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A nurse is caring for a client who is experiencing an acute ischemic cerebrovascular event due to a thrombus in a cerebral vessel. Which of the following drugs should the nurse expect to administer?
- A. Alteplase
- B. Aspirin
- C. Clopidogrel
- D. Heparin
Correct Answer: A
Rationale: The correct answer is A: Alteplase. Alteplase is a thrombolytic agent used to dissolve blood clots and restore blood flow in acute ischemic stroke. It is crucial to administer within a specific time frame for the best outcome. Aspirin (B) and Clopidogrel (C) are antiplatelet agents that prevent further clot formation but are not used for immediate clot dissolution in acute ischemic stroke. Heparin (D) is an anticoagulant that prevents clot formation and is not typically used as the initial treatment for acute ischemic stroke.
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Cooley's anemia is:
- A. Sickle cell an.
- B. thalassemia major
- C. high ESR
- D. aplastic an.
Correct Answer: B
Rationale: Step 1: Cooley's anemia is another term for thalassemia major, a genetic disorder affecting hemoglobin production.
Step 2: Thalassemia major results in severe anemia due to the body's inability to produce enough functional hemoglobin.
Step 3: Sickle cell anemia (Choice A) is a different genetic disorder characterized by abnormal hemoglobin shape.
Step 4: High ESR (Choice C) is a non-specific marker of inflammation, not specific to Cooley's anemia.
Step 5: Aplastic anemia (Choice D) is a condition where the bone marrow does not produce enough blood cells, not specific to Cooley's anemia.
What are the six dimensions of quality care according to the Institute of Medicine?
- A. Safe, timely, effective, efficient, equitable, and person-centered
- B. Safe, transparent, effective, efficient, equitable, and person-centered
- C. Safe, timely, effective, low-cost, equitable, and person-centered
- D. Safe, timely, effective, efficient, cutting-edge, and person-centered
Correct Answer: A
Rationale: The correct answer is A: Safe, timely, effective, efficient, equitable, and person-centered. This aligns with the six dimensions of quality care outlined by the Institute of Medicine. Safety ensures patient well-being, timeliness reduces delays, effectiveness means providing evidence-based care, efficiency minimizes waste, equity ensures fair access, and person-centered care considers individual preferences.
Choice B is incorrect because transparency is not included in the Institute of Medicine's six dimensions. Choice C is incorrect as "low-cost" is not a recognized dimension of quality care. Choice D is incorrect because "cutting-edge" is not part of the established dimensions of quality care.
A 35-year-old male is admitted to the hospital complaining of severe headaches, vomiting, and testicular pain. His blood work shows reduced numbers of platelets, leukocytes, and erythrocytes, with a high proportion of immature cells. The nurse caring for this patient suspects a diagnosis of what?
- A. AML
- B. CML
- C. MDS
- D. ALL
Correct Answer: D
Rationale: The correct answer is D: ALL (Acute Lymphoblastic Leukemia). In this scenario, the patient presents with symptoms of headaches, vomiting, testicular pain, and abnormal blood work showing reduced platelets, leukocytes, and erythrocytes with a high proportion of immature cells. These findings are characteristic of ALL, a type of leukemia that primarily affects lymphoid cells. The combination of symptoms and blood work results suggests a rapid and aggressive proliferation of immature lymphoid cells, leading to bone marrow failure and symptoms such as anemia, thrombocytopenia, and leukopenia. AML (choice A) primarily affects myeloid cells, not lymphoid cells. CML (choice B) typically presents with elevated leukocyte count and presence of the Philadelphia chromosome. MDS (choice C) is a group of disorders characterized by ineffective hematopoiesis leading to cytopenias, but does not typically present with the rapid onset of symptoms seen in this case
The nurse is documenting findings after completing data collection with a patient. What term should the nurse use to document a large area of discoloration from hemorrhage under the skin?
- A. Pallor
- B. Rubor
- C. Petechiae
- D. Ecchymosis
Correct Answer: D
Rationale: The correct term for a large area of discoloration from hemorrhage under the skin is "Ecchymosis" (Choice D). Ecchymosis refers to the medical term for a bruise, which is characterized by a large area of skin discoloration caused by bleeding beneath the skin due to trauma or injury. Pallor (Choice A) refers to paleness of the skin due to decreased blood flow or anemia, not discoloration from hemorrhage. Rubor (Choice B) refers to redness of the skin due to increased blood flow, not discoloration from hemorrhage. Petechiae (Choice C) are tiny red or purple spots on the skin caused by broken capillaries, not a large area of discoloration from hemorrhage as described in the question.
A nurse is teaching a client about taking ferrous sulfate to treat iron deficiency anemia. Which of the following instructions should the nurse include? (Select All)
- A. Eat iron-enriched foods.
- B. Spread the dosage across each day.
- C. Take the drug on an empty stomach.
- D. Report dark green or black stools.
Correct Answer: A
Rationale: The correct answer is A: Eat iron-enriched foods. Iron-enriched foods help increase iron levels in the body, supporting the treatment of iron deficiency anemia. The rationale is that consuming foods rich in iron can complement the effects of ferrous sulfate, aiding in the replenishment of iron stores.
Summary:
- B: Spreading the dosage throughout the day can help with better absorption, but it is not the priority instruction.
- C: Taking the drug on an empty stomach can enhance absorption, but it may also cause stomach upset.
- D: Reporting dark green or black stools is important to monitor for possible gastrointestinal bleeding, but it is not an instruction for taking ferrous sulfate.