Cardiovascular and Hematology ATI

A nurse is preparing to infuse a blood transfusion using packed cells (250 mL) to a client in a 4 hr. The blood set delivers 10 gtts per mL. What is the proper drip rate to use for the unit of packed cells?

10 gtt/min

A nurse is planning 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 postprocedure plan of care? A) instruct the client on long-term cardiac conditioning program B) administer scheduled doses of acetaminophen C) check for peak laboratory markers of myocardial damage D) Monitor for bleeding

D) Monitor for bleeding Bleeding is a postprocedure complication of PTCA because of the administration of heparin during the procedure and the removal of the femoral sheath

A nurse is caring for a client diagnosed with angina pectoris and is scheduled to undergo a PTCA. the nurse explains to the client that PTCA is used to do which of the following?

Dilate an obstructed coronary artery

A nurse is caring for a client with dyspnea who is diagnosed with having CHF related to mitral stenosis. The nurse is aware the cause of dyspnea is due to which of the following?

Fluid accumulation in the lungs

A nurse assess a client who has fluid volume excess. Which of the following manifestations indicate fluid volume excess?

Jugular vein distension Decreased hematocrit Increased heart rate Moist crackles

A nurse is caring for a client experiencing an acute angina attack. The nurse should monitor the client for which of the following?

Transient abnormal PMI (point of maximal impulse)

A nurse is caring for a client who had a MI 24 hr ago. At this time, it is essential for the nurse to look for which of the following?

Ventricular dysrhythmias

A nurse is providing teaching about lifestyle changes to a client who has a MI and has a new prescription for a beta blocker. 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 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/min, RR 22/min, and SpO2 95%. Which of the following actions should the nurse take? a. administer antihypertensive medication for BP b. monitor that urinary output is 20 mL/hr c. withhold pain medication to prepare for surgery d. take vital signs every 2 hr

a. administer antihypertensive medication for BP

A nurse is caring for a client 5 days following a myocardial infarction (MI). the client has a sudden onset of shortness of breath. The nurse notes that the client appears air hungry and is coughing frothy, pink sputum. When auscultating the client's breath sounds, the nurse expects to hear which of the following bilateral sounds? a. coarse crackles b. wheezes c. rhonchi d. friction rub

a. coarse crackles

A nurse is caring for a client following a vein ligation and stripping for varicose veins. Following this surgery, the nurse should know to place the client in which positions? a. position the client supine with his legs elevated when in bed. b. encourage the client to ambulate for 15 min every hour while awake for the first 24 hr. c. tell the client to sit with his legs dependent after ambulating. d. instruct the client to wear knee-length socks for 2 weeks after surgery.

a. position the client supine with his legs elevated when in bed.

A nurse is caring for a client with CHF whose EKG shows a flattening of the T wave. Which of the following laboratory results should the nurse anticipate with the EKG change? a. potassium 2.8 mEq/L b. digoxin level 0.7 ng/mL c. hemoglobin 9.8 g/dL d. calcium 8.0 mg

a. potassium 2.8 mEq/L

A nurse administered a transfusion of fresh frozen plasma (FFP) to a client. Four hours later, the client has repeat laboratory work drawn. which value should the nurse analyze to evaluate the client's response to the transfusion? a. prothrombin time b. WBC count c. platelet count d. hematocrit

a. prothrombin time

A nurse is caring for a client on telemetry who has an irregular radial pulse. The progress notes say that the client has had atrial flutter. Which EKG pattern does the nurse recognize as corresponding to atrial flutter? a. P waves occurring at 0.16 seconds before each QRS complex. b. atrial rate of 300/min with QRS complex of 80/min. c. ventricular rate of 82/min with an atrial rate of 80/min. d. an irregular ventricular rate of 125/min with a wide QRS pattern.

b. atrial rate of 300/min with QRS complex of 80/min.

A nurse is monitoring 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? a. increased cardiac output b. increased pulmonary congestion c. decreased left atria pressure d. decreased pulmonary artery pressure

b. increased pulmonary congestion

A nurse is assessing for cardiac tamponade on a client who had a coronary artery bypass grafts. Which of the following actions should the nurse take? a. check for hypertension b. auscultate for loud, bounding heart sounds c. auscultate BP for pulsus paradoxus d. check for a pulse deficit

c. auscultate BP for pulsus paradoxus

A nurse in a clinic is assessing the lower extremities and ankles of a client who has a hx of PAD. Which of the following findings should the nurse expect? a. pitting edema b. areas of reddish-brown pigmentation c. dry, pale skin with minimal body hair d. sunburned appearance with desquamation

c. dry, pale skin with minimal body hair

A nurse is caring for a client with pericarditis. Which of the following manifestations should the nurse expect to find on assessment? a. bradycardia with S-T segment depression b. relief of chest pain with deep inspiration c. dyspnea with hiccups d. chest pain that increases when sitting upright

c. dyspnea with hiccups

A nurse is caring for a client with pernicious anemia. The nurse should know that to treat this condition, the client will require which of the following? a. administer ferrous sulfate supplementation. b. increase dietary intake of folic acid. c. initiate weekly injections of vitamin B12. d. initiate a blood transfusion.

c. initiate weekly injections of vitamin B12.

A nurse is monitoring a client who had a myocardial infarction. For which of the following complications should the nurse monitor in the first 24 hr? a. ineffective endocarditis b. pericarditis c. ventricular dysrhythmias d. pulmonary emboli

c. ventricular dysrhythmias

A nurse is preparing to transfuse a unit of packed RBC's to a client who has anemia. Which of the following actions should the nurse take first? a. hang an IV infusion of 0.9% sodium chloride with the blood. b. check the client's identification number with the number on the blood. c. witness the informed consent. d. obtain pretransfusion vital signs.

c. witness the informed consent.

A nurse is caring for a client with suspected hypovolemic shock. Which solution is appropriate for the nurse to administer in this circumstance? a. 0.45% sodium chloride b. dextrose 5% in 0.9% sodium chloride c. dextrose 10% in water d. 0.9% sodium chloride

d. 0.9% sodium chloride

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? a. chest pain is relieved soon after resting. b. nitroglycerin relieves chest pain. c. physical exertion does not precipitate chest pain. d. chest pain lasts longer than 15 min.

d. chest pain lasts longer than 15 min.

A nurse is caring for an adult client with sickle cell disease who has a history of having received many transfusions. The nurse realizes that b/c of his history, the client is at risk for which of the following? a. hypokalemia b. lead poisoning c. hypercalcemia d. iron toxicity

d. iron toxicity

A nurse is caring for a client with aplastic anemia. The nurse expects the client to have which of the following symptoms? a. plethoric appearance of facial skin b. glossitis and weight loss c. jaundice with an enlarged liver d. petechiae and ecchymosis

d. petechiae and ecchymosis