ATI Medical-Surgical: Cardiovascular and Hematology questions

A nurse is caring for a client who has emphysema & chronic respiratory acidosis. the nurse should monitor the client for which of the following electrolyte imbalances? A. Hyperkalemia B. Hyponatremia C. Hypercalcemia D. Hypomagnesemia

A. Hyperkalemia

A nurse is providing discharge teaching for a client who had a bone marrow transplant & has thrombocytopenia. Which of the following statements indicates that the client understands the precautions he must take home? A. I'll stick with soft foods for now B. my family will be bringing me fresh flowers today C. I'll use a new disposable razor each day D. I'll blow my nose more often to avoid nosebleeds

A. I'll stick with soft foods for now

A nurse is examining the ECG of a client who is having an acute myocardial infarction. The nurse should identify that the elevated ST segment on the ECG indicate which of the following? A. Necrosis B. hypokalemia C. hypomagnesemia D. Insufficiency

A. Necrosis

A nurse is completing a medication history for a client who is reports using fish oil as al dietary supplement. Which of the following substances in fish oil should the nurse recognize as a health benefit to the client? A. Omega-3 fatty acids B. Antioxidants C. Vitamins A, D, C D. Beta-carotene

A. Omega-3 fatty acids

A nurse is administering a unit of pack red blood cells (RBCs) to a client who is postoperative. The client reports itching & hives 30 minutes after the infusion begins. Which of the following actions should the nurse take first? A. Maintain IV access w/ 0.9% sodium chloride B. Stop the infusion of blood C. Send the blood container & tubing to the blood bank D. Obtain a urine sample

B. Stop the infusion of blood

A nurse is providing discharge teaching to a client who has aplastic anemia. Which of the following statements indicates that the client understands the instruction? A. I need to stay active to prevent blood clots in my legs B. If I have a bad headache, I can take aspirin to get rid of it C. I should eliminate uncooked foods from my diet for now D. I should eat more Iron-fortified cereal to strengthen my blood

C. I should eliminate uncooked food from my diet for now

A nurse is preparing an in-service presentation about assessing clients who are having an acute myocardial infarction (MI). What is the most common assessment finding with acute MI? A. Dyspnea B. Pain in the shoulder & left arm C. Substernal chest pain D. Palpitations

C. Substernal chest pain

A client who just learned that he has variant (Prinzmetal's) angina asks the nurse how this type of angina compares with stable angina. Which of the following replies should the nurse Make? A. Exertion often brings on pain B. Variant angina occurs randomly at various times C. Variant angina can causes changes on your electrocardiogram D. Reducing you cholesterol can help you experience less pain

C. Variant angina can causes changes on your electrocardiogram

A nurse is monitoring a client who had a myocardial infarction. For which of the following complications should the nurse monitor in the first 24hr? A. Ineffective endocarditis B. Pericarditis C. ventricular dysrhythmias D. Pulmonary emboli

C. ventricular dysrhythmias

A nurse is assessing a client who is 85 years old. Which of the following findings should the nurse identify as a manifestation of myocardial infarction? A. Sudden hemoptysis B. Acute diarrhea C. Frontal headache D. Acute confusion

D. Acute confusion

A nurse is preparing to transfuse 250ml of packed red blood cells (RBCs) to a client over 4 hr. A blood administration set is available that delivers 10gtt/mL. The nurse should set the manual blood transfusion to deliver how many gtt/min?

10gtt/min

A nurse is caring for a client who has an upper gastrointestinal bleed and a hematocrit of 24%. Prior to initiating a transfusion of packed red blood cells (RBCs), which of the following actions should the nurse take? (Select all that apply) A. Assess & document the client's vital signs B. Restart the IV with a 22 gauge needle C. Verify with another nurse the blood type & Rh of the packed RBCs D. Hang a bag of lactated ringer's IV solution E. Change IV tubing to a set that has a filter

A. Assess & document the client's vital signs C. Verify with another nurse the blood type & Rh of the packed RBCs E. Change IV tubing to a set that has a filter

A nurse is teaching about a low-cholesterol diet to a client who had a myocardial infarction. Which of the following meal selections by the client indicates an understanding of the teaching? A. Chicken breast & corn on the cob B. Shrimp & rice C. Cheese omelet & turkey bacon D. Liver & onions

A. Chicken breast & corn on the cob

A nurse is teaching a client who has pernicious anemia. The nurse should encourage the client to increase consumption of which of the following foods? A. Eggs B. Squash C. Kale D. Tofu

A. Eggs

A nurse is caring for a client with heart failure whose telemetry readings displays a flattening of the T wave. Which of the following laboratory results should the nurse anticipate as the cause of this ECG 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 is caring for a client who has a demand pacemaker inserted with a set rate of 72/min. Which of the following findings should the nurse appect? A. Telemetry monitoring showing QRS complexes occurring at a rate of 74/min with no pacing spikes B. premature ventricular complexes at 12/min C. Telemetry monitoring showing pacing spikes with no QRS complexes D. Hiccups

A. Telemetry monitoring showing QRS complexes occurring at a rate of 74/min with no pacing spikes

A nurse is reviewing the menu selections of a client who has heart failure & anticipates discharge to home the following day. Which of the following lunch choices should the nurse identify as an indication that the client understands his dietary instructions? A. Turkey on whole wheat B. Hamburger & French fries C. Frankfurter on white roll D. Macaroni & cheese

A. Turkey on whole wheat

A nurse is monitoring a client for reperfusion following thrombolytic therapy to treat acute myocardial infarction (MI). Which of the following indicators should the nurse identify to confirm reperfusion? A. Ventricular dysrhythmias B. Appearance of Q waves C. Elevated ST segments D. Recurrence of chest pain

A. Ventricular dysrhythmias

A nurse is assessing a client who has late-stage heart failure & is experiencing fluid volume overload. Which of the following findings should the nurse expect? A. Weight gain of 1 kg (2.2lbs) in 1 day B. Pitting edema +1 C. Client report of a nocturnal cough D. B-type natriuretic peptide (BNP) level of 100 Pg/mL

A. Weight gain of 1 kg (2.2lbs) in 1 day

A nurse is assessing a client who has peripheral vascular disease & a venous ulcer on the right ankle. Which of the following findings should the nurse expect in the client's affected extremity? A. Absent pedal pulses B. Ankles swelling C. Hair loss D. Skin atrophy

B. Ankles swelling

A nurse is caring for a client who has acute lymphocytic leukemia & reports a fever, chills, fatigue, & pallor over the past week. When checking the client's laboratory results, which of the following values should the nurse identify as contributing to the client's fatigue & pallor. A. Magnesium 2.0mEq/L B. Hgb 6.5 g/dL C. WBC count 9.6/mm^3 D. Creatinine 0.8 mg/dL

B. Hgb 6.5 g/dL

A nurse is planning care for a client who has thrombocytopenia. Which of the following interventions should the nurse include in the plan of care? A. Restrict fluids to 1,000 mL per day B. Measure the client's abdominal girth daily C. Check IV sites every 4 hr for bleeding D. Administer an enema as needed for constipation

B. Measure the client's abdominal girth daily

A nurse is teaching a client who has polycythemia vera about self-care measures. Which of the following interventions should the nurse include? A. Drink at least 1 liter of fluids each day B. Continuously wear support hose C. Elevate your legs when sitting D. Use dental floss daily

C. Elevate your legs when sitting

A nurse is caring for a client who has thrombocytopenia & develops epistaxis. Which of the following actions should the nurse take? A. Have the client gently blow clots from nose every 5 min B. Instruct the client to sit with his head hyperextended C. Apply ice compresses to the back of the client's neck D. Apply lateral pressure to the client's nose for 10 min

D. Apply lateral pressure to the client's nose for 10 min

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 for longer than 15 min

D. Chest pain lasts for longer than 15 min

A nurse is assessing a client who has right-sided heart failure. Which of the following findings should the nurse expect? A. Decreased capillary refill B. Dyspnea C. Orthopnea D. Dependent edema

D. Dependent edema

A nurse is planning car for a client during a sickle cell crisis. Which of the following interventions should the nurse include in the client's plan of care? A. Maintain the client's knees & hips in a flexed position B. Apply cold compresses to painful joints C. Withhold opioids until the crisis is resolved D. Encourage increased fluid intake

D. Encourage increased fluid intake

A nurse is assessing a client who had an abdominal aortic aneurysm. Which of the following manifestations should the nurse expect? A. Midsternal chest pain B. thrill C. Pitting edema in lower extremity D. Lower back discomfort

D. Lower back discomfort

A nurse is showing a client who has right-sided heart failure an illustration of the heart. Which of the following blood vessels carry deoxygenated blood to the right atrium A. Right coronary artery B. left carotid artery C. Aorta D. superior vena cava

D. superior vena cava

A nurse is checking paradoxical blood pressure of a client who has a possible cardiac tamponade. In what order should the nurse complete the following steps? A. Identify the first BP sound audible on expiration & then on inspiration B. Subtract the inspiratory pressure from the expiratory pressure C. Deflate the cuff slowly & listen for the first audible sound D. inspect for jugular venous distention & notify the provider E. Palpate the blood pressure & inflate the cuff above the systolic pressure.

E. Palpate the blood pressure & inflate the cuff above the systolic pressure. C. Deflate the cuff slowly & listen for the first audible sound A. Identify the first BP sound audible on expiration & then on inspiration B. Subtract the inspiratory pressure from the expiratory pressure D. inspect for jugular venous distention & notify the provider

A nurse is rewarming a client following coronary artery bypass (CABG) surgery. For which of the following complications of the rewarming process should the nurse monitor the client? A. Acidosis B. Infection C. Hypertension D. Cardiac tamponade

A. Acidosis

A nurse in a clinic is assessing the lower extremities & ankles of a client who has a history of peripheral arterial disease. 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 who had a myocardial infarction 5 days ago. The client has sudden onset of shortness of breath & begins coughing frothy, pink sputum. The nurse auscultates loud, bubbly sounds on inspiration. Which of the following adventitious breath sounds should the nurse document A. Coarse crackles B. Wheezes C. Rhonchi D. Friction rub

A. Coarse crackles

A nurse is caring for a client who has a platelet count 50,000/mm^3. After discontinuing the client's peripheral IV site, which of the following actions should the nurse take? A. Apply warm compress B. Apply pressure to the catheter removal site for 5 min C. place the affected arm in a dependent position D. Clean the insertion site with alcohol

B. Apply pressure to the catheter removal site for 5 min

A nurse on a telemetry unit is caring for a client who has an irregular radial pulse. Which of the following ECG abnormalities should the nurse recognize as atrial flutter A. P waves occurring at 0.16 seconds before the QRS complex B. Atrial rate of 300/min with QRS complex of 80/min C. Ventricular rate of 82/min with atrial rate of 80/min D. 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 providing teaching about lifestyle changes to a client who experienced a myocardial infarction & has a new prescription for a beta blocker. Which of the following clients statements indicates an understanding of the teaching? A. I should eat foods that are high in saturated fat B. Before taking my medication, I will count my radial pulse rate C. I will exercise once a week for an hour at the health club D. I will stop taking my medication when my blood pressure is within normal range

B. Before taking my medication, I will count my radial pulse rate

A nurse is preparing to administer packed RBCs to a client who is anemic. Which of the following actions should the nurse take? (select all that apply) A. insert a 23-gauge angiocatheter w/ an IV adapter B. Check to determine the packed RBCs are less than 1 week old C. Administer the RBCs over a 6-hr period D. Ask another nurse to check the packed RBCs' label against the medical record E. Prime the transfusion tubing with 0.9% sodium chloride

B. Check to determine the packed RBCs are less than 1 week old D. Ask another nurse to check the packed RBCs' label against the medical record E. Prime the transfusion tubing with 0.9% sodium chloride

A nurse is examining the ECG of a client who has frequent premature ventricular contractions (PVCs). Which of the following QRS changes should the nurse expect to see on the client's ECG? A. Narrower than usual QRS complexes B. Much greater amplitude than the usual QRS complexes C. Same polarity as the usual QRS complexes D. Immediate resumption of the usual rhythm

B. Much greater amplitude than the usual QRS complexes

A nurse is caring for a client who has hemophilia. The client reports pain & swelling in a joint following a injury. Which of the follow actions should the nurse take first? A. Obtain blood samples to test platelet function B. Prepare for replacement of the missing clotting factor C. Administer aspirin for the clients pain D. Place the bleeding joint in the dependent position

B. Prepare for replacement of the missing clotting factor