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For a client with polycythemia vera, how can the nurse help decrease the risk for thrombus formation?
- A. Teach the client how to perform isometric exercises
- B. Help the client don thromboembolic stocking or support hose during waking hours
- C. Advise drinking 3 quarts (L) of fluid per day
- D. Instruct the client to rest immediately if chest pain develops  A1 PASSERS TRAINING, RESEARCH, REVIEW & DEVELOPMENT COMPANY MEDICAL SURGICAL NURSING SET I THE HEMATOLOGIC SYSTEM
Correct Answer: B
Rationale: For a client with polycythemia vera, there is an increased risk for thrombus formation due to the increased viscosity of the blood. Wearing thromboembolic stockings or support hose can help promote circulation, prevent stasis, and reduce the risk of thrombus formation. Compression stockings provide external pressure to the legs, which helps prevent blood from pooling and clotting. This intervention is commonly recommended for patients at risk for thrombus formation to improve blood flow in the lower extremities and reduce the risk of deep vein thrombosis (DVT) and pulmonary embolism.
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Clay is an 8-year-old boy diagnosed with heart failure. Which of the following shows that he is strictly following the directed therapeutic regimen?
- A. Daily use of an antibiotic
- B. Pulse rate less than 50 beats/minute
- C. Normal weight for age
- D. Elevation in red blood cell (RBC) count
Correct Answer: C
Rationale: In a young child like Clay who is diagnosed with heart failure, following the directed therapeutic regimen would involve maintaining a normal weight for his age. Weight monitoring is crucial in managing heart failure as excessive weight gain could lead to worsening of symptoms and complications. Ensuring that Clay stays within a normal weight range for his age shows his adherence to dietary recommendations, fluid restrictions, and overall treatment plan aimed at managing his heart failure effectively. Monitoring his weight would also help healthcare providers assess if the treatment plan is working and make necessary adjustments as needed. Therefore, Clay maintaining a normal weight for his age indicates that he is strictly following the directed therapeutic regimen for his heart failure.
20-year old Mr. Ang fell off from his horse, and sustained a lft hip fracture. Buck's extension traction is applied. The following statements are true about Buck's extension traction except:
- A. used as a temporary measure in adults to control muscle spasm and pain
- B. applied by orthopedic surgeon under aseptic conditions using wires and pins
- C. The pulling force is transmitted to the musculoskeletal structures
- D. used definitively to treat fractures in children
Correct Answer: D
Rationale: Buck's extension traction is typically used as a temporary measure in adults to control muscle spasm and pain while awaiting definitive treatment, such as surgery. It is applied by an orthopedic surgeon under aseptic conditions using wires and pins, through which the pulling force is transmitted to the musculoskeletal structures of the patient. However, Buck's extension traction is not used definitively to treat fractures in children; other treatment modalities are often preferred for pediatric fractures.
Childhood primary brain stem tumors are a heterogeneous group of tumors; the outcome usually depends on the tumor location. Which tumor, depending on the site of tumor, carries the worst prognosis?
- A. focal dorsally exophytic
- B. cervicomedullary diffuse intrinsic
- C. none of the above
- D. diffuse intrinsic
Correct Answer: D
Rationale: Diffuse intrinsic pontine gliomas (DIPG) have the worst prognosis among brainstem tumors.
What is the most important postoperative instruction the nurse must give a client who has just returned from the operating room after receiving a subarachnoid block?
- A. "Avoid drinking liquids until the gag reflex returns."
- B. "Avoid eating milk products for 24 hours."
- C. "Notify a nurse if you experience blood in your urine."
- D. "Remain supine for the time specified by the physician."
Correct Answer: D
Rationale: After receiving a subarachnoid block, the client may experience a sudden drop in blood pressure that can lead to complications such as dizziness or fainting upon standing. Therefore, it is crucial for the client to remain in a supine position for the duration specified by the physician to allow for proper monitoring and management of any potential postoperative complications. This instruction helps prevent the occurrence of hypotension and other adverse effects by allowing adequate time for the block to wear off and for the body to adjust to changes in blood pressure. It also ensures the safety and well-being of the client during the immediate postoperative period.
The nurse should include which of the following in preprocedure teaching for a patient scheduled for carotid angiography?
- A. "You will be put to sleep before the needle Is inserted."
- B. "The test will take several hours."
- C. "You may fee! a burning sensation when the dye is injected."
- D. "There will be no complications."
Correct Answer: C
Rationale: It is important for the nurse to include in preprocedure teaching for a patient scheduled for carotid angiography the information that the patient may feel a burning sensation when the dye is injected. This information helps prepare the patient for a common sensation during the procedure, reducing anxiety and promoting patient understanding and cooperation. Providing this education enhances the patient's overall experience and enables them to better cope with the procedure. The other options are not accurate or complete in providing necessary preprocedure information for the patient.