Concepts: Med Surg- Cardiovascular and Hematology

- Potassium 2.8 mEq/L - Digoxin level 0.7ng/mL - Hemoglobin 11.5g/dL - Calcium 8.0 mg

A nurse if caring for a client who has heart failure and is lethargic with muscle weakness. The client's telemetry reading displays dysrhythmias. Which of the following laboratory results should the nurse anticipate?

- Pitting edema - Areas of reddish-brown pigmentation - Cool, pale skin with minimal body hair - Sunburned appearance with desquamation Cool, pale skin with minimal body hair

A nurse in a clinic is collecting data from a client who has a history of peripheral arterial disease. Which of the following findings on the clients lower extremities should the nurse expect?

- Weigh the client weekly - Monitor the client for ototoxicity - Place the client on a 24 hour urine collection analysis - Monitor for hypoglycemia Monitor the client for ototoxicity

A nurse is administering a loop diuretic to a client who has a 3+ pitting edema in the lower extremities. Which of the following actions should the nurse take?

- the client reports chest pain when at rest - nitroglycerin relives chest pain - physical exertion does not precipitate chest pain -chest pain lasts less than 5 min the client reports chest pain when at rest

A nurse is assisting in collecting data from a client who has a history of unstable angina. Which of the following findings should the nurse expect?

- Verify the information on the packed RBC's with another nurse - Administer the packed RBC's through an 18 gauge IV catheter - Infuse the packed RBCs over 2 hours - Allow the packed RBCs to warm at room temp for 1 hour before starting the transfusion Verify the information on the packed RBCs with another nurse

A nurse is assisting in developing the plan of care for an older adult client who is to receive a unit of packed red blood cells. Which of the following actions should the nurse recommend?

- infective endocarditis - pericarditis - ventricular dysrhthmias - pulmonary emboli ventricular dysrhythmias

A nurse is assisting in monitoring a client who had a myocardial infarction. For which of the following complications should the nurse monitor in the first 24 hours?

-Administer antihypertensive medication for blood pressure. - Monitor the urinary output is 20mL/gr. - Withhold pain medication to prepare for surgery - Take vital signs every 2 hours. Administer antihypertensive medication for blood pressure.

A nurse is assisting in the care of a client who has an abdominal aortic aneurysm and is scheduled for surgery. The client's vital signs are blood pressure 160/98 mm HG, heart rate 102/min, respirations 22/min, and SpO2 95%. Which of the following actions should the nurse take?

- 0.45% sodium chloride - Dextrose 5% in 0.9% sodium chloride -Dextrose 10% in water - 0.9% sodium chloride 0.9% sodium chloride

A nurse is assisting in the care of a client who is in hypovolemic shock. While waiting for a unit go blood, the nurse should plan to administer which of the following IV solutions?

- Reinforce teaching with the client about a long term conditioning program - Administer scheduled doses of acetaminophen - Check for peak laboratory markers of myocardial damage - Initiate an aspirin regimin Initiate an aspirin regimen

A nurse is assisting in the plan of care for a client who is having a percutaneous transluminal coronary angioplasty (PTCA) with stent placement. Which of the following actions should the nurse anticipate in the postoperative plan of care?

- Hang an IV infusion of 0.9% sodium chloride with the blood - Check the client's ID number with the number on the blood - Witness the informed consent - Prepare the blood with a Y-type infusion set Witness the informed consent

A nurse is assisting in the preparation of a unit of packed red blood cells for a client who has anemia. Which of the following actions should the nurse take first?

- Wheeze - Coarse crackles - Rhonchi - Friction rub Coarse crackles

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

- Place the client in low fowler's position - Assist the client to use the incentive spirometer every 4 hour - Weight the client every other day - Enforce fluid restrictions enforce fluid restrictions

A nurse is caring for a client who has advanced heart failure. Which of the following actions should the nurse take?

-Obtain blood samples to test platelet function - prepare for replacement of the missing clotting factor - Administer aspirin for the client's pain - Place the bleeding joint in the dependent position 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?

- weight gain of 1 kg (2.2 lbs) in 1 day - pitting edema +1 - client reports nocturnal cough - b-type natriuretic peptide (BNP) of 100/pg/ml weight gain of 1 kg in a day

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

-Position the client supine with his legs elevated when in bed. - Encourage the client to ambulate for 15 min every hour while awake for the first 24 hr - Tell the client to sit with his legs dependent after ambulating. - Reinforce with the client that he should wear knee-length socks for 2 weeks after surgery. Position the client supine with his legs elevated when in bed.

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

-Check for hypoertension - Auscultate for loud, bounding heart sounds - Auscultate blood pressure for pulses paradoxus - Check for a pulse deficit Auscultate blood pressure for pulses paradoxus

A nurse is checking for cardiac tamponade on a client who has pericarditis. Which of the following actions should the nurse take?

- Hypokalemia - Lead Poisoning - Hypercalcemia - Elevated bilirubin Elevated bilirubin

A nurse is checking laboratory values for an adult client who has sickle cell anemia and is in crisis. For which of the following complications should the nurse monitor?

- Midsternal chest pain - Thrill - Pitting edema in lower extremities - Lower back discomfort Lower back discomfort

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

- JVD - Moist crackles - Postural hypotension - Increased heart rate - Fever - JVD -Moist crackles - Increased heart rate

A nurse is collecting data from a client who has fluid volume overload resulting from a cardiovascular disorder. Which of the following manifestation should the nurse expect?

-Plethoric appearance of facial skin - Glossitis and weight loss - Jaundice with an enlarged liver -Petechiae and ecchymosis petechiae and ecchymosis

A nurse is collecting data from a client who has manifestations of aplastic anemia. Which of the following findings should the nurse expect?

- Bradycardia - Relief of chest pain with deep inspiration - Dyspnea - Chest pain that increases when sitting upright Dyspnea

A nurse is collecting data from a client who has pericarditis. Which of the following manifestation should the nurse expect?

-decreased capillary refill - dyspnea -dizziness - dependent edema dependent edema

A nurse is collecting data from a client who has right sides heart failure. Which of the following findings should the nurse expect?

-Omega-3 fatty acids - Antioxidants - Vitamins A, D, and C - Beta-carotene Omega 3 fatty acids

A nurse is collecting data from 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?

- Administer ferrous sulfate supplementation - Increase dietary intake of folic acid -Initiate weekly injections of vitamin B12 - Initiate a blood transfusion

A nurse is contributing to the plan of care for a client who has pernicious anemia. Which of the following interventions should the nurse recommend?

- WBC count - Prothrombin time - Platelet count - Hematocrit Prothrombin time

A nurse is evaluating a client's repeat laboratory results 4 hours after administering fresh frozen plasma. Which of the following lab values should the nurse review?

- Maintain the IV access with 0.9% sodium chloride -Stop the infusion of blood - Send the blood container and tubing to the blood bank - Obtain a urine sample Stop the infusion of blood

A nurse is monitoring a client who is receiving a unit of packed red blood cells (RBCs) following surgery. The client reports itching and has hives 30 min after the infusion begins. Which of the following actions should the nurse take first?

10 gtt/min

A nurse is preparing to transfuse 250 mL of packed RBCs to a client over 4 hours. Available is a blood administration set that delivers 10 get/mL. The nurse should set the manual blood transfusion to deliver how many gtt/min?

-"avoid lifting both arms above your head when dressing" -"use your cell phone on the same ear as the pacemaker site is located" -"avoid travel by airplane" -"hiccups are an expected outcome of having a pacemaker" avoid lifting both arms above your head when dressing

A nurse is reinforcing discharge teaching with a client who has a new permanent pacemaker. Which of the following information should the nurse include in the teaching?

- "I should eat foods high in saturated fat" - "Before taking my medication, I will check my blood pressure and radial pulse rate" - " I will exercise once a week for an hour at the health club" - "I will stop taking my medication when my blood pressure is within normal range" "Before taking my medication I will check my blood pressure and radial pulse rate"

A nurse is reinforcing teaching about lifestyle changes with a client who had a myocardial infarction and has a new prescription for a beta blocker. Which of the following client statements indicates an understanding of the teaching?

- Hospitalization is required when administering each treatment - The maximum effect of the medication will occur in 6 months - Hypertension is a common adverse affect of this medication - Blood transfusion are needed with each treatment Hypertension is a common adverse affect of this medication

A nurse is reinforcing teaching with a client who has anemia and a new prescription for epoetin alfa. Which of the following information should the nurse include in the teaching?