An individual has accidentally cut his hand, immediately initiating the process of hemostasis. Following vasoconstriction, what event in the process of hemostasis will take place?
- A. Fibrin will be activated at the bleeding site.
- B. Platelets will aggregate at the injury site.
- C. Thromboplastin will form a clot.
- D. Prothrombin will be converted to thrombin.
Correct Answer: B
Rationale: Following vasoconstriction, circulating platelets aggregate at the site and adhere to the vessel and to one another, forming an unstable hemostatic plug. Events involved in the clotting cascade take place subsequent to this initial platelet action.
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The nurse is describing the role of plasminogen in the clotting cascade. Where in the body is plasminogen present?
- A. Myocardial muscle tissue
- B. All body fluids
- C. Cerebral tissue
- D. Venous and arterial vessel walls
Correct Answer: B
Rationale: Plasminogen, which is present in all body fluids, circulates with fibrinogen. Plasminogen is found in body fluids, not tissue.
An older adult client is exhibiting many of the characteristic signs and symptoms of iron deficiency. In addition to a complete blood count, what diagnostic assessment should the nurse anticipate?
- A. Stool for occult blood
- B. Bone marrow biopsy
- C. Lumbar puncture
- D. Urinalysis
Correct Answer: A
Rationale: Iron deficiency in the adult generally indicates blood loss (e.g., from bleeding in the GI tract or heavy menstrual flow). Bleeding in the GI tract can be preliminarily identified by testing stool for the presence of blood. A bone marrow biopsy would not be undertaken for the sole purpose of investigating an iron deficiency. Lumbar puncture and urinalysis would not be clinically relevant.
The nurses brief review of a patients electronic health record indicates that the patient regularly undergoes therapeutic phlebotomy. Which of the following rationales for this procedure is most plausible?
- A. The patient may chronically produce excess red blood cells.
- B. The patient may frequently experience a low relative plasma volume.
- C. The patient may have impaired stem cell function.
- D. The patient may previously have undergone bone marrow biopsy.
Correct Answer: A
Rationale: Persistently elevated hematocrit is an indication for therapeutic phlebotomy. It is not used to address excess or deficient plasma volume and is not related to stem cell function. Bone marrow biopsy is not an indication for therapeutic phlebotomy.
A patient lives with a diagnosis of sickle cell anemia and receives frequent blood transfusions. The nurse should recognize the patients consequent risk of what complication of treatment?
- A. Hypovolemia
- B. Vitamin B12 deficiency
- C. Thrombocytopenia
- D. Iron overload
Correct Answer: D
Rationale: Patients with chronic transfusion requirements can quickly acquire more iron than they can use, leading to iron overload. These individuals are not at risk for hypovolemia and there is no consequent risk for low platelet or vitamin B12 levels.
The nurses review of a patients most recent blood work reveals a significant increase in the number of band cells. The nurses subsequent assessment should focus on which of the following?
- A. Respiratory function
- B. Evidence of decreased tissue perfusion
- C. Signs and symptoms of infection
- D. Recent changes in activity tolerance
Correct Answer: C
Rationale: Ordinarily, band cells account for only a small percentage of circulating granulocytes, although their percentage can increase greatly under conditions in which neutrophil production increases, such as infection. This finding is not suggestive of problems with oxygenation and subsequent activity intolerance.
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