MED SURG MOD 6

95% of patients with high blood pressure have this form of hypertension?

About 95% of patients with high blood pressure have primary hypertension (also called essential hypertension), which is defined as high blood pressure from an unidentified cause. The remaining small percentage, about 5%, have secondary hypertension

Which of the following medications may induce a platelet disorder?

Asprin

Blood pressure is the product of _______ output multiplied by peripheral resistance.

CARDIAC

Common physical manifestations for Immune Thrombocytopenic Purpura are which of the following? Select all that apply.

Common physical manifestations for Immune Thrombocytopenic Purpura are easy bruising, heavy menses, and petechiae on the extremities or trunk.

The hallmark symptom of peripheral arterial occlusive disease is intermittent claudication, described as which of the following? Select all that apply.

Cramping Aching Activity intolerance Weakness

Signs and symptoms of a blood transfusion reaction include which of the following? Select all that apply.

Even for patients who have received prior transfusions, a brief review of the signs and symptoms of transfusion reactions is advised. Signs and symptoms of a blood transfusion reaction include fever, chills, respiratory distress, low back pain, nausea, pain at the IV site, or anything "unusual."

95% of patients with high blood pressure have generic hypertension.

FALSE

Which of the following is caused by antibodies to donor leukocytes that remain in the unit of blood or blood component? (It is the most common type of transfusion reaction).

A febrile nonhemolytic reaction is caused by antibodies to donor leukocytes that remain in the unit of blood or blood component; it is the most common type of transfusion reaction

Which of the following assessments, along with the measurement of baseline vital signs and fluid status, are important before transfusing any blood product?

A systematic physical assessment and measurement of baseline vital signs and fluid status are important before transfusing any blood product.

Which of the following describe the most common or potentially severe transfusion-related complications? Select all that apply.

Febrile nonhemolytic reaction Acute Hemolytic Reaction Allergic Reaction Transfusion-Associated Circulatory Overload (TACO) Bacterial Contamination Transfusion-Related Acute Lung Injury (TRALI) Delayed hemolytic reactions

Send the blood container and tubing to the blood bank Notify the primary provider of the assessment findings Assess the patient carefully Notify the blood bank Stop the transfusion)

For repeat typing and culture. The patient's identity and blood component identifying tags and numbers are verified. Implement any treatments prescribed. Continue to monitor the patient's vital signs and respiratory, cardiovascular, and renal status. Compare the vital signs with baseline, including oxygen saturation. Assess the patient's respiratory status carefully. Note the presence of adventitious breath sounds; the use of accessory muscles; extent of dyspnea; and changes in mental status, including anxiety and confusion. That a suspected transfusion reaction has occurred. Maintain the IV line with normal saline solution through new IV tubing, given at a slow rate.

Which of the following studies is not performed on the initial evaluation to determine anemia?

Hematrocrit

Hemochromatosis is a genetic condition in which excess iron is absorbed from which of the following?

Hemochromatosis is a genetic condition in which excess iron is absorbed from the GI tract

Which of the following Hepatitis can cause thrombocytopenia?

Hepatitis B or C can cause thrombocytopenia

Which of the following describes a situation in which blood pressure is very elevated but there is no evidence of impending or progressive target organ damage?

Hypertensive urgency

Which of the following signs and symptoms must the nurse monitor for, as there are potential problems associated with heart failure related to the use of diuretics? Select all that apply.

Hyponatremia Excessive and repeated diuresis Hyperkalemia

Which type of anemia results from defective red blood cell production?

Hypoproliferative

Which of the following are indications for corticosteroid use? Select all that apply.

Idiopathic thrombocytopenic purpura and Hemolytic anemia are indications for corticosteroid use.

Common physical manifestations for which of the following are easy bruising, heavy menses, and petechiae on the extremities or trunk?

Immune Thrombocytopenic Purpura

The objectives of guideline-directed patient management include which of the following? Select all that apply.

Improvement of cardiac function with optimal pharmacologic management Reduction of symptoms and improvement of functional status Stabilization of patient condition and lowering of the risk of hospitalization Delay of the progression of HF and extension of life expectancy Promotion of a lifestyle conducive to cardiac health

A patient taking the hemorrheologic agent pentoxifiylline [Trental] for four weeks reports walking without pain and improvement in walking distance. The nurse knows this is improvement in which of the following?

Intermittent claudication is pain and/or cramping in the lower leg due to inadequate blood flow to the muscles due to peripheral arterial occlusive disease. Medication treatment include pentoxifylline, cliostazol, aspirin, clopidogrel, and statins.

Which of the following statements are true when treating folate deficiency in anemia?

It is treated by increasing the amount of folic acid in the diet. Administration of 1 mg of folic acid daily Intramuscular injections in people with malabsorption problems

Lifestyle recommendations for patients with heart failure include which of the following? Select all that apply.

Lifestyle recommendations include restriction of dietary sodium; avoidance of smoking, including passive smoke; avoidance of excessive fluid and alcohol intake; weight reduction when indicated; and regular exercise.

Like endogenous glucocorticoids, exogenous corticosteroids act at the __________ level by binding to drug receptors in target tissues.

Like endogenous glucocorticoids, exogenous corticosteroids act at the cellular level by binding to drug receptors in target tissues.

Thrombocytopenia means which of the following?

Low platelet level

Atherosclerosis includes which of the modifiable risk factors? Select all that apply.

Modifiable Risk Factors Nicotine use (i.e., tobacco product such as cigarettes, e-cigarettes, or chewing tobacco) Diet (contributing to hyperlipidemia) Hypertension Diabetes (speeds the atherosclerotic process by thickening the basement membranes of both large and small vessels) Hyperlipidemia Stress Sedentary lifestyle Elevated C-reactive protein Hyperhomocysteinemia Non-modifiable Risk Factors Increasing age Female gender Familial predisposition/genetics

The term heart failure indicates which of the following?

Myocardial disease

Which of the following is considered to be the prototype corticosteroid?

Prednisone

Prolonged blood pressure elevation gradually damages blood vessels throughout the body, particularly in target organs such as? Select all that apply.

Prolonged blood pressure elevation gradually damages blood vessels throughout the body, particularly in target organs such as the heart, kidneys, brain, and eyes.

Researchers estimate that genetics play a role in explaining blood pressure variation between individuals in what percentage of cases?

Researchers estimate that genetics play a role in explaining blood pressure variation between individuals in 30% to 70% of cases

Patients with platelet dysfunction may be at risk for which of the following after trauma or invasive procedures (e.g., biopsy, dental extraction)?

Significant bleeding

Which of the following medications improve endothelial function in patients with peripheral arterial occlusive disease with the goal of improved symptoms of intermittent claudication and also increased walking distance?

Statins improve endothelial function in patients with peripheral arterial occlusive disease. Studies suggest that statins improve symptoms of intermittent claudication and also increase walking distance to the onset of claudication

Which of the following steps are taken to determine the type and severity of the reaction? Select all that apply.

Stop the transfusion. Maintain the IV line with normal saline solution through new IV tubing, given at a slow rate. Assess the patient carefully. Compare the vital signs with baseline, including oxygen saturation. Assess the patient's respiratory status carefully. Note the presence of adventitious breath sounds; the use of accessory muscles; extent of dyspnea; and changes in mental status, including anxiety and confusion. Note any chills, diaphoresis, jugular vein distention, and reports of back pain or urticaria. Notify the primary provider of the assessment findings, and implement any treatments prescribed. Continue to monitor the patient's vital signs and respiratory, cardiovascular, and renal status. Notify the blood bank that a suspected transfusion reaction has occurred. Send the blood container and tubing to the blood bank for repeat typing and culture. The patient's identity and blood component identifying tags and numbers are verified.

Systemic clinical manifestations of Right Sided Heart Failure include which of the following? Select all that apply.

Systemic clinical manifestations of Right Sided Heart Failure include edema of the lower extremities (dependent edema), hepatomegaly (enlargement of the liver), ascites (accumulation of fluid in the peritoneal cavity), and weight gain due to retention of fluid.

Blood pressure is the product of cardiac output multiplied by peripheral resistance.

TRUE

Which of the following is known as a group of hereditary anemias characterized by hypochromia (an abnormal decrease in the hemoglobin content of erythrocytes)?

Thalassemias

The definitive method of establishing the diagnosis of iron deficiency anemia is by which of the following?

The definitive method of establishing the diagnosis of iron deficiency anemia is bone marrow aspiration.

The diagnosis of peripheral arterial occlusive disease may be made using which of the following? Select all that apply.

The diagnosis of peripheral arterial occlusive disease may be made using CW Doppler and ABIs, treadmill testing for claudication, duplex ultrasonography, or other imaging studies

The diagnosis of which of the following may be made using CW Doppler and ABIs, treadmill testing for claudication, duplex ultrasonography, or other imaging studies?

The diagnosis of peripheral arterial occlusive disease may be made using CW Doppler and ABIs, treadmill testing for claudication, duplex ultrasonography, or other imaging studies

Which of the following has the hallmark described as aching, cramping, or inducing fatigue or weakness that occurs with some degree of exercise or activity, which is relieved with rest?

The hallmark symptom is intermittent claudication described as aching, cramping, or inducing fatigue or weakness that occurs with some degree of exercise or activity, which is relieved with rest.

The medications used for treating hypertension decrease which of the following? Select all that apply.

The medications used for treating hypertension decrease peripheral resistance, blood volume, or the strength and rate of myocardial contraction.

The most common direct results of atherosclerosis in arteries include which of the following? Select all that apply.

The most common direct results of atherosclerosis in arteries include narrowing (stenosis) of the lumen, obstruction by thrombosis, aneurysm, ulceration, and rupture

The hallmark symptom is intermittent claudication, described as aching, cramping, or inducing fatigue or weakness that occurs with some degree of exercise or activity, which is relieved with rest. The pain commonly occurs in muscle groups positioned in which of the following to the area of stenosis or occlusion?

The pain commonly occurs in muscle groups distal to the area of stenosis or occlusion.

The patient with ITP is instructed to avoid all agents that interfere with platelet function, including herbal therapies and OTC medications. The patient should avoid which of the following? Select all that apply.

The patient with ITP is instructed to avoid all agents that interfere with platelet function, including herbal therapies and OTC medications. The patient should avoid constipation, the Valsalva maneuver (e.g., straining at stool), and vigorous flossing of the teeth. Electric razors should be used for shaving, and soft-bristled toothbrushes should replace stiff-bristled ones.

Thrombocytopenia (low platelet level) can result from which of the following factors? Select all that apply.

Thrombocytopenia (low platelet level) can result from various factors: decreased production of platelets within the bone marrow, increased destruction of platelets, or increased consumption of platelets (e.g., the use of platelets in clot formation).

Which bleeding disorder can result from various factors: decreased production of platelets within the bone marrow, increased destruction of platelets, or increased consumption of platelets (e.g., the use of platelets in clot formation)?

Thrombocytopenia (low platelet level) can result from various factors: decreased production of platelets within the bone marrow, increased destruction of platelets, or increased consumption of platelets (e.g., the use of platelets in clot formation).

Which of the following are the two types of major types of chronic heart failure?

Two major types of HF are identified by assessment of left ventricular function, usually by echocardiogram. The most common type is an alteration in ventricular contraction called systolic heart failure, which is characterized by a weakened heart muscle. A second type is diastolic heart failure, which is characterized by a stiff and noncompliant heart muscle, making it difficult for the ventricle to fill.

Which of the following are attractive for many patients with PAD as they may not have access to a supervised exercise program?

Unsupervised walking exercise programs

Delayed hemolytic reactions Acute Hemolytic Reaction Transfusion-Related Acute Lung Injury (TRALI) Bacterial Contamination Allergic Reaction Febrile nonhemolytic reaction Transfusion-Associated Circulatory Overload (TACO)

Usually occur within 14 days after transfusion, when the level of antibody has been increased to the extent that a reaction can occur. The most dangerous, and potentially life-threatening, type of transfusion reaction occurs when the donor blood is incompatible with that of the recipient. Is a potentially fatal, idiosyncratic reaction that is defined as the development of acute lung injury occurring within 6 hours after the blood transfusion. Is very low; however, administration of contaminated products puts the patient at great risk. Contamination can occur at any point during procurement or processing but often results from organisms on the donor's skin. Some patients develop urticaria (hives) or generalized itching during a transfusion; the cause is thought to be a sensitivity reaction to a plasma protein within the blood component being transfused. Caused by antibodies to donor leukocytes that remain in the unit of blood or blood component; it is the most common type of transfusion reaction. If too much blood is infused too quickly, hypervolemia can occur. This condition can be aggravated in patients who already have increased circulatory volume.

Which of the following medications prevent the formation of thromboemboli, in patients with peripheral arterial occlusive disease, which can lead to myocardial infarction and stroke?

aspirin or clopidogrel (Plavix)

A systematic physical assessment and measurement of baseline vital signs and fluid status are important before transfusing any product.

blood

In intermittent claudication the pain commonly occurs in muscle groups to the area of stenosis or occlusion.

distal

A focused physical assessment and measurement of baseline vital signs and fluid status are important before transfusing any blood product.

false

ASH and HSA have defined the standards for blood pressure measurement, including conditions required before measurements are made, equipment specifications, and techniques for measuring blood pressure to obtain accurate and reliable readings.

false

Atherosclerotic lesions are of two types: short streaks and muscle plaque.

false

Congestive and Pulmonic HF are the two types of major types of chronic heart failure.

false

Corticosteroids are administered to cure underlying disease processes.

false

Cortisone is considered to be the prototype corticosteroid.

false

In general, hypertension drugs act to decrease blood pressure by increasing cardiac output or peripheral vascular resistance.

false

In the case of vitamin B12 deficiency, it is typically caused by inadequate dietary intake.

false

Intravenous iron supplementation is considered to be the primary mode of treating iron deficiency anemia.

false

Iron supplements should be taken on an empty stomach two hours before or one hour after a meal.

false

Megaloblastic anemias develop quickly and causes the body to not be able to compensate well.

false

Most often, HF is a chronic, progressive condition that is managed with lifestyle changes and medications to prevent episodes of acute compensated heart failure.

false

Nicardipine and labetalol (Trandate) have demonstrated safety and effectiveness in treating hypotension, with nicardipine demonstrating more predictability in controlling blood pressure

false

Patients with platelet dysfunction may not be at risk for significant bleeding after trauma or invasive procedures (e.g., biopsy, dental extraction).

false

People who customarily live a sedentary are more likely to have symptoms of anemia.

false

Pulmonary congestion occurs when the right ventricle cannot effectively pump blood out of the ventricle into the aorta and the systemic circulation.

false

Suppression of the HPA axis may occur with corticosteroid therapy and may lead to life-threatening inability to decrease cortisol secretion when needed to cope with stress.

false

The destruction of red blood cells is known as hypoproliferation.

false

The hallmark symptom is intermittent claudication, described as aching, cramping, or inducing fatigue or weakness that occurs with some degree of exercise or activity, which is relieved with rest. The pain commonly occurs in muscle groups proximal to the area of stenosis or occlusion.

false

The most common causes of iron deficiency anemia in premenopausal women are bleeding from ulcers, gastritis, inflammatory bowel disease, or GI tumors.

false

The term heart failure indicates vascular disease.

false

When the blood pressure is less than 160/100 mm Hg for at least 1 year, gradual reduction of the types and doses of medication is indicated.

false

With vitamin B12 deficiency, if the deficiency is due to the more common defect in absorption or the absence of intrinsic factor, replacement is by weekly intramuscular injections of vitamin B12.

false

deficiency anemia typically results when the intake of dietary iron is inadequate for hemoglobin synthesis.

iron

The patient with which of the following is instructed to avoid all agents that interfere with platelet function, including herbal therapies and OTC medications. The patient should avoid constipation, the Valsalva maneuver (e.g., straining at stool), and vigorous flossing of the teeth. Electric razors should be used for shaving, and soft-bristled toothbrushes should replace stiff-bristled ones?

itp

Which of the following medication are used in the treatment of hypertensive crisis? Select all that apply.

nalaprilat (Vasotec) clevidipine (Cleviprex) nitroglycerin

ITP interefers with which function?

platelet

If platelet dysfunction is marked, bleeding can often be prevented by transfusion of normal before invasive procedures.

platelet

The objective in the postoperative period is to maintain adequate circulation through the arterial repair.

primary

The following steps are taken to determine the type and severity of the reaction: the transfusion: assess the patient carefully, notify the primary provider, notify the blood bank and send the blood container and tubing to the blood bank.

stop

Signs and symptoms of a blood reaction include fever, chills, respiratory distress, low back pain, nausea, pain at the IV site, or anything "unusual."

transfusion

Aplastic anemia is a rare disease caused by a decrease in or damage to marrow stem cells, damage to the microenvironment within the marrow, and replacement of the marrow with fat.

true

Aspirin may induce a platelet disorder.

true

Blood pressure is the product of cardiac output multiplied by peripheral resistance.

true

Common physical manifestations for Immune Thrombocytopenic Purpura are easy bruising, heavy menses, and petechiae on the extremities or trunk.

true

Corticosteroids are administered to control symptoms but do not cure underlying disease processes.

true

Hemolysis is often mild and self-limited. However, in the more severe Mediterranean type of G-6-PD deficiency, spontaneous recovery may not occur.

true

Hepatitis B or C can cause thrombocytopenia; thus, the patient should be screened for these diseases.

true

Hypoproliferative- Results from Defective RBC Production Bleeding- Results from RBC loss Hemolytic- Results from RBC Destruction

true

In many situations, aplastic anemia occurs when a medication or chemical is ingested in toxic amounts. However, in a few people, it develops after a medication has been taken at the recommended dosage.

true

Iron supplements should be taken on an empty stomach one hour before or two hours after a meal.

true

Left-sided heart failure (left ventricular failure) causes different manifestations than right-sided heart failure (right ventricular failure).

true

Medications including pentoxifylline, cliostazol, aspirin, clopidogrel, and statins are used to manage intermittent claudication associated with peripheral arterial occlusive disease.

true

Megaloblastic anemias develop slowly (over months) and thus the body can compensate well for a long time.

true

Most often, HF is a chronic, progressive condition that is managed with lifestyle changes and medications to prevent episodes of acute decompensated heart failure.

true

Nicardipine and labetalol (Trandate) have demonstrated safety and effectiveness in treating hypertensive crises, with nicardipine demonstrating more predictability in controlling blood pressure

true

Patients with chronic alcoholism are more prone to anemia.

true

People who customarily are very active tend to have more pronounced symptoms than sedentary people.

true

Pulmonary congestion occurs when the left ventricle cannot effectively pump blood out of the ventricle into the aorta and the systemic circulation.

true

Researchers estimate that genetics play a role in explaining blood pressure variation between individuals in 30% to 70% of cases.

true

Signs and symptoms of a blood transfusion reaction include fever, chills, respiratory distress, low back pain, nausea, pain at the IV site, or anything "unusual."

true

Suppression of the HPA axis may occur with corticosteroid therapy and may lead to life-threatening inability to increase cortisol secretion when needed to cope with stress.

true

The BNP level is a key diagnostic indicator of HF; high levels are a sign of high cardiac filling pressure and can aid in both the diagnosis and management of HF.

true

The alpha-thalassemias occur mainly in people from Asia and the Middle East, and the beta-thalassemias are most prevalent in people from Mediterranean regions but also occur in those from the Middle East or Asia.

true

The definitive method of establishing the diagnosis of iron deficiency anemia is bone marrow aspiration.

true

The destruction of red blood cells is known as Hemolysis.

true

The diagnosis of peripheral arterial occlusive disease may be made using CW Doppler and ABIs, treadmill testing for claudication, duplex ultrasonography, or other imaging studies.

true

The hallmark symptom is intermittent claudication described as aching, cramping, or inducing fatigue or weakness that occurs with some degree of exercise or activity, which is relieved with rest.

true

The impact of even mild anemia on function in older adults is significant and may include decreased physical performance, decreased mobility, increased frailty, increased rates of depression, increased risk for falling, and delirium.

true

The nurse is caring for a client who has had a blood pressure reading of 148/95 for the past three visits to the clinic. This client is in stage 2 hypertension.

true

The primary objective in the postoperative period is to maintain adequate circulation through the arterial repair.

true

The remaining complete blood count (CBC) values are useful in determining whether the anemia is an isolated problem or part of another hematologic condition, such as leukemia.

true

The thalassemias are a group of hereditary anemias characterized by hypochromia (an abnormal decrease in the hemoglobin content of erythrocytes).

true

Tranexamic acid also is used for short periods (2-8 days) in patients with hemophilia to prevent or decrease bleeding from tooth extraction or menorrhagia.

true

Unsupervised walking exercise programs are attractive for many patients with PAD as they may not have access to a supervised exercise program, their insurance will not cover a supervised exercise program, or they like the independence that an unsupervised program gives them.

true

When the blood pressure is less than 140/90 mm Hg for at least 1 year, gradual reduction of the types and doses of medication is indicated.

true