RNSG 2539 FINAL EXAM LATEST ACTUAL EXAM 500 QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) ALREADY GRADED A+

RNSG 2539 FINAL EXAM LATEST ACTUAL EXAM 500 QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) ALREADY GRADED A+ A nurse is providing care to a child with idiopathic thrombocytopenic purpura with a platelet count of 18,000/mm3. Which medication would the nurse most likely expect to be ordered? A) Folic acid B) Intravenous immune globulin C) Dimercaprol D) Deferoxamine - ANSWER-B) Intravenous immune globulin The nurse is caring for a 12-year-old boy with idiopathic thrombocytopenia. The nurse is providing discharge instructions about home care and safety recommendations to the boy and his parents. Which response indicates a need for further teaching? A) "We should avoid aspirin and drugs like ibuprofen." B) "He can resume participation in football in 2 weeks." C) "Swimming would be a great activity." D) "Our son cannot take any antihistamines." - ANSWER-B) "He can resume participation in football in 2 weeks." The results of a patient's most recent blood work and physical assessment are suggestive of immune thrombocytopenic purpura (ITP). This patient should undergo testing for which of the following potential causes? Select all that apply. A) Hepatitis B) Acute renal failure C) HIV D) Malignant melanoma E) Cholecystitis - ANSWER-A) Hepatitis C) HIV A patient with a recent diagnosis of ITP has asked the nurse why the care team has not chosen to administer platelets, stating, 'I have low platelets, so why not give me a transfusion of exactly what I'm missing?' How should the nurse best respond? A) 'Transfused platelets usually aren't beneficial because they're rapidly destroyed in the body.' B) 'A platelet transfusion often blunts your body's own production of platelets even further.' C) 'Finding a matching donor for a platelet transfusion is exceedingly difficult.' D) 'A very small percentage of the platelets in a transfusion are actually functional.' - ANSWER-A) 'Transfused platelets usually aren't beneficial because they're rapidly destroyed in the body.' In immune thrombocytopenia purpura (ITP), the client has what type of disorder that primarily destroys which blood component? A) Allergic; fibrinogen B) Alloimmune; factor VIII C) Autoimmune; platelets D) Immunoglobulin; B cells - ANSWER-C) Autoimmune; platelets A client has been admitted for immune thrombocytopenic purpura. The client has not responded to corticosteroid treatment. The priority nursing intervention for this client would include which of the following treatment measures? A) Place the client in isolation, so the skin rashes will not spread to other clients. B) Insert an intravenous catheter, so immune globulin can be administered in a timely manner. C) Insert a Foley catheter to monitor hourly urine output. D) Prepare a surgical permit for an emergency splenectomy. - ANSWER-B) Insert an intravenous catheter, so immune globulin can be administered in a timely manner. A nurse is admitting a patient with immune thrombocytopenic purpura to the unit. In completing the admission assessment, the nurse must be alert for what medications that potentially alter platelet function? Select all that apply. A) Antihypertensives B) Penicillins C) Sulfa-containing medications D) Aspirin-based drugs E) NSAIDs - ANSWER-C) Sulfa-containing medications D) Aspirin-based drugs E) NSAIDs A client was started on a protocol for the prevention of deep vein thrombosis shortly after admission and has been receiving 5000 units of heparin twice daily for the last week. An immune response to this treatment may increase the client's chance of developing which health problem? A) Antiphospholipid syndrome B) Disseminated intravascular coagulation (DIC) C) Von Willebrand disease D) Thrombocytopenia - ANSWER-D) Thrombocytopenia When the nurse administers heparin it is anticipated the drug will have what action on the patient's body? A) Binds to factor X B) Blocks the formation of thrombin C) Binds to factor Xa D) Promotes the inactivation of factor VIII - ANSWER-B) Blocks the formation of thrombin The nurse is reviewing the laboratory test results of a pregnant client. Which one of the following findings would alert the nurse to the development of HELLP syndrome? A) Hyperglycemia B) Elevated platelet count C) Leukocytosis D) Elevated liver enzymes - ANSWER-D) Elevated liver enzymes A woman is receiving magnesium sulfate as part of her treatment for severe preeclampsia. The nurse is monitoring the woman's serum magnesium levels. Which level would the nurse identify as therapeutic? A) 3.3 mEq/L B) 6.1 mEq/L C) 8.4 mEq/L D) 10.8 mEq/L - ANSWER-B) 6.1 mEq/L A nurse is providing discharge education to a patient who has recently been diagnosed with a bleeding disorder. What topic should the nurse prioritize when teaching this patient? A) Avoiding buses, subways, and other crowded, public sites B) Avoiding activities that carry a risk for injury C) Keeping immunizations current D) Avoiding foods high in vitamin K - ANSWER-B) Avoiding activities that carry a risk for injury The nurse is caring for a 12-year-old boy with idiopathic thrombocytopenia. The nurse is providing discharge instructions about home care and safety recommendations to the boy and his parents. Which response indicates a need for further teaching? A) "We should avoid aspirin and drugs like ibuprofen." B) "He can resume participation in football in 2 weeks." C) "Swimming would be a great activity." D) "Our son cannot take any antihistamines." - ANSWER-B) "He can resume participation in football in 2 weeks." A postpartum woman who developed deep vein thrombosis is being discharged on anticoagulant therapy. After teaching the woman about this treatment, the nurse determines that additional teaching is needed when the woman states which of the following? A) "I will use a soft toothbrush to brush my teeth." B) "I can take ibuprofen if I have any pain." C) "I need to avoid drinking any alcohol." D) "I will call my health care provider if my stools are black and tarry." - ANSWER-B) "I can take ibuprofen if I have any pain." A nurse is preparing to discharge a patient newly prescribed warfarin (Coumadin). While assessing the patient's knowledge of the drug, what would indicate that the patient needs further instruction concerning drug therapy? A) "I love to eat homegrown tomatoes in the summer." B) "I take aspirin for my arthritis." C) "I walk 2 miles a day." D) "I drink a glass of wine about once a week." - ANSWER-B) "I take aspirin for my arthritis." A young man has been diagnosed with hemophilia and the nurse is planning his discharge teaching and includes what teaching point? A) Using nonsteroidal anti-inflammatory drugs (NSAIDs) for mild pain B) Preventing trauma to the body C) Receiving IV factor VIII therapy at home D) Understanding the condition is an X-linked recessive disorder - ANSWER-B) Preventing trauma to the body A 55-year-old man has been newly diagnosed with acute pancreatitis and admitted to the acute medical unit. How should the nurse most likely explain the pathophysiology of this patient's health problem? A) Toxins have accumulated and inflamed your pancreas B) Bacteria likely migrated from your intestines and became lodged in your pancreas C) A virus that was likely already present in your body has begun to attack your pancreatic cells D) The enzymes that your pancreas produces have damaged the pancreas itself - ANSWER-D) The enzymes that your pancreas produces have damaged the pancreas itself A patient's assessment and diagnostic testing are suggestive of acute pancreatitis. When the nurse is performing the health interview, what assessment questions address likely etiologic factors? Select all that apply. A) How many alcoholic drinks do you typically consume in a week? B) Have you ever been tested for diabetes? C) Have you ever been diagnosed with gall stones? D) Would you say you eat a particularly high fat diet? E) Does anyone in your family have cystic fibrosis? - ANSWER-A) How many alcoholic drinks do you typically consume in a week? C) Have you ever been diagnosed with gall stones? A nurse who provides care at a walk-in clinic assesses a wide range of individuals. The nurse should identify which of the following patients as having the highest risk for chronic pancreatitis? A) A 45-year-old obese woman with a high fat diet B) An 18-year-old man who is a weekend binge drinker C) A 39-year old man with chronic alcoholism D) A 51-year old-woman who smokes one- and one-half packs of cigarettes per day - ANSWER-C) A 39-year old man with chronic alcoholism A 37-year-old man presents to the ED complaining of N/V and severe abdominal pain. The patient's abdomen is rigid and there is bruising to the patient's flank. The patient's wife states that he was on a drinking binge for the past 2 days. The ED nurse should assist in assessing the patient for what health problem? A) Severe pancreatitis with possible peritonitis B) Acute cholecystitis C) Chronic pancreatitis D) Acute appendicitis with possible perforation - ANSWER-A) Severe pancreatitis with possible peritonitis A patient with chronic pancreatitis had a pancreatojejunostomy created 3 months ago for relief of pain and to restore drainage of pancreatic secretions. The patient has come to the office for a routine appointment. The patient is frustrated that the pain has not decreased. What is the most appropriate initial response by the nurse? A)The majority of patients who have a pancreaticojejunostomy have their normal digestion restored but do not achieve pain relief." B) "Pain relief occurs by 6 months in most patients who undergo this procedure, but some people experience a recurrence of their pain." C) "Your physician will likely want to discuss the removal of your gallbladder to achieve pain relief." D) "You are probably not appropriately taking the medications for your pancreatitis and pain, so we will need to discuss your medication regimen in detail." - ANSWER-B) "Pain