Nokea
A nurse is caring for a client who is about to begin therapy with recombinant factor IX to treat hemophilia B. The client asks the nurse about the risk of disease transmission with recombinant factor IX as compared with plasma derived factor IX. The nurse should explain that the recombinant factor IX practically eliminates the risk for which of the following?
- A. HIV
- B. Cytomegalovirus
- C. Creutzfeldt-Jakob disease
- D. Anaphylaxis
Correct Answer: C
Rationale: Rationale:
1. Recombinant factor IX is produced synthetically, not from human blood, hence no risk of Creutzfeldt-Jakob disease.
2. HIV and cytomegalovirus can still be present in plasma-derived factor IX.
3. Anaphylaxis risk is not eliminated by using recombinant factor IX.
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Platelet aggregation is an important event in hemostasis. Which of the following statement is true for platelet aggregation in vascular injury?
- A. There will be initial vasodilation
- B. Clotting factors play no role in its formation
- C. Platelets change their shape during the process
- D. Serotonin stimulates platelet aggregation
Correct Answer: C
Rationale: The correct answer is C: Platelets change their shape during the process of platelet aggregation in vascular injury. Platelets undergo shape change from a discoid to a spiky form, leading to the exposure of their glycoprotein receptors, which then bind to fibrinogen and other platelets to form a platelet plug. This process is crucial for hemostasis and preventing excessive bleeding.
Explanation for why other choices are incorrect:
A: There will be initial vasodilation - Vasodilation is not a direct result of platelet aggregation but rather an initial response to vascular injury to increase blood flow to the area.
B: Clotting factors play no role in its formation - Clotting factors are essential for the later stages of hemostasis, but platelet aggregation is primarily driven by platelet activation and shape change.
D: Serotonin stimulates platelet aggregation - While serotonin is released from platelets upon activation, it does not directly stimulate platelet aggregation.
A client is having a radioisotopic imaging scan. What action by the nurse is most important?
- A. Assess the client for shellfish allergies.
- B. Place the client on radiation precautions.
- C. Sedate the client before the scan.
- D. Teach the client about the procedure.
Correct Answer: D
Rationale: The correct answer is D because educating the client about the procedure is crucial for informed consent, cooperation, and reducing anxiety. This empowers the client to participate actively in their care. Assessing for shellfish allergies (A) is irrelevant unless a specific contrast agent is used. Placing the client on radiation precautions (B) is unnecessary for radioisotopic imaging. Sedating the client (C) may not be indicated and should be avoided if possible. Teaching the client about the procedure (D) addresses the immediate need and supports client safety and understanding.
A nurse is caring for a patient who is being treated for leukemia in the hospital. The patient was able to maintain her nutritional status for the first few weeks following her diagnosis but is now exhibiting early signs and symptoms of malnutrition. In collaboration with the dietitian, the nurse should implement what intervention?
- A. Arrange for total parenteral nutrition (TPN).
- B. Facilitate placement of a percutaneous endoscopic gastrostomy (PEG) tube.
- C. Provide the patient with several small, soft-textured meals each day.
- D. Assign responsibility for the patient's nutrition to the patient's friends and family.
Correct Answer: C
Rationale: The correct answer is C: Provide the patient with several small, soft-textured meals each day. This intervention is appropriate for the patient showing early signs of malnutrition as it aims to increase the patient's nutrient intake in a manageable way. Small, soft-textured meals are easier for the patient to consume and digest, promoting better absorption of nutrients. This approach also aligns with the principle of promoting oral intake whenever possible before resorting to more invasive measures like TPN or PEG tube placement.
Incorrect choices:
A: Total parenteral nutrition (TPN) is typically reserved for patients who cannot tolerate oral feeding at all or have significant malabsorption issues.
B: Percutaneous endoscopic gastrostomy (PEG) tube placement is usually considered if the patient cannot meet their nutritional needs orally in the long term.
D: Assigning responsibility for the patient's nutrition to friends and family is not a sustainable or appropriate solution for addressing malnutrition in a hospitalized patient.
The nurse is concerned that a patient is demonstrating signs of red blood cell production. What laboratory value did the nurse most likely use to make this decision?
- A. Iron
- B. Bilirubin
- C. Thrombin
- D. Intrinsic factor
Correct Answer: B
Rationale: The correct answer is B: Bilirubin. Elevated levels of bilirubin can indicate increased red blood cell breakdown or hemolysis, prompting the body to produce more red blood cells to compensate for the loss. Iron (A) is involved in red blood cell production but is not a direct indicator. Thrombin (C) is a clotting factor, not related to red blood cell production. Intrinsic factor (D) is necessary for vitamin B12 absorption, not directly linked to red blood cell production. Therefore, Bilirubin is the most likely laboratory value used to indicate increased red blood cell production.
A patient who is infected with hookworms produces signs and symptoms of anemia. Which of the following can be seen in the peripheral blood smear of the patient?
- A. Howell-Jolly bodies
- B. Basophilic stippling
- C. Target cells
- D. Spherocytes
Correct Answer: B
Rationale: The correct answer is B: Basophilic stippling. Hookworm infection can lead to anemia due to chronic blood loss. Basophilic stippling is a characteristic finding in the peripheral blood smear of patients with iron deficiency anemia, which can result from hookworm infection. Basophilic stippling represents the aggregation of ribosomes and is seen in erythrocytes that contain denatured ribosomal RNA. Howell-Jolly bodies are remnants of nuclear material and are typically seen in patients with functional asplenia. Target cells are seen in conditions like liver disease or hemoglobinopathies. Spherocytes are seen in immune hemolytic anemias.