NRNP 6540 Advanced Practice Care Of Older Adults NEW 2023 GRADED A

NRNP 6540 Advanced Practice Care Of Older Adults NEW 2023 GRADED A+ What is the most important precaution to prevent harm that a nurse will teach a client who is prescribed to take the anticoagulant drug warfarin? A. Apply an ice pack to any body area that you bump or otherwise injure to reduce bleeding B. Check with your primary health care provider before taking any vitamin supplements C. Always take your medication within an hour of the same time every day and never with meals D. Avoid taking aspirin or any aspirin-containing product unless prescribed Which client history information is most relevant for the nurse to document when assessing for a possible hematologic problem? (SATA) A. Eats a vegan diet B. Participates in basketball twice weekly C. Mother has pernicious anemia D. Has a sister with Down syndrome E. Sprays fertilizers and weed killers for a lawn care company F. Takes aspirin or NSAIDs occasionally for minor muscle pain G. Has used a vaping device instead of cigarette smoking for the past 2 years When reviewing the laboratory results for a client in the emergency department, which finding does the nurse report immediately to prevent harm? A. International normalized ration (INR) of 5.2 B. Platelet count of 180,000/mm3 C. Hematocrit of 27% (0.27 volume fraction) D. Reticulocyte value of 4% Which statement regarding erythrocytes is true? A. Reticulocytes represent the final stage of mature erythrocytes B. The lack of a nucleus in a mature erythrocyte increases its lifespan C. Each erythrocyte can carry up to a maximum of four molecules of oxygen D. The main trigger for erythrocyte production is the secretion of thrombopoietin Which response or health problem does the nurse expect to be present in a client who has a lifelong deficiency of antithrombin III? A. Chronic fatigue resulting from reduced production of normal hemoglobin B. Failure to produce and maintain normal circulating levels of platelets C. Prolonged bleeding and hematoma formation at sites of tissue injury D. Increased risk for clot formation and disruption of perfusion Which precaution has the highest priority for prevention of harm when the nurse teaches the client about home care after a bone marrow aspiration? A. Clean the suture line daily with soap and water B. Drink at least 4 L of fluid to ensure adequate hydration C. Avoid taking any aspirin or aspirin containing products D. Stay in bed and get up only to use the bathroom for the next 2 days Which change in laboratory test results of a client with sickle cell disease who was started on therapy with Endari 2 months ago indicates to the nurse that the therapy is effective? A. Increased HbF from 2% to 10% B. Increased HbA from 3% to 5% C. Decreased reticulocyte count from 12% to 4% D. Decreased white blood cells from 8200/mm3 to 7000/mm3 With which types of anemia does the nurse ask the client about the presence of the disorder in other family members? (SATA) A. Sickle cell anemia B. Folic acid deficiency anemia C. Glucose-6-phosphate dehydrogenase deficiency anemia D. Iron deficiency anemia E. Pernicious anemia F. Vitamin B12 deficiency anemia A client returning to the clinic 7 weeks after hematopoietic stem cell transplantation for leukemia has a total white blood cell (WBC) count of 5200/mm3 and a neutrophil count of 3000/mm3. What is the nurse's priority action in view of these values? A. Notify the oncology health care provider immediately B. Assess the client for other symptoms of infection C. Document the laboratory report as the only action D. Obtain a urine specimen, sputum specimen, and chest x-ray The family of a client receiving a blood transfusion report with distress to the nurse that although the blood bag hanging has the client's name on it, the bag label says B negative and the client's blood type is B positive. What is the nurse's priority action? A. Alert the blood bank and rapid response team about a potential error B. Thank the family for being alert and preventing a serious complication C. Explain that a person who is Rh positive can receive Rh negative blood D. Immediately go and stop the infusion but keep the IV line open with normal saline Which new symptoms in a client who is being managed for sickle cell crisis does the nurse report immediately to prevent harm? (SATA) A. Decreased handgrip strength on one side B. Diffuse abdominal pain C. Fever of 102.2F (39C) D. Increased urine output E. Shortness of breath F. Sore throat Which intervention is a priority for the nurse to teach the client with polycythemia vera to prevent harm related to injury as a result of impaired platelet function? A. Wear gloves and socks outdoors in cool weather B. Elevate your feet whenever you are seated C. Drink at least 3 L of liquids per day D. Use a soft-bristle toothbrush A nurse caring for a client with sickle cell disease (SCD) reviews the client's laboratory test results. Which finding would the nurse report to the primary health care provider? a. Creatinine: 2.9 mg/dL (256 mcmol/L) b. Hematocrit: 30% c. Sodium: 146 mEq/L (146 mmol/L) d. White blood cell count: 12,000/mm3 (12 109 /L) The nurse is assessing a client in sickle cell disease (SCD) crisis. What priority client problem will the nurse expect? a. Infection b. Pallor c. Pain d. Fatigue A client in sickle cell crisis is dehydrated and in the emergency department. The nurse plans to start an IV. Which fluid choice is best? a. 0.45% normal saline b. 0.9% normal saline c. Dextrose 50% (D50) d. Lactated Ringer's solution A client presents to the emergency department in sickle cell disease crisis. What intervention by the nurse takes priority? a. Administer oxygen. b. Initiate pulse oximetry. c. Give pain medication. d. Start an IV line. The nurse is caring for a client experiencing sickle cell disease crisis. Which priority action would help prevent infection? a. Administering prophylactic antibiotics b. Monitoring the client's temperature c. Checking the client's white blood cell count d. Performing frequent handwashing A nurse in a hematology clinic is working with four clients who have polycythemia vera. Which client would the nurse assess first? a. Client with a blood pressure of 180/98 mm Hg b. Client who reports shortness of breath c. Client who reports calf tenderness and swelling d. Client with a swollen and painful left great toe The nurse is teaching a client who has pernicious anemia about necessary dietary changes. Which statement by the client indicates understanding about those changes? a. "I'll increase animal proteins like fish and meat." b. "I'll work on increasing my fats and carbohydrates." c. "I'll avoid eating green leafy vegetables. d. "I'll limit my intake of citrus fruits." An assistive personnel is caring for a client with leukemia and asks why the client is still at risk for infection when the white blood cell count (WBC) is high. What response by the nurse is correct? a. "If the WBCs are high, there already is an infection present." b. "The client is in a blast crisis and has too many WBCs." c. "There must be a mistake; the WBCs should be very low." d. "Those WBCs are abnormal and don't provide protection." The family of a neutropenic client reports that the client "is not acting right." What action by the nurse is the priority? a. Ask the client about pain. b. Assess the client for infection. c. Take a set of vital signs. d. Review today's laboratory results. A nurse is caring for a client who is about to receive a bone marrow transplant. To best help the client cope with the long recovery period, what action by the nurse is best? a. Arrange a visitation schedule among friends and family. b. Explain that this process is difficult but must be endured. c. Help the client find things to hope for each day of recovery. d. Provide plenty of diversionary activities for this time A client asks about the process of graft-versus-host disease. What explanation by the nurse is correct? a. "Because of immunosuppression, the donor cells take over." b. "It's like a transfusion reaction because no perfect matches exist." c. "The patient's cells are fighting donor cells for dominance." d. "The donor's cells are actually attacking the patient's cells." The nurse is caring for a patient with leukemia who has severe fatigue. What action by the client best indicates that an important outcome to manage this problem has been met? a. Doing activities of daily living (ADLs) using rest periods b. Helping plan a daily activity schedule c. Requesting a sleeping pill at night d. Telling visitors to leave when fatigued A nurse is caring for a young male client with lymphoma who is to begin treatment. What teaching topic is a priority? a. Genetic testing b. Infection prevention c. Sperm banking d. Treatment options A client has a platelet count of 9000/mm3 (9 X109/L). The nurse finds the client confused and mumbling. What nursing action takes priority at this time? a. Call the Rapid Response Team. b. Take a set of vital signs. c. Institute bleeding precautions. d. Place the client on bedrest A nurse is preparing to administer a blood transfusion. What action is most important? a. Correctly identify client using two identifiers. b. Ensure that informed consent is obtained. c. Hang the blood product with Ringer's lactate. d. Stay with the client for the entire transfusion. A nurse is preparing to administer a blood transfusion. Which action is most important? a. Document the transfusion. b. Place the client on NPO status. c. Place the client in isolation. d. Put on a pair of gloves A client receiving a blood transfusion develops anxiety and low back pain. After stopping the transfusion, what action by the nurse is most important? a. Document the events in the client's medical record. b. Double-check the client and blood product identification. c. Place the client on strict bedrest until the pain subsides. d. Review the client's medical record for known allergies A client has thrombocytopenia. What statement indicates that the client understands self-management of this condition? a. "I brush and use dental floss every day." b. "I chew hard candy for my dry mouth." c. "I usually put ice on bumps or bruises." d. "Nonslip socks are best when I walk."