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A patient is diagnosed with primary hypertension and asks the nurse what caused the condition. Which response would the nurse give?
- A. There is no identified cause!
- B. A decrease in plasma renin levels.
- C. Too much plaque in the blood vessels.
- D. Kidney disease is the most common cause.
Correct Answer: A
Rationale: Primary hypertension, or essential hypertension, has no identifiable cause in most cases, distinguishing it from secondary hypertension.
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After noting that a patient with leukemia has thrombocytopenia, which action will the nurse plan to take?
- A. Palpate lymph nodes for swelling.
- B. Check temperature for elevation.
- C. Inspect skin for bruising or petechiae.
- D. Examine oral mucosa for ulceration.
Correct Answer: C
Rationale: Inspecting the skin for bruising or petechiae is specific to thrombocytopenia, as petechiae are small, red or purple dots that appear on the skin when platelet count is low, indicating a bleeding tendency.
A patient with thalassemia major who is receiving a blood transfusion shows signs of hemochromatosis. The nurse anticipates a prescription for which medication?
- A. Methotrexate.
- B. Deferoxamine.
- C. Ferrous gluconate.
- D. Iron dextran complex.
Correct Answer: B
Rationale: Deferoxamine is an iron chelating agent used to treat iron overload conditions like hemochromatosis. It binds to excess iron and promotes its excretion from the body, preventing complications such as organ damage.
A patient's arterial blood gas (ABG) results include a pH of 7.32, a PaCO2 of 56 mm Hg, and an HCO3 of 24 mEq/L. Which acid-base imbalance would the nurse use when developing the patient's plan of care?
- A. Metabolic acidosis.
- B. Metabolic alkalosis.
- C. Respiratory acidosis.
- D. Respiratory alkalosis.
Correct Answer: C
Rationale: Respiratory acidosis is characterized by low pH (7.32) and high PaCO2 (56 mm Hg), with normal HCO3 indicating no metabolic compensation.
A patient's blood pressure (BP) reading is 142/91 mm Hg. How would the nurse classify the BP?
- A. Normal.
- B. Prehypertension.
- C. Hypertension, stage 1.
- D. Hypertension, stage 2.
Correct Answer: C
Rationale: A BP of 142/91 mm Hg is classified as stage 1 hypertension, with systolic 140-159 mm Hg or diastolic 90-99 mm Hg.
A patient reports episodic chest pain lasting a few minutes that is provoked by exertion and relieved within 10 minutes upon resting. Which cause of the patient's symptoms would the nurse suspect?
- A. Spasm of a major coronary artery.
- B. Exposure of the thrombogenic surface to plaque.
- C. Myocardial ischemia due to coronary artery disease.
- D. Myocardial ischemia secondary to microvascular disease.
Correct Answer: C
Rationale: Myocardial ischemia due to coronary artery disease causes chest pain provoked by exertion and relieved by rest, characteristic of stable angina.