ANSWERS; 100% CORRECT; GRADE A
A 36-yr-old patient suspected of having leukemia is scheduled
for a bone marrow aspiration. What statement in the patient's
health history requires immediate follow-up by the nurse?
"I had a bad reaction to iodine before and almost died."
"I am taking an antibiotic to treat a urinary tract infection."
"I have rheumatoid arthritis and take aspirin for joint pain."
"I have dialysis for chronic renal failure three times a week." -
correct answer- "I have rheumatoid arthritis and take
aspirin for joint pain."
Rationale: Complications of bone marrow aspiration are
minimal, but there is a possibility of damaging underlying
structures, especially if the sternum site is used. Other
complications include hemorrhage, particularly if the pt is
thrombocytopenic, & infection if the WBC count is low. The risk
of hemorrhage is increased if the pt takes aspirin because it
promotes bleeding by inhibiting platelet aggregation.
Contrast dye is not used during a bone marrow aspiration. A
bone marrow aspiration is *not* contraindicated in pts who
,have chronic renal failure on dialysis or a urinary tract infection
on an antibiotic.
A 62-yr-old patient with disseminated intravascular coagulation
(DIC) after urosepsis has a platelet count of 48,000/μL. The
nurse should assess the patient for which abnormality?
Pallor
Purpura
Pruritus
Palpitation - correct answer- Purpura
Rationale: The normal range for a platelet count is 150,000 to
400,000/μL. Purpura is caused by decreased platelets or clotting
factors, resulting in small hemorrhages into the skin or mucous
membranes.
Pallor is decreased or absent coloration in the conjunctiva or
skin.
Pruritus is an intense itching sensation.
Palpitation is a sensation of feeling the heart beat, flutter, or
pound in the chest.
,A 70-yr-old man who has end-stage lung cancer is admitted to
the hospital with confusion and oliguria for 2 days. Which
finding would the nurse report immediately to the health care
provider?
Weight gain of 6 lb
Nausea and vomiting
Urine specific gravity of 1.004
Serum sodium level of 118 mEq/L - correct answer-
Serum sodium level of 118 mEq/L
Rationale: Lung cancer cells are able to manufacture and release
antidiuretic hormone (ADH) with resultant water retention and
hyponatremia. Hyponatremia (serum sodium levels less than
135 mEq/L) may lead to central nervous system symptoms such
as confusion, seizures, coma, and death. The other options listed
are also symptoms of hyponatremia but are not as critical to
report to the health care provider.
A blood type and cross-match has been ordered for a patient
who has an upper gastrointestinal bleed. The results of the
blood work indicate that the patient has type A blood. Which
description explains this result?
, The patient can be transfused with type AB blood.
The patient may only receive a type A transfusion.
The patient has A antigens on his red blood cells (RBCs).
Antibodies are present on the surface of the patient's RBCs. -
correct answer- The patient has A antigens on his red
blood cells (RBCs).
Rationale: A person with type A blood has A antigens, not A
antibodies, on his RBCs. An AB transfusion would result in
agglutination, but he may be transfused with either type A or
type O blood.
A complication of the hyperviscosity of polycythemia is
A. Thrombosis
B. Cardiomyopathy
C. Pulmonary edema
D. Disseminated intravascular coagulation (DIC) - correct
answer-