The nurse is caring for a client who had a thrombotic stroke in the Emergency Department. It has been less than 3 hours since the onset of symptoms. The rationale for using tissue plasminogen activator (t-PA) for this client is to:

reduce the risk of blood vessel spasm.

prevent platelet aggregation.

dissolve the blood clot.

prevent infection in the brain.

Answer and Explanation

The Correct Answer is C

A.   While blood vessel spasms can occur after a stroke, t-PA does not directly affect them.
B.   Platelet aggregation is the process by which platelets stick together to form a clot. t-PA dissolves clots, but it does not prevent their formation.
C.   Tissue plasminogen activator (t-PA) is a medication that can dissolve blood clots. In the case of a thrombotic stroke, a blood clot has blocked blood flow to the brain. By dissolving the clot, t-PA can restore blood flow and limit brain damage.
D.   t-PA does not have any direct effect on the risk of infection in the brain.

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Correct Answer is ["14"]

Explanation

154 lbs ÷ 2.2 lbs/kg = 70 kg

20 units/kg * 70 kg = 1400 units

1400 units ÷ 25,000 units/250 mL = 14 mL

Therefore, the nurse will administer 14 mL of Heparin.

A. Trisomy 21 (Down syndrome) B. Fragile X syndrome C. BRCA1 gene mutation D. Philadelphia chromosome (BCR-ABL fusion gene)

Correct Answer is D

Explanation

A. Trisomy 21 is a chromosomal disorder resulting in Down syndrome. While individuals with Down syndrome have an increased risk of developing certain leukemias (such as acute lymphoblastic leukemia), it is not directly associated with CML.
B. Fragile X syndrome is a genetic condition caused by a mutation in the FMR1 gene on the X chromosome, leading to intellectual disability and other developmental issues. It is not associated with CML or any form of leukemia. This option is unrelated to the genetic abnormalities seen in CML.
C. The BRCA1 gene mutation is associated with an increased risk of breast and ovarian cancers. While mutations in BRCA1 can affect cancer susceptibility, they are not linked to Chronic Myelogenous Leukemia. Thus, this option does not apply to CML.
D. The Philadelphia chromosome is a specific genetic abnormality found in the majority of patients with CML. It results from a translocation between chromosomes 9 and 22, creating the BCR-ABL fusion gene, which produces a tyrosine kinase that drives the proliferation of leukemic cells.

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Blood Cell	Normal Ranges
Red blood cells (mature, circulating)	Male 4.51-6.01 million/mm3 Female: 4.01-5.51 million/mm3
Hemoglobin	Adult (15-64 yr) Male 14-17.3 g/dL Female 11.7-15.5 g/dL
Hematocrit	42% -52% in males 36% -48% in females
Reticulocytes	0.5% -2.5% of total RBC count
White blood cells (total)	4.5-11.1 103/mm3
Neutrophils	59% Bands 3% Segs-56%
Eosinophils	2.7%
Basophils	0.5%
Lymphocytes	34%
Monocytes	4%
Platelets	150,000-450,000/mm3

The nurse is caring for a client who had a thrombotic stroke in the Emergency Department. It has been less than 3 hours since the onset of symptoms. The rationale for using tissue plasminogen activator (t-PA) for this client is to:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient is ordered 20 unit/kg IV bolus of Heparin. The patient weighs 154 lbs. Heparin is supplied 25,000 units/250 mL. How many mL will the nurse administer? (round to the nearest whole number)

Correct Answer is ["14"]

Explanation

What genetic abnormality would a nurse expect in a client diagnosed with Chronic Myelogenous Leukemia (CML)?

Correct Answer is D

Explanation

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