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Ati med surg quiz
Ati med surg quiz
Total Questions : 22
Showing 10 questions Sign up for moreA low-sodium diet is prescribed for a client who has fluid volume overload due to chronic heart failure. The nurse recognizes that additional teaching is necessary when the client makes which statement?
Explanation
A. This statement indicates a lack of understanding about hidden sodium in restaurant foods. Many restaurant dishes contain high levels of sodium, even if additional salt is not added at the table. The client needs to be educated about choosing low-sodium options when dining out and asking about the sodium content of meals.
B. This statement reflects correct understanding, as fresh vegetables typically contain less sodium than canned vegetables, which often have added salt.
C. This statement shows proper knowledge, as reading nutrition labels helps identify foods with high sodium content, allowing for better dietary choices.
D. This statement is appropriate, as using lemon juice and herbs is a good alternative to adding salt for flavoring food.
A nurse is caring for a client who has a diagnosis of immune thrombocytopenic purpura (ITP). Despite medication therapy, the client's platelets are low. Which of the following procedures would reduce the destruction of platelets for a client who has ITP?
Explanation
A. While a platelet transfusion can temporarily increase platelet counts, it does not reduce the destruction of platelets in ITP and is generally not effective as a long-term solution.
B. Replacement of ADAMTS-13 is relevant in thrombotic thrombocytopenic purpura (TTP), not ITP. It is not used for reducing platelet destruction in ITP.
C. Protamine sulfate is an antidote for heparin overdose and does not address the platelet destruction in ITP.
D. A laparoscopic splenectomy is often considered for clients with ITP who do not respond to medication therapy. The spleen is a primary site for platelet destruction, and its removal can reduce the destruction of platelets, leading to increased platelet counts.
A nurse is caring for a client is who has a deep vein thrombosis and is prescribed heparin by continuous IV infusion at 1,200 units/hr. Available is heparin 25,000 units in 500 mL DSW. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest tenth/whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Explanation
To calculate the IV pump rate, you'll need to use the formula: (Ordered amount of medication (units/hr) × Volume of fluid in mL) / Amount of medication in the volume = IV pump rate in mL/hr. For the given scenario, the ordered amount is 1,200 units/hr, the volume of fluid is 500 mL, and the amount of medication in the volume is 25,000 units. Plugging these numbers into the formula gives you: (1,200 units/hr × 500 mL) / 25,000 units = 24 mL/hr. Therefore, the nurse should set the IV pump to deliver 24 mL/hr.
A client is brought to the emergency department by ambulance with chest pain 10/10 which began 30 minutes prior. The client's troponin levels are 1.20 ng/mL and an ST-elevation is noted on the electrocardiogram (ECG). The nurse understands that the priority intervention for this patient is which of the following?
Explanation
A. Transporting the patient to the cardiac catheterization lab for percutaneous coronary intervention (PCI) is the priority intervention for a patient with an ST-elevation myocardial infarction (STEMI). PCI is the preferred treatment to restore blood flow to the affected coronary artery.
B. Aggressive diuresis and digoxin are not appropriate for the acute management of a STEMI. Diuresis may be used in cases of heart failure but is not the immediate priority.
C. Synchronized cardioversion and radiofrequency catheter ablation are treatments for certain arrhythmias but are not indicated for the acute management of STEMI.
D. Administering gemfibrozil, a lipid-lowering agent, and preparing for a stress test are not appropriate interventions in the acute setting of a STEMI. Immediate reperfusion therapy is necessary.
A nurse is caring for a client who has been diagnosed with thrombotic thrombocytopenic purpura (TTP) and will begin plasmapheresis ment should the nurse plan to include when educating the client about this treatment?
Explanation
A. Plasmapheresis in TTP aims to remove abnormal blood components, not ADAMTS-13. In fact, plasmapheresis helps replenish ADAMTS-13.
B. The primary goal of plasmapheresis in TTP is to remove large von Willebrand factor molecules that are causing platelet aggregation and clot formation.
C. Removing macrophages from the spleen is not the objective of plasmapheresis.
D. Plasmapheresis is usually performed daily until clinical and laboratory parameters improve, not just once a week.
A nurse is providing education to a client with heart failure who will begin taking digoxin daily at home. Which of the following statements made by the client indicates an understanding of the teaching? (Select all that apply.)
Explanation
A. Digoxin improves cardiac output by increasing the force of cardiac contractions, not by increasing the heart rate. In fact, it may slow the heart rate.
B. Holding the dose and calling the doctor if the heart rate is less than 60 beats per minute is correct, as digoxin can cause bradycardia.
C. Doubling the dose is incorrect and dangerous. Missed doses should be handled according to physician instructions, typically by skipping the missed dose and taking the next scheduled dose.
D. Loss of appetite and nausea can be signs of digoxin toxicity and should be reported to the healthcare provider.
E. Frequent urination is not an expected side effect of digoxin; it is more commonly associated with diuretics.
A client with a long history of poorly-managed left-sided heart failure complains of decreased urine output. Lab results show anemia and elevated serum creatinine levels. Based on these findings, which condition should the nurse suspect the client is experiencing?
Explanation
A. Pleural effusion may be a complication of heart failure but does not directly explain the decreased urine output and elevated serum creatinine.
B. Myocardial infarction would present with different symptoms, such as chest pain, rather than decreased urine output and elevated creatinine.
C. Cardiorenal syndrome refers to the interdependence of the heart and kidneys, where chronic heart failure leads to worsening kidney function, causing symptoms like decreased urine output and elevated serum creatinine.
D. Heparin-induced thrombocytopenia (HIT) is related to the use of heparin and presents with low platelet counts, not decreased urine output and elevated creatinine.
A nurse is providing education before administering apixaban (Eliquis) to a client who has persistent atrial fibrillation. Which of the following statements made by the client indicates an understanding of the teaching?
Explanation
A. Apixaban is an anticoagulant used to prevent clot formation and reduce stroke risk, not specifically to reduce bleeding risk.
B. Rate control is typically achieved with medications like beta-blockers or calcium channel blockers, not anticoagulants like apixaban.
C. Apixaban does not convert heart rhythm; it prevents blood clots.
D. The primary purpose of apixaban in patients with atrial fibrillation is to reduce the risk of stroke by preventing blood clot formation.
A nurse is providing discharge teaching to a client who has a new diagnosis of heart failure. Which of the following statements made by the client requires the nurse to provide correction and additional teaching?
Explanation
A. Taking furosemide in the morning helps prevent nocturia and ensures better management of fluid balance during the day.
B. Gaining 3 pounds in 2 days likely indicates fluid retention rather than an issue with calorie intake. The client should contact their healthcare provider as it may indicate worsening heart failure.
C. Avoiding extreme temperatures is important as they can place additional stress on the cardiovascular system.
D. Limiting salt intake to 2 grams or less per day and reading nutrition labels is appropriate for managing heart failure.
A client who has been diagnosed with chronic stable angina is placed on multiple medications to manage the condition. The nurse understands that the client is receiving lisinopril for which reason?
Explanation
A. Lisinopril is not used to reduce LDL cholesterol and triglycerides; statins are used for that purpose.
B. Lisinopril does not prevent platelet aggregation; antiplatelet agents like aspirin are used for that purpose.
C. Lisinopril is not used to relieve acute angina; nitrates like nitroglycerin are used for that purpose.
D. Lisinopril is an ACE inhibitor that helps decrease blood pressure and reduce the workload on the heart, which is beneficial in managing chronic stable angina.
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