Ch.30 MD Flashcards
The nurse is caring for a patient who is being discharged after an emergency splenectomy following an automobile accident. Which instructions should the nurse include in the discharge teaching? a. Watch for excess bruising. b. Check for swollen lymph nodes. c. Take iron supplements to prevent anemia. d. Wash hands and avoid persons who are ill.
d.
Wash hands and avoid persons who are ill.
The nurse assesses a patient who has numerous petechiae on both arms. Which question should the nurse ask the patient?
a.
“Do you take salicylates?”
b.
“Are you taking any oral contraceptives?”
c.
“Have you been prescribed antiseizure drugs?”
d.
“How long have you taken antihypertensive drugs?”
a.
“Do you take salicylates?”
a nurse reviews the laboratory data for an older patient. The nurse would be most concerned about which finding? a. Hematocrit of 35% b. Hemoglobin of 11.8 g/dL c. Platelet count of 400,000/µL d. White blood cell (WBC) count of 2800/µL
d.
White blood cell (WBC) count of 2800/µL
A patient with pancytopenia has a bone marrow aspiration from the left posterior iliac crest. Which action would be important for the nurse to take after the procedure?
a.
Elevate the head of the bed to 45 degrees.
b.
Apply a sterile 2-inch gauze dressing to the site.
c.
Use a half-inch sterile gauze to pack the wound.
d.
Have the patient lie on the left side for 1 hour.
d.
Have the patient lie on the left side for 1 hour.
The nurse assesses a patient with pernicious anemia. Which assessment finding would the nurse expect? a. Yellow-tinged sclerae b. Shiny, smooth tongue c. Numbness of the extremities d. Gum bleeding and tenderness
c.
Numbness of the extremities
A patient’s complete blood count (CBC) shows a hemoglobin of 19 g/dL and a hematocrit of 54%. Which question should the nurse ask to determine possible causes of this finding?
a.
“Have you had a recent weight loss?”
b.
“Do you have any history of lung disease?”
c.
“Have you noticed any dark or bloody stools?”
d.
“What is your dietary intake of meats and protein?”
b.
“Do you have any history of lung disease?”
The nurse is reviewing laboratory results and notes an aPTT level of 28 seconds. The nurse should notify the health care provider in anticipation of adjusting which medication? a. Aspirin b. Heparin c. Warfarin d. Erythropoietin
b.
Heparin
When assessing a newly admitted patient, the nurse notes pallor of the skin and nail beds. The nurse should ensure that which laboratory test has been ordered? a. Platelet count b. Neutrophil count c. White blood cell count d. Hemoglobin (Hgb) level
d.
Hemoglobin (Hgb) level
The nurse examines the lymph nodes of a patient during a physical assessment. Which assessment finding would be of most concern to the nurse?
a.
A 2-cm nontender supraclavicular node
b.
A 1-cm mobile and nontender axillary node
c.
An inability to palpate any superficial lymph nodes
d.
Firm inguinal nodes in a patient with an infected foot
a.
A 2-cm nontender supraclavicular node
A patient who had a total hip replacement had an intraoperative hemorrhage 14 hours ago. Which laboratory result would the nurse expect to find? a. Hematocrit of 46% b. Hemoglobin of 13.8 g/dL c. Elevated reticulocyte count d. Decreased white blood cell (WBC) count
c.
Elevated reticulocyte count
The complete blood count (CBC) indicates that a patient is thrombocytopenic. Which action should the nurse include in the plan of care? a. Avoid intramuscular injections. b. Encourage increased oral fluids. c. Check temperature every 4 hours. d. Increase intake of iron-rich foods.
a.
Avoid intramuscular injections.
The health care provider's progress note for a patient states that the complete blood count (CBC) shows a “shift to the left.” Which assessment finding will the nurse expect? a. Cool extremities b. Pallor and weakness c. Elevated temperature d. Low oxygen saturation
c.
Elevated temperature
The health care provider orders a liver/spleen scan for a patient who has been in a motor vehicle accident. Which action should the nurse take before this procedure? a. Check for any iodine allergy. b. Insert a large-bore IV catheter. c. Place the patient on NPO status. d. Assist the patient to a flat position.
d.Assist the patient to a flat position.
A patient with pancytopenia of unknown origin is scheduled for the following diagnostic tests. The nurse will provide a consent form to sign for which test? a. ABO blood typing b. Bone marrow biopsy c. Abdominal ultrasound d. Complete blood count (CBC)
b.
Bone marrow biopsy
The nurse reviews the complete blood count (CBC) and white blood cell (WBC) differential of a patient admitted with abdominal pain. Which information will be most important for the nurse to communicate to the health care provider? a. Monocytes 4% b. Hemoglobin 13.6 g/dL c. Platelet count 168,000/µL d. White blood cells (WBCs) 15,500/µL
d.
White blood cells (WBCs) 15,500/µL
Which information shown in the accompanying figure about a patient who has just arrived in the emergency department is most urgent for the nurse to communicate to the health care provider?
a. Platelet count b. White blood cell count c. History of abdominal pain d. Blood pressure and heart rate
a.
Platelet count
