ATI Med-
g
Surg: Cardiovascular and Hematology Question
g g g g
s A charge nurse is observing a newly licensed nurse administer an IV medication to a client
g g g g g g g g g g g g g g g
g whoghasgangimplantedgvenousgaccessgport.gWhichgofgthegfollowinggobservationsgrequiresgi
nterventiongbygthegchargegnurse?
A. Agdressinggisgnotgappliedgtogthegportgsitegafterguse
B. Ag22-gaugegnon-coringgneedlegisgusedgtogaccessgthegport
C. Bloodgreturngisgnotedgpriorgtogadministeringgthegmedication
D. Agsolutiongofg5gmLgheparing1,000gunits/mLghasgbeengpreparedg-g✔✔-
D.gAgsolutiongofg5gmLgheparing1,000gunits/mLghasgbeengprepared
Implantedgportsgshouldgbegflushedgaftergeachgusegandgatgleastgoncegagmonthgwhengnotging
use.gThisgpracticegisgsometimesgreferredgtogasg"locking"gorg"de-
accessing."gItgisgperformedgtogpreventgthegformationgofgbloodgclotsgingthegcatheter,gwhichg
wouldgdisruptgthegpropergfunctioninggofgthegcatheter.gThegsolutiongofg5gmLgheparingshouldg
beg100gunits/mL;gtherefore,gthisgactiongrequiresginterventiongbygthegchargegnurse.
- A:gAngimplantedgaccessgportgisgsurgicallygplacedgingthegsubcutaneousgtissue,gusuallyging
theguppergchestgorganguppergextremity.gThesegsitesgdognotgrequiregagdressinggtogcovergthe
gportgsite.
- B:gAgspecialgnon-
coringgneedlegmustgbegusedgtogaccessgimplantedgports.gThesegneedlesghavegagdeflectedgti
pgthatgisgspecificallygdesignedgtogpenetrategthegdensegseptumgwithoutgcoringgsmallgpiecesg
ofgit.gImplantedgportsgplacedgingthegchestgcangusuallygtolerategaboutg2,000gpunctures.gTheg
edgesgofgthegportgshouldgbegcarefullygpalpatedgtogidentifygthegseptum
,priorgtogplacementgofgthegneedle.gItgisgappropriategforgthegnursegtogusegag22-
gaugegnon-coringgneedlegtogaccessgthegdevice.
- C:gPriorgtogadministeringgmedicationgthroughgthegimplantedgport,gthegnursegshouldgalways
checkgthegsitegforgbloodgreturn.gIfgtheregisgnogbloodgreturn,gthegnursegshouldgholdgthegmedi
g
cationguntilgpotencygcangbegensured.gSeriousgextravasationgcangoccurgduegtogthegformatio
ngofgagfibringsheathgovergthegtipgofgthegcathetergcausinggretrogradegsubcutaneousgleakage.
Agclientgwhoghasgthrombocytopeniagasksgthegnursegwhygplateletsgaregsogimportant.gWhichg
ofgthegfollowinggresponsesgshouldgthegnursegmake?
A. Plateletsghelpgthegbodygfightginfection
B. Plateletsghelpgbreakgdowngclotsgingthegbody
C. Plateletsgpluggbreaksgingbloodgvessels
D. Plateletsgproducegthegmoleculesgthatgcarrygoxygeng-g✔✔-
C.gPlateletsgpluggbreaksgingbloodgvessels
Plateletsghelpgmaintainghemostasisgandgcoagulationgbygplugginggdisruptionsgingthegintegrityg
ofgbloodgvessels.gWhenganginjurygoccursgtogagbloodgvessel,gplateletsgcollectgatgthegedgegofgt
hegbreakgandgadheregtogeachgothergtogpluggtheginjuredgareagandglimitgbloodgloss.
- A:gLeukocytes,gnotgplatelets,ghelpgthegbodygfightginfection
- B:gPlasmingisgamonggthegmanygsubstancesgthatghelpgbreakgdowngbloodgclotsgingthegbody.
Plateletsgdognotgperformgthisgfunction.
g
- D:gRedgbloodgcellsgproduceghemoglobingmolecules,gwhichgtransportgoxygengthroughout
thegbody
g
,Agclientgwhogjustglearnedgthatgheghasgvariantg(Prinzmetal's)ganginagasksgthegnurseghowgthisg
typegofganginagcomparesgwithgstablegangina.gWhichgofgthegfollowinggrepliesgshouldgthegnurs
egmake?
A. Exertiongoftengbringsgongpain
B. Variantganginagoccursgrandomlygatgvariousgtimes
C. Variantganginagcangcausegchangesgongyourgelectrocardiogram
D. Reducinggyourgcholesterolgcanghelpgyougexperienceglessgpaing-g✔✔-
C.gVariantganginagcangcausegchangesgongyourgelectrocardiogram
VariantganginagcausesgECGgchangesgthatgreflectgcoronarygarterygspasms,gwhichgresultsgingl
essgoxygengsupplyinggthegmyocardium.
- A:gVariantganginagtypicallygoccursgwithgrest
- B:gVariantganginagpaingtendsgtogoccurgatgthegsamegtimegofgday
- D:gVasospasm,gnotgatherosclerosis,gcausesgvariantgangina.gIfgthegclient'sgcholesterolglevel
isgabovegthegexpectedgreferencegrange,gattemptsgshouldgbegmadegtoglowergit;ghowever,gthi
g
sgmeasuregisgunlikelygtogaffectgvariantgangina
Agnursegcompletinggangassessmentgongagclient.gWhichgofgthegfollowinggfindingsgshouldgthe
nursegidentifygasgagriskgfactorgforgcoronarygarterygdisease?
g
(Selectgallgthatgapply.)
A. Hypothyroidism
B. Hypertension
, C. Diabetesgmellitus
D. Hyperlipidemia
E. Tobaccogsmokingg-g✔✔-B,gC,gD,gE
B. Hypertension
C. Diabetesgmellitus
D. Hyperlipidemia
E. Tobaccogsmoking
Agclientgwhoghasghypertension,gdiabetesgmellitus,ghyperlipidemia,gorgaghistorygofgsmokinggto
baccogisgatgriskgforgcoronarygarterygdiseaseg(CAD).
- Diabetesgcangcausegdamagegtoglargegandgsmallgbloodgvessels,gwhichgleadsgtogpoor
perfusion,gcellgdeath,gandgorgangdamage
g
- Cholesterolglevels,gsuchgasgtotalgHDLgandgLDLglevels,gshouldgbegmonitoredgsince
elevatedgtotalgserumgcholesterolglevelsgincreasegthegriskgofgagmyocardialginfarction
g
.
- Finally,gsmokinggacceleratesgthegrategofgthegnarrowinggofgthegcoronarygarteriesgand
increasesgthegriskgofgclotgformation
g
Agnursegisgadmittinggagclientgwhogisgingsicklegcellgcrisis.gBesidesgpaingmanagement,gwhichg
ofgthegfollowingginterventionsgshouldgthegnursegincludegingthegclient'sgplangofgcare?
A. Flexiongofgthegextremities
B. Therapeuticghypothermia
C. Uprightgpositioning
g
Surg: Cardiovascular and Hematology Question
g g g g
s A charge nurse is observing a newly licensed nurse administer an IV medication to a client
g g g g g g g g g g g g g g g
g whoghasgangimplantedgvenousgaccessgport.gWhichgofgthegfollowinggobservationsgrequiresgi
nterventiongbygthegchargegnurse?
A. Agdressinggisgnotgappliedgtogthegportgsitegafterguse
B. Ag22-gaugegnon-coringgneedlegisgusedgtogaccessgthegport
C. Bloodgreturngisgnotedgpriorgtogadministeringgthegmedication
D. Agsolutiongofg5gmLgheparing1,000gunits/mLghasgbeengpreparedg-g✔✔-
D.gAgsolutiongofg5gmLgheparing1,000gunits/mLghasgbeengprepared
Implantedgportsgshouldgbegflushedgaftergeachgusegandgatgleastgoncegagmonthgwhengnotging
use.gThisgpracticegisgsometimesgreferredgtogasg"locking"gorg"de-
accessing."gItgisgperformedgtogpreventgthegformationgofgbloodgclotsgingthegcatheter,gwhichg
wouldgdisruptgthegpropergfunctioninggofgthegcatheter.gThegsolutiongofg5gmLgheparingshouldg
beg100gunits/mL;gtherefore,gthisgactiongrequiresginterventiongbygthegchargegnurse.
- A:gAngimplantedgaccessgportgisgsurgicallygplacedgingthegsubcutaneousgtissue,gusuallyging
theguppergchestgorganguppergextremity.gThesegsitesgdognotgrequiregagdressinggtogcovergthe
gportgsite.
- B:gAgspecialgnon-
coringgneedlegmustgbegusedgtogaccessgimplantedgports.gThesegneedlesghavegagdeflectedgti
pgthatgisgspecificallygdesignedgtogpenetrategthegdensegseptumgwithoutgcoringgsmallgpiecesg
ofgit.gImplantedgportsgplacedgingthegchestgcangusuallygtolerategaboutg2,000gpunctures.gTheg
edgesgofgthegportgshouldgbegcarefullygpalpatedgtogidentifygthegseptum
,priorgtogplacementgofgthegneedle.gItgisgappropriategforgthegnursegtogusegag22-
gaugegnon-coringgneedlegtogaccessgthegdevice.
- C:gPriorgtogadministeringgmedicationgthroughgthegimplantedgport,gthegnursegshouldgalways
checkgthegsitegforgbloodgreturn.gIfgtheregisgnogbloodgreturn,gthegnursegshouldgholdgthegmedi
g
cationguntilgpotencygcangbegensured.gSeriousgextravasationgcangoccurgduegtogthegformatio
ngofgagfibringsheathgovergthegtipgofgthegcathetergcausinggretrogradegsubcutaneousgleakage.
Agclientgwhoghasgthrombocytopeniagasksgthegnursegwhygplateletsgaregsogimportant.gWhichg
ofgthegfollowinggresponsesgshouldgthegnursegmake?
A. Plateletsghelpgthegbodygfightginfection
B. Plateletsghelpgbreakgdowngclotsgingthegbody
C. Plateletsgpluggbreaksgingbloodgvessels
D. Plateletsgproducegthegmoleculesgthatgcarrygoxygeng-g✔✔-
C.gPlateletsgpluggbreaksgingbloodgvessels
Plateletsghelpgmaintainghemostasisgandgcoagulationgbygplugginggdisruptionsgingthegintegrityg
ofgbloodgvessels.gWhenganginjurygoccursgtogagbloodgvessel,gplateletsgcollectgatgthegedgegofgt
hegbreakgandgadheregtogeachgothergtogpluggtheginjuredgareagandglimitgbloodgloss.
- A:gLeukocytes,gnotgplatelets,ghelpgthegbodygfightginfection
- B:gPlasmingisgamonggthegmanygsubstancesgthatghelpgbreakgdowngbloodgclotsgingthegbody.
Plateletsgdognotgperformgthisgfunction.
g
- D:gRedgbloodgcellsgproduceghemoglobingmolecules,gwhichgtransportgoxygengthroughout
thegbody
g
,Agclientgwhogjustglearnedgthatgheghasgvariantg(Prinzmetal's)ganginagasksgthegnurseghowgthisg
typegofganginagcomparesgwithgstablegangina.gWhichgofgthegfollowinggrepliesgshouldgthegnurs
egmake?
A. Exertiongoftengbringsgongpain
B. Variantganginagoccursgrandomlygatgvariousgtimes
C. Variantganginagcangcausegchangesgongyourgelectrocardiogram
D. Reducinggyourgcholesterolgcanghelpgyougexperienceglessgpaing-g✔✔-
C.gVariantganginagcangcausegchangesgongyourgelectrocardiogram
VariantganginagcausesgECGgchangesgthatgreflectgcoronarygarterygspasms,gwhichgresultsgingl
essgoxygengsupplyinggthegmyocardium.
- A:gVariantganginagtypicallygoccursgwithgrest
- B:gVariantganginagpaingtendsgtogoccurgatgthegsamegtimegofgday
- D:gVasospasm,gnotgatherosclerosis,gcausesgvariantgangina.gIfgthegclient'sgcholesterolglevel
isgabovegthegexpectedgreferencegrange,gattemptsgshouldgbegmadegtoglowergit;ghowever,gthi
g
sgmeasuregisgunlikelygtogaffectgvariantgangina
Agnursegcompletinggangassessmentgongagclient.gWhichgofgthegfollowinggfindingsgshouldgthe
nursegidentifygasgagriskgfactorgforgcoronarygarterygdisease?
g
(Selectgallgthatgapply.)
A. Hypothyroidism
B. Hypertension
, C. Diabetesgmellitus
D. Hyperlipidemia
E. Tobaccogsmokingg-g✔✔-B,gC,gD,gE
B. Hypertension
C. Diabetesgmellitus
D. Hyperlipidemia
E. Tobaccogsmoking
Agclientgwhoghasghypertension,gdiabetesgmellitus,ghyperlipidemia,gorgaghistorygofgsmokinggto
baccogisgatgriskgforgcoronarygarterygdiseaseg(CAD).
- Diabetesgcangcausegdamagegtoglargegandgsmallgbloodgvessels,gwhichgleadsgtogpoor
perfusion,gcellgdeath,gandgorgangdamage
g
- Cholesterolglevels,gsuchgasgtotalgHDLgandgLDLglevels,gshouldgbegmonitoredgsince
elevatedgtotalgserumgcholesterolglevelsgincreasegthegriskgofgagmyocardialginfarction
g
.
- Finally,gsmokinggacceleratesgthegrategofgthegnarrowinggofgthegcoronarygarteriesgand
increasesgthegriskgofgclotgformation
g
Agnursegisgadmittinggagclientgwhogisgingsicklegcellgcrisis.gBesidesgpaingmanagement,gwhichg
ofgthegfollowingginterventionsgshouldgthegnursegincludegingthegclient'sgplangofgcare?
A. Flexiongofgthegextremities
B. Therapeuticghypothermia
C. Uprightgpositioning
