Med Surg Test bank ( Red HESI Test
bank Med-Surg and other resources)
Questions And Answers
1.oAonurseoisoreviewingotheohematologicotestoresultsoforoaopatientoinowhomotheohematocrito
(Hct)oisoreportedoatoaoreadingoofo30%.oBasedoonothisoresult,otheonurseoshouldointerpretoth
atotheopatiento
A.oisosusceptibleotoobleedingodisorders.o
B.ohasofeweroredobloodocellsothanonormal.oC.oisoexperiencingoanoinflammatoryoresponse.o
D.oisoexperiencingoanoacuteohemolyticocrisis.o-oCORRECTooANSWER-
B.ohasofeweroredobloodocellsothanonormal.TheoHctoisotheomeasureoofotheovolumeooforedobl
oodocellsoinowholeobloodoexpressedoasoaopercentage.oThisotestoisousefuloinotheodiagnosiso
ofoanemia,opolycythemia,oandoabnormalohydrationostates.oPatientsowhooareosusceptibleot
oobleedingodisordersolikelyowillohaveoaolowoplateletocount.oTheoinflammatoryoresponseoma
yobestobeoevaluatedobyoexaminationooforesultsothatoincludeotheowhiteobloodocellocountowith
odifferentialoanalysis.oAcuteohemolyticocrisisodevelopsoinopatientsoreceivingobloodocompon
entsoinowhichoincompatibilityooccursooroinopatientsowithobleedingodisordersooroconditionsot
hatopromoteocellularodamage,osuchoasodamageoassociatedowithoshock.
1.oTheoarterialobloodogaso(ABG)oreadingsothatoindicateocompensatedorespiratoryoacidosis
oareoaoPaCO2oofo
A.o30ommoHgoandobicarbonateoleveloofo24omEq/L.o
B.o30ommoHgoandobicarbonateoleveloofo30omEq/L.o
C.o50ommoHgoandobicarbonateoleveloofo20omEq/L.
D.o50ommoHgoandobicarbonateoleveloofo30omEq/L.o-oCORRECTooANSWER-
D.o50ommoHgoandobicarbonateoleveloofo30omEq/L.oIfocompensationoisopresent,ocarbonodio
xideoandobicarbonateoareoabnormalo(oronearlyoso)oinooppositeodirectionso(e.g.,ooneoisoacid
oticoandotheootheroalkalotic).
1.oWhenoassessingoaopatient'sonutritional-
metabolicopatternorelatedotoohematologicohealth,otheonurseowould:o
A.oInspectotheoskinoforopetechiae.o
B.oAskotheopatientoaboutojointopain.o
C.oAssessoforovitaminoCodeficiency.o
D.oDetermineoifotheopatientocanoperformoADLs.o-oCORRECTooANSWER-
A.oInspectotheoskinoforopetechiae.oAnyochangesoinotheoskin'sotextureoorocoloroshouldobeoex
ploredowhenoassessingotheopatient'sonutritional-
metabolicopatternorelatedotoohematologicohealth.oTheopresencesoofopetechiaeooroecchym
oticoareasocouldobeoindicativeoofohematologicodeficienciesorelatedotoopooronutritionalointak
eoororelatedocauses.
,10.oAnticoagulantotherapyoisousedoinotheotreatmentoofothromboembolicodiseaseobecauseo
anticoagulantsocano
A.odissolveotheothrombi.o
B.odecreaseobloodoviscosity.o
C.opreventoabsorptionoofovitaminoK.o
D.oinhibitotheosynthesisoofoclottingofactors.o-oCORRECTooANSWER-
D.oinhibitotheosynthesisoofoclottingofactors.oAnticoagulantotherapyoisobasedoonotheopremise
othatotheoinitiationooroextensionoofothrombiocanobeopreventedobyoinhibitingotheosynthesisoof
oclottingofactorsoorobyoacceleratingotheiroinactivation.oTheoanticoagulantsoheparinoandowar
farinodoonotoinduceothrombolysisobutoeffectivelyopreventoclotoextension.
10.oDuringodischargeoteachingoforoao65-year-
oldopatientowithoemphysemaoandopneumonia,owhichoofotheofollowingovaccinesoshouldotheo
nurseorecommendotheopatientoreceive?o
A.oS.oaureuso
B.oH.oinfluenzaeo
C.oPneumococcalo
D.oBacilleoCalmette-Guérino(BCG)o-oCORRECTooANSWER-
C.oPneumococcaloTheopneumococcalovaccineoisoimportantoforopatientsowithoaohistoryoofoh
eartoorolungodisease,orecoveringofromoaosevereoillness,oageo65ooroover,oorolivingoinoaolong-
termocareofacility.
10.oIfoaonurseoisocaringoforoano80-year-
oldopatientowithoaotemperatureoofo100.4°oF,ocracklesoatotheorightolungobase,opainowithodee
poinspiration,oandodyspnea,owhichoofotheofollowingoordersoisotheonurse'sopriority?oA.oSputu
mospecimenoforocultureoandosensitivityo
B.oCodeineo15omgoorallyoeveryo6ohoursoasoneeded
C.oIncentiveospirometeroeveryo2ohoursowhileoawakeo
D.oAmoxicillino(Amoxil)o500omgoorallyo4otimesoaodayo-oCORRECTooANSWER-
A.oSputumospecimenoforocultureoandosensitivityoTheopatientopresentsowithosignsoofoaorespi
ratoryoinfection.oTooinitiateotheomostoeffectiveotherapy,otheohealthocareoprescriberomustokn
owotheopathogenocausingotheoinfection.oTherefore,otheosputumospecimenoisotheonurse'sop
riority.oIfotheoantibioticoisoadministeredobeforeotheospecimenoisoobtained,otheoresultsoofothe
ocultureomightonotobeoasoaccurateoandocouldoimpairotheoeffectivenessoofotherapy.oAfterothe
ospecimenoisoobtained,otheonurseocanoadministerocodeineoforocoughingoandobeginotheoinc
entiveospirometryotoomobilizeosecretionsoandoimproveotheopatient'soabilityotooexpectorateot
heosecretions.
10.oTheobloodobankonotifiesotheonurseothatotheotwoounitsoofobloodoorderedoforoanoanemico
patientoareoreadyoforopickoup.oTheonurseoshouldotakeowhichoofotheofollowingoactionsotoopre
ventoanoadverseoeffectoduringothisoprocedure?o
A.oImmediatelyopickoupobothounitsoofobloodofromotheobloodobank.o
B.oRegulateotheofloworateosoothatoeachounitotakesoatoleasto4ohoursotootransfuse.o
C.oSetoupotheoY-tubingoofotheobloodosetowithodextroseoinowateroasotheoflushosolution.o
D.oInfuseotheobloodoslowlyoforotheofirsto15ominutesoofotheotransfusion.o-
oCORRECTooANSWER-
,D.oInfuseotheobloodoslowlyoforotheofirsto15ominutesoofotheotransfusion.oBecauseoaotransfusi
onoreactionoisomoreolikelyotoooccuroatotheobeginningoofoaotransfusion,otheonurseoshouldoinit
iallyoinfuseotheobloodoatoaorateonoofasterothano2oml/minoandoremainowithotheopatientoforothe
ofirsto15ominutesoafterohangingoaounitoofoblood.
11.oIfoaopatientohasoperniciousoanemia,otheonurseoshouldoprovideoinformationoregardingo
A.ofrequentoboutsoofodyspnea.o
B.orisksorelativeotoodehydration.o
C.odeficiencyoofointrinsicofactor.o
D.olackoofoanyoeffectiveotreatmentoforothisocondition.o-oCORRECTooANSWER-
C.odeficiencyoofointrinsicofactor.oPerniciousoanemiaoisoaotypeoofoanemiaocausedobyofailureo
ofoabsorptionoofovitaminoB12o(cobalamin).oTheomostocommonocauseoisolackoofointrinsicofa
ctor,oaoglucoproteinoproducedobyotheoparietalocellsoofotheogastricolining.
11.oTheonurseoevaluatesothatodischargeoteachingoforoaopatientohospitalizedowithopneumon
iaohasobeenomostoeffectiveowhenotheopatientostatesowhichoofotheofollowingomeasuresotoopr
eventoaorelapse?o
A.o"Iowilloincreaseomyofoodointakeotoo2400ocaloriesoaodayotookeepomyoimmuneosystemowell
."o
B.o"Iomustouseohomeooxygenotherapyoforo3omonthsoandothenowillohaveoaochestox-
rayotooreevaluate."o
C.o"Iowilloseekoimmediateomedicalotreatmentoforoanyoupperorespiratoryoinfections."o
D.o"Ioshouldocontinueotoodoodeep-
breathingoandocoughingoexercisesoforoatoleasto6oweeks."o-oCORRECTooANSWER-
D.o"Ioshouldocontinueotoodoodeep-
breathingoandocoughingoexercisesoforoatoleasto6oweeks."oItoisoimportantoforotheopatientotoo
continueowithocoughingoandodeepobreathingoexercisesoforo6otoo8oweeksountiloalloofotheoinfe
ctionohasoclearedofromotheolungs.oAopatientoshouldoseekomedicalotreatmentoforoupperores
piratoryoinfectionsothatopersistoforomoreothano7odays.oIncreasedofluidointake,onotocaloricoint
ake,oisorequiredotooliquefyosecretions.oHomeoO2oisonotoaorequirementounlessotheopatient'so
oxygenationosaturationoisobelowonormal.
11.oWhenoassessingoaopatient'sorespiratoryostatus,owhichoofotheofollowingononrespiratoryo
dataoareomostoimportantoforotheonurseotooobtain?
A.oHeightoandoweighto
B.oNeckocircumferenceo
C.oOccupationoandohobbieso
D.oUsualodailyofluidointakeo-oCORRECTooANSWER-
C.oOccupationoandohobbiesManyorespiratoryoproblemsooccuroasoaoresultoofochronicoexpo
sureotooinhalationoirritants.oCommonooccupationalosourcesoofoinhalationoirritantsoincludeo
mines,ogranaries,ofarms,olawnocareocompanies,opaint,oplasticsoandorubberomanufacture,o
andobuildingoremodeling.oHobbiesoassociatedowithoinhalationoirritantsoincludeowoodworki
ng,ometalofinishing,ofurnitureorefinishing,opainting,oandoceramics.oDailyofluids,oheight,oando
weightoareomoreorelatedotoorespiratoryoproblemsosecondaryotoocardiacoissues.
, 12.oAonurseoisoprovidingocareotooanoadultofemaleopatientoandoobservesothatotheoHbolaborat
oryoanalysisoresultoiso9og/dl.oBasedoonothisofinding,otheonurseoshouldoexpectotooobserveo
A.odyspnea.o
B.obradycardia.o
C.owarm,odryoskin.o
D.oactivityotoleranceowithoutocomplaintoofofatigue.o-oCORRECTooANSWER-
A.odyspnea.Hbolevelsoareousedotoodetermineotheoseverityoofoanemia.oPatientsowithomoder
ateoanemiao(Hbo6otoo10og/dL)omayosufferofromodyspnea,opalpitations,odiaphoresisowithoex
ertion,oandochronicofatigue.oPatientsowhooareoanemicousuallyohaveocooloskinorelatedotooco
mpensatoryomechanismoofomildovasoconstriction.oPatientsowhooareoanemicoexperienceot
achycardiaobecauseoofoincreasedodemandsoplacedoonotheoheartotoomeetooverallometaboli
corequirements.oActivityotoleranceowithoutocomplaintoisonotocorrectobecauseopatientsowitho
anemicoconditionsofatigueoreadily.
12.oAfteroadmittingoaopatientotootheomedicalounitowithoaodiagnosisoofopneumonia,otheonurs
eowilloverifyothatowhichoofotheofollowingophysicianoordersohaveobeenocompletedobeforeoad
ministeringoaodoseoofocefotetano(Cefotan)otootheopatient?o
A.oSerumolaboratoryostudiesoorderedoforoAMo
B.oPulmonaryofunctionoevaluationo
C.oOrthostaticobloodopressureso
D.oSputumocultureoandosensitivityo-oCORRECTooANSWER-
D.oSputumocultureoandosensitivityTheonurseoshouldoensureothatotheosputumoforocultureoan
dosensitivityowasosentotootheolaboratoryobeforeoadministeringotheocefotetan.oItoisoimportant
othatotheoorganismsoareocorrectlyoidentifiedo(byotheoculture)obeforeotheironumbersoareoaffe
ctedobyotheoantibiotic;otheotestowilloalsoodetermineowhetherotheoproperoantibioticohasobeen
oorderedo(sensitivityotesting).oAlthoughoantibioticoadministrationoshouldonotobeoundulyodel
ayedowhileowaitingoforotheopatientotooexpectorateosputum,oalloofotheootherooptionsowillonoto
beoaffectedobyotheoadministrationoofoantibiotics.
12.oIfoaonurseoisoassessingoaopatientowhoseorecentobloodogasodeterminationoindicatedoaop
Hoofo7.32oandorespirationsoareomeasuredoato32obreaths/min,owhichoofotheofollowingoisotheo
mostoappropriateonursingoassessment?o
A.oTheorapidobreathingoisocausingotheolowopH.o
B.oTheonurseoshouldosedateotheopatientotooslowodownorespirations.o
C.oTheorapidobreathingoisoanoattemptotoocompensateoforotheolowopH.o
D.oTheonurseoshouldogiveotheopatientoaopaperobagotoobreatheointootoocorrectotheolowopH.o-
oCORRECTooANSWER-
C.oTheorapidobreathingoisoanoattemptotoocompensateoforotheolowopH.oTheorespiratoryosyst
emoinfluencesopHo(acidity)othroughocontroloofocarbonodioxideoexhalation.oThus,orapidobre
athingoincreasesotheopH.oBreathingointooaopaperobagoaidsoaopatientowhooisohyperventilatin
g;oinorespiratoryoalkalosis,oitoaidsoinoloweringotheopH.oTheouseoofosedationocanocauseoresp
iratoryodepressionoandohypoventilation,oresultingoinoanoevenoloweropH.
13.oIfoaopatientowithoanouncuffedotracheostomyotubeocoughsoviolentlyoduringosuctioningoa
ndodislodgesotheotracheostomyotube,oaonurseoshouldofirsto
A.ocallotheophysician.o
bank Med-Surg and other resources)
Questions And Answers
1.oAonurseoisoreviewingotheohematologicotestoresultsoforoaopatientoinowhomotheohematocrito
(Hct)oisoreportedoatoaoreadingoofo30%.oBasedoonothisoresult,otheonurseoshouldointerpretoth
atotheopatiento
A.oisosusceptibleotoobleedingodisorders.o
B.ohasofeweroredobloodocellsothanonormal.oC.oisoexperiencingoanoinflammatoryoresponse.o
D.oisoexperiencingoanoacuteohemolyticocrisis.o-oCORRECTooANSWER-
B.ohasofeweroredobloodocellsothanonormal.TheoHctoisotheomeasureoofotheovolumeooforedobl
oodocellsoinowholeobloodoexpressedoasoaopercentage.oThisotestoisousefuloinotheodiagnosiso
ofoanemia,opolycythemia,oandoabnormalohydrationostates.oPatientsowhooareosusceptibleot
oobleedingodisordersolikelyowillohaveoaolowoplateletocount.oTheoinflammatoryoresponseoma
yobestobeoevaluatedobyoexaminationooforesultsothatoincludeotheowhiteobloodocellocountowith
odifferentialoanalysis.oAcuteohemolyticocrisisodevelopsoinopatientsoreceivingobloodocompon
entsoinowhichoincompatibilityooccursooroinopatientsowithobleedingodisordersooroconditionsot
hatopromoteocellularodamage,osuchoasodamageoassociatedowithoshock.
1.oTheoarterialobloodogaso(ABG)oreadingsothatoindicateocompensatedorespiratoryoacidosis
oareoaoPaCO2oofo
A.o30ommoHgoandobicarbonateoleveloofo24omEq/L.o
B.o30ommoHgoandobicarbonateoleveloofo30omEq/L.o
C.o50ommoHgoandobicarbonateoleveloofo20omEq/L.
D.o50ommoHgoandobicarbonateoleveloofo30omEq/L.o-oCORRECTooANSWER-
D.o50ommoHgoandobicarbonateoleveloofo30omEq/L.oIfocompensationoisopresent,ocarbonodio
xideoandobicarbonateoareoabnormalo(oronearlyoso)oinooppositeodirectionso(e.g.,ooneoisoacid
oticoandotheootheroalkalotic).
1.oWhenoassessingoaopatient'sonutritional-
metabolicopatternorelatedotoohematologicohealth,otheonurseowould:o
A.oInspectotheoskinoforopetechiae.o
B.oAskotheopatientoaboutojointopain.o
C.oAssessoforovitaminoCodeficiency.o
D.oDetermineoifotheopatientocanoperformoADLs.o-oCORRECTooANSWER-
A.oInspectotheoskinoforopetechiae.oAnyochangesoinotheoskin'sotextureoorocoloroshouldobeoex
ploredowhenoassessingotheopatient'sonutritional-
metabolicopatternorelatedotoohematologicohealth.oTheopresencesoofopetechiaeooroecchym
oticoareasocouldobeoindicativeoofohematologicodeficienciesorelatedotoopooronutritionalointak
eoororelatedocauses.
,10.oAnticoagulantotherapyoisousedoinotheotreatmentoofothromboembolicodiseaseobecauseo
anticoagulantsocano
A.odissolveotheothrombi.o
B.odecreaseobloodoviscosity.o
C.opreventoabsorptionoofovitaminoK.o
D.oinhibitotheosynthesisoofoclottingofactors.o-oCORRECTooANSWER-
D.oinhibitotheosynthesisoofoclottingofactors.oAnticoagulantotherapyoisobasedoonotheopremise
othatotheoinitiationooroextensionoofothrombiocanobeopreventedobyoinhibitingotheosynthesisoof
oclottingofactorsoorobyoacceleratingotheiroinactivation.oTheoanticoagulantsoheparinoandowar
farinodoonotoinduceothrombolysisobutoeffectivelyopreventoclotoextension.
10.oDuringodischargeoteachingoforoao65-year-
oldopatientowithoemphysemaoandopneumonia,owhichoofotheofollowingovaccinesoshouldotheo
nurseorecommendotheopatientoreceive?o
A.oS.oaureuso
B.oH.oinfluenzaeo
C.oPneumococcalo
D.oBacilleoCalmette-Guérino(BCG)o-oCORRECTooANSWER-
C.oPneumococcaloTheopneumococcalovaccineoisoimportantoforopatientsowithoaohistoryoofoh
eartoorolungodisease,orecoveringofromoaosevereoillness,oageo65ooroover,oorolivingoinoaolong-
termocareofacility.
10.oIfoaonurseoisocaringoforoano80-year-
oldopatientowithoaotemperatureoofo100.4°oF,ocracklesoatotheorightolungobase,opainowithodee
poinspiration,oandodyspnea,owhichoofotheofollowingoordersoisotheonurse'sopriority?oA.oSputu
mospecimenoforocultureoandosensitivityo
B.oCodeineo15omgoorallyoeveryo6ohoursoasoneeded
C.oIncentiveospirometeroeveryo2ohoursowhileoawakeo
D.oAmoxicillino(Amoxil)o500omgoorallyo4otimesoaodayo-oCORRECTooANSWER-
A.oSputumospecimenoforocultureoandosensitivityoTheopatientopresentsowithosignsoofoaorespi
ratoryoinfection.oTooinitiateotheomostoeffectiveotherapy,otheohealthocareoprescriberomustokn
owotheopathogenocausingotheoinfection.oTherefore,otheosputumospecimenoisotheonurse'sop
riority.oIfotheoantibioticoisoadministeredobeforeotheospecimenoisoobtained,otheoresultsoofothe
ocultureomightonotobeoasoaccurateoandocouldoimpairotheoeffectivenessoofotherapy.oAfterothe
ospecimenoisoobtained,otheonurseocanoadministerocodeineoforocoughingoandobeginotheoinc
entiveospirometryotoomobilizeosecretionsoandoimproveotheopatient'soabilityotooexpectorateot
heosecretions.
10.oTheobloodobankonotifiesotheonurseothatotheotwoounitsoofobloodoorderedoforoanoanemico
patientoareoreadyoforopickoup.oTheonurseoshouldotakeowhichoofotheofollowingoactionsotoopre
ventoanoadverseoeffectoduringothisoprocedure?o
A.oImmediatelyopickoupobothounitsoofobloodofromotheobloodobank.o
B.oRegulateotheofloworateosoothatoeachounitotakesoatoleasto4ohoursotootransfuse.o
C.oSetoupotheoY-tubingoofotheobloodosetowithodextroseoinowateroasotheoflushosolution.o
D.oInfuseotheobloodoslowlyoforotheofirsto15ominutesoofotheotransfusion.o-
oCORRECTooANSWER-
,D.oInfuseotheobloodoslowlyoforotheofirsto15ominutesoofotheotransfusion.oBecauseoaotransfusi
onoreactionoisomoreolikelyotoooccuroatotheobeginningoofoaotransfusion,otheonurseoshouldoinit
iallyoinfuseotheobloodoatoaorateonoofasterothano2oml/minoandoremainowithotheopatientoforothe
ofirsto15ominutesoafterohangingoaounitoofoblood.
11.oIfoaopatientohasoperniciousoanemia,otheonurseoshouldoprovideoinformationoregardingo
A.ofrequentoboutsoofodyspnea.o
B.orisksorelativeotoodehydration.o
C.odeficiencyoofointrinsicofactor.o
D.olackoofoanyoeffectiveotreatmentoforothisocondition.o-oCORRECTooANSWER-
C.odeficiencyoofointrinsicofactor.oPerniciousoanemiaoisoaotypeoofoanemiaocausedobyofailureo
ofoabsorptionoofovitaminoB12o(cobalamin).oTheomostocommonocauseoisolackoofointrinsicofa
ctor,oaoglucoproteinoproducedobyotheoparietalocellsoofotheogastricolining.
11.oTheonurseoevaluatesothatodischargeoteachingoforoaopatientohospitalizedowithopneumon
iaohasobeenomostoeffectiveowhenotheopatientostatesowhichoofotheofollowingomeasuresotoopr
eventoaorelapse?o
A.o"Iowilloincreaseomyofoodointakeotoo2400ocaloriesoaodayotookeepomyoimmuneosystemowell
."o
B.o"Iomustouseohomeooxygenotherapyoforo3omonthsoandothenowillohaveoaochestox-
rayotooreevaluate."o
C.o"Iowilloseekoimmediateomedicalotreatmentoforoanyoupperorespiratoryoinfections."o
D.o"Ioshouldocontinueotoodoodeep-
breathingoandocoughingoexercisesoforoatoleasto6oweeks."o-oCORRECTooANSWER-
D.o"Ioshouldocontinueotoodoodeep-
breathingoandocoughingoexercisesoforoatoleasto6oweeks."oItoisoimportantoforotheopatientotoo
continueowithocoughingoandodeepobreathingoexercisesoforo6otoo8oweeksountiloalloofotheoinfe
ctionohasoclearedofromotheolungs.oAopatientoshouldoseekomedicalotreatmentoforoupperores
piratoryoinfectionsothatopersistoforomoreothano7odays.oIncreasedofluidointake,onotocaloricoint
ake,oisorequiredotooliquefyosecretions.oHomeoO2oisonotoaorequirementounlessotheopatient'so
oxygenationosaturationoisobelowonormal.
11.oWhenoassessingoaopatient'sorespiratoryostatus,owhichoofotheofollowingononrespiratoryo
dataoareomostoimportantoforotheonurseotooobtain?
A.oHeightoandoweighto
B.oNeckocircumferenceo
C.oOccupationoandohobbieso
D.oUsualodailyofluidointakeo-oCORRECTooANSWER-
C.oOccupationoandohobbiesManyorespiratoryoproblemsooccuroasoaoresultoofochronicoexpo
sureotooinhalationoirritants.oCommonooccupationalosourcesoofoinhalationoirritantsoincludeo
mines,ogranaries,ofarms,olawnocareocompanies,opaint,oplasticsoandorubberomanufacture,o
andobuildingoremodeling.oHobbiesoassociatedowithoinhalationoirritantsoincludeowoodworki
ng,ometalofinishing,ofurnitureorefinishing,opainting,oandoceramics.oDailyofluids,oheight,oando
weightoareomoreorelatedotoorespiratoryoproblemsosecondaryotoocardiacoissues.
, 12.oAonurseoisoprovidingocareotooanoadultofemaleopatientoandoobservesothatotheoHbolaborat
oryoanalysisoresultoiso9og/dl.oBasedoonothisofinding,otheonurseoshouldoexpectotooobserveo
A.odyspnea.o
B.obradycardia.o
C.owarm,odryoskin.o
D.oactivityotoleranceowithoutocomplaintoofofatigue.o-oCORRECTooANSWER-
A.odyspnea.Hbolevelsoareousedotoodetermineotheoseverityoofoanemia.oPatientsowithomoder
ateoanemiao(Hbo6otoo10og/dL)omayosufferofromodyspnea,opalpitations,odiaphoresisowithoex
ertion,oandochronicofatigue.oPatientsowhooareoanemicousuallyohaveocooloskinorelatedotooco
mpensatoryomechanismoofomildovasoconstriction.oPatientsowhooareoanemicoexperienceot
achycardiaobecauseoofoincreasedodemandsoplacedoonotheoheartotoomeetooverallometaboli
corequirements.oActivityotoleranceowithoutocomplaintoisonotocorrectobecauseopatientsowitho
anemicoconditionsofatigueoreadily.
12.oAfteroadmittingoaopatientotootheomedicalounitowithoaodiagnosisoofopneumonia,otheonurs
eowilloverifyothatowhichoofotheofollowingophysicianoordersohaveobeenocompletedobeforeoad
ministeringoaodoseoofocefotetano(Cefotan)otootheopatient?o
A.oSerumolaboratoryostudiesoorderedoforoAMo
B.oPulmonaryofunctionoevaluationo
C.oOrthostaticobloodopressureso
D.oSputumocultureoandosensitivityo-oCORRECTooANSWER-
D.oSputumocultureoandosensitivityTheonurseoshouldoensureothatotheosputumoforocultureoan
dosensitivityowasosentotootheolaboratoryobeforeoadministeringotheocefotetan.oItoisoimportant
othatotheoorganismsoareocorrectlyoidentifiedo(byotheoculture)obeforeotheironumbersoareoaffe
ctedobyotheoantibiotic;otheotestowilloalsoodetermineowhetherotheoproperoantibioticohasobeen
oorderedo(sensitivityotesting).oAlthoughoantibioticoadministrationoshouldonotobeoundulyodel
ayedowhileowaitingoforotheopatientotooexpectorateosputum,oalloofotheootherooptionsowillonoto
beoaffectedobyotheoadministrationoofoantibiotics.
12.oIfoaonurseoisoassessingoaopatientowhoseorecentobloodogasodeterminationoindicatedoaop
Hoofo7.32oandorespirationsoareomeasuredoato32obreaths/min,owhichoofotheofollowingoisotheo
mostoappropriateonursingoassessment?o
A.oTheorapidobreathingoisocausingotheolowopH.o
B.oTheonurseoshouldosedateotheopatientotooslowodownorespirations.o
C.oTheorapidobreathingoisoanoattemptotoocompensateoforotheolowopH.o
D.oTheonurseoshouldogiveotheopatientoaopaperobagotoobreatheointootoocorrectotheolowopH.o-
oCORRECTooANSWER-
C.oTheorapidobreathingoisoanoattemptotoocompensateoforotheolowopH.oTheorespiratoryosyst
emoinfluencesopHo(acidity)othroughocontroloofocarbonodioxideoexhalation.oThus,orapidobre
athingoincreasesotheopH.oBreathingointooaopaperobagoaidsoaopatientowhooisohyperventilatin
g;oinorespiratoryoalkalosis,oitoaidsoinoloweringotheopH.oTheouseoofosedationocanocauseoresp
iratoryodepressionoandohypoventilation,oresultingoinoanoevenoloweropH.
13.oIfoaopatientowithoanouncuffedotracheostomyotubeocoughsoviolentlyoduringosuctioningoa
ndodislodgesotheotracheostomyotube,oaonurseoshouldofirsto
A.ocallotheophysician.o
