Exam 3

The nurse is expecting the following interventions for a patient with PUD as part of the care plan?

All of the above

The nurse is assessing a patient with a bleeding duodenal ulcer. When examining the patient's stool, which characteristic would the nurse be most likely to find?

Black and tarry appearance

A client undergoes a biopsy of a suspicious lesion. The biopsyreport classifies the lesion according to the TNM staging systemas Tis, N0, M0. What does this classification mean?

Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis

Doxorubicin and daunorubicin are used for what purpose?

Chemotherapeutic agents that cause cardiac impairment

A patient is prescribed a histamine (H2) receptor antagonist. The nurse understands that this might include which medications?

Cimetidine, Fimotidine, Ranitidine

Which is a true statement regarding hospice care?

Clients have a life expectancy of 6 months or less

What is one of the clinical manifestations of GERD?

Dysphagia

Red blood cells are very vital for survival. Which statement below is NOT correct about red blood cells?

Extreme loss of red blood cells can lead to a suppressed immune system and clotting problems.

The nurse is aware that hemorrhage is a common complication of PUD. Therefore, assessment for indicators of bleeding is an important nursing responsibility. Which of the following are indicators of bleeding?

Hematemesis, confusion, tachycardia

Which term refers to the symptom of gastroesophageal reflux disease (GERD) which is characterized by a burning sensation in the esophagus?

Pyrosis

Erythropoietin growth factor increases production of which of the following?

Red blood cells

A patient has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the patient has developed stomatitis?

Red, open sores on the oral mucosa

A patient started receiving their first unit of blood at 1000. It is now 1010 and the patient is reporting itching, chills, and a headache. In addition, the patient's temperature is now 99.8'F from 98'F. Your next nursing action is:

Stop the transfusion

What are mannitol and lasix used for in relation to renal impairment?

Used to promote diuresis

The nurse is caring for a patient with chronic gastritis. The nurse knows this patient is at risk for which vitamin deficiency?

Vit B12

You're gathering supplies to start a blood transfusion. You will gather?

Y-tubing with in-line and 0.9% Normal Saline

If cancer has spread outside of lobule or duct it is considered..

invasive

Before starting a blood transfusion the nurse will perform a verification process with__________. This will include?

licensed personnel only (another RN); physician's order, patient's identification, blood bank's information, patient's blood type and donor's type along with Rh factor, expiration date, assess the bag of blood for damage or abnormal substances

You've started the first unit of packed red blood cells on a patient. You stay with thepatient during the first 15 minutes and:

run the blood at 20 mL/min and then increase the rate after 15 minutes, if tolerated by the patient

The nurse tells a breast cancer patient that he is going to prescribe hormone therapy that has been found to significantly reduce mortality. Which drug would most likely be prescribed?

tamoxifen

As the nurse you know that there is a risk of a transfusion reaction during the administration of red blood cells. Which patient below it is at most RISK for a febrile (non-hemolytic) transfusion reaction?

A 42 year old female who is immunocompromised.

According to the American Association of Blood Banks, what is the recommended hemoglobin level for a blood transfusion?

7-8 g/dL

A patient with PUD has H-Pylori and must begin triple medication therapy. Which drug regimen is appropriate and for how long?

2 antibiotics & a PPI, 10-14 days

Your patient needs 1 unit of packed red blood cells. You've completed all the prep and the blood bank notifies you the patient's unit of blood is ready. You send for the blood and the transporter arrives with the unit at 1200. You know that you must start transfusing the blood within:

30 minutes

A patient who needs a unit of packed red blood cells is ordered by the physician to be premedicated with oral diphenhydramine and acetaminophen. You will administer these medications?

30 minutes before starting the transfusion

JP Drain

5-10ccs per 8hrs; 15-30cc fluid/24 hours

Your patient is having a transfusion reaction. You immediately stop the transfusion. Next you will:

Disconnect the blood tubing from the IV site and replace it with a new IV tubing set-up and keep the vein open with normal saline 0.9%.

When treating anemia due to myelosuppresion, what can you expect the HgB and HcT increase to be when transfusing PRBCs?

HcT increases 3% per unit of PRBC, HgB increases 1gm per unit of PRBC

You're providing care to a 36 year old male. The patient experienced abdominal trauma, and in the ED had a hemoglobin of 7 g/dL and recently received 2 units of packed red blood cells. The next day you are assessing the patient's morning lab results. Which lab result below demonstrates that the blood transfusion was successful?

Hemoglobin level 9 g/dL

A patient is receiving 1 unit of packed red blood cells. The unit of blood will be doneat 1200. The patient is scheduled to have IV antibiotics at 1000. As the nurse you will:

Hold the antibiotic until the blood transfusion is done

What is administered when a patient with myelosuppression is experiencing thrombocytopenia?

Interleukin II tranfusion w/ platelets

A patient with esophageal cancer is to receive 2 units of PRBCs (packed red blood cells). A PICC line is inserted by the physician. The nurse knows that the primary reason for using a central line when available is that:

It decreases the chance of the vein collapsing

The nurse administers serum albumin to a patient to assist in:

Maintenance of oncotic pressure

A patient with O+ blood received A+ blood. The patient is at risk for?

None: O+ and A+ are compatible blood types

What solution or solutions below are compatible with red blood cells?

Normal saline

Before initiating the blood transfusion, you obtain the patient's baseline vital signs, which are: heart rate 100, blood pressure 115/72, respiratory rate 18, and temperature 100.8'F. Your next action is to:

Notify the physician before starting the transfusion.

A patient is ordered to receive 2 units of packed red blood cells. The first unit was started at 1400 and ended at 1800. You send for the other bag of red blood cells. As the nurse you know it is priority to:

Obtain a new y-tubing set for this unit of blood

Diagnostic imaging and a physical exam have revealed that a patient with PUD has suffered a perforated ulcer. The nurse recognizes that the patient is at risk for which of the following conditions?

Peritonitis

Palliation refers to...

Relief of symptoms associated w/ cancer

What is the purpose of a sentinel node biopsy?

Surgical procedure where dye is injected into lymph nodes that shows which lymph nodes receive the most drainage from the affected breast

Before a blood transfusion you educate the patient to immediately report which of the following signs and symptoms during the blood transfusion that could represent a transfusion reaction: -sweating, chills, hives, poikilothermia, tinnitus, headache, back pain, pruritis, paresthesia, SOB, nausea

Sweating, chills, hives, headache, back pain, pruritis, SOB, nausea

A nurse is providing care for a patient with Peptic Ulcer Disease (PUD) is going to be treated with a Bilroth I procedure (gastroduodenostomy). The nurse should address what topic when providing health education?

The procedure carries a risk of dumping syndrome

What is the purpose of gabapentin (Neurontin)?

Used to treat neuropathic pain