finding should the nurse caring for a patient with thrombocytopenia communicate immediately to the healthcare provider?

The patient is difficult to arouse

During preoperative teaching for the patient scheduled for a total laryngectomy. What should the nurse include?

The postoperative use of nonverbal communication techniques

The ambulatory care nurse would arrange for periodic monitoring of blood levels for a client with COPD, who is beginning to use

Theophylline (theo-dur)

A nurse assess a client who has a mediastal chest tube. Which symptoms require the nurses immediate intervention? Select all that apply.

Tracheal deviation. Sudden onset of shortness of breath. Drainage greater than 70 mL per hour. Disconnection at Y site Possibly changed answer choice to drainage of 225 cc in the first 45 minutes and emphysema

A patient is in a third-degree, heart block and a symptomatic. The treatment for this patient is which of the following? Select all that apply.

Transcutaneous, transvenous pacing, dopamine

The nurse is educating a patient about his diagnosis of stage two Hodgkin disease. Which statement indicates that the nurse is teaching has been successful?

Two nodes in my left arm area are affected

During change of shift report on a medical unit, the nurse learns that a patient with aspiration pneumonia, who was admitted with respiratory distress has become increasingly agitated. Which action should the nurse take first?

Use pulse oximetry to check the oxygen saturation.

What teaching is appropriate for a client with acute rhinitis and sinusitis? Select all that apply.

Using hot packs over the sinuses Saline irrigations Taking echinacea

The primary healthcare provider is about to remove a chest tube from a client. Once the dressing is removed, and the sutures have been cut, the nurse assisting the primary healthcare provider asks the client to do what action?

Valsalva maneuver

The nurse is caring for a 30 year old American Indian female, who is taking rifater a drug containing rifampin, isoniazid, and pyrazinamide. The patient asks how long she will have to take the medication. Which response explains when the patient may discontinue the medication?

When two or three consecutive sputum cultures are negative

A patient age 68 has a long history of COPD and is admitted to the hospital with cor pulmonale. He says his doctor said his heart was feeling and asked whether he's having a heart attack. Which explanation by the nurse is most correct?

You aren't having a heart attack but your heart has been damaged by changes in your lungs caused by your respiratory disease

The nurse interprets which arterial blood gas values as partially compensated metabolic acidosis?

c. pH 7.32, HCO3- 17 mEq/L, PCO2 25 mm Hg, PO2 98 mm Hg

Which therapeutic effect of atropine is expected after administration?

increased heart rate

The nurse is alerted to a clients telemetry monitor. After assessing the following ECG what is the nurses priority intervention?

perform defibrillation The ECG is showing ventricular fibrillation

The patient has been admitted for possible carcinoma of the larynx. The first sign or symptom that may be present in carcinoma of the larynx is often.

persistent hoarseness

A 62-year-old. Patient is seen in the emergency department with an epistaxis. When a patient has an epistaxis, the correct nursing interventions would be

place the patient in Fowler's position with the head forward.

The nurse is assessing a patient who coughed up pink frothy sputum several times during the day. What is the probable cause for this finding

pulmonary edema