Nokea
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.
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The nurse is preparing to administer a unit of platelets to an adult patient. When administering this blood product, which of the following actions should the nurse perform?
- A. Administer the platelets as rapidly as the patient can tolerate.
- B. Establish IV access as soon as the platelets arrive from the blood bank.
- C. Ensure that the patient has a patent central venous catheter.
- D. Aspirate 10 to 15 mL of blood from the patients IV immediately following the transfusion.
Correct Answer: A
Rationale: The nurse should infuse each unit of platelets as fast as patient can tolerate to diminish platelet clumping during administration. IV access should be established prior to obtaining the platelets from the blood bank. A central line is appropriate for administration, but peripheral IV access (22-gauge or larger) is sufficient. There is no need to aspirate after the transfusion.
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.
Which of the following circumstances would most clearly warrant autologous blood donation?
- A. The patient has type-O blood.
- B. The patient has sickle cell disease or a thalassemia.
- C. The patient has elective surgery pending.
- D. The patient has hepatitis C.
Correct Answer: C
Rationale: Autologous blood donation is useful for many elective surgeries where the potential need for transfusion is high. Type-O blood, hepatitis, sickle cell disease, and thalassemia are not clear indications for autologous donation.
A patients electronic health record states that the patient receives regular transfusions of factor IX. The nurse would be justified in suspecting that this patient has what diagnosis?
- A. Leukemia
- B. Hemophilia
- C. Hypoproliferative anemia
- D. Hodgkins lymphoma
Correct Answer: B
Rationale: Administration of clotting factors is used to treat diseases where these factors are absent or insufficient; hemophilia is among the most common of these diseases. Factor IX is not used in the treatment of leukemia, lymphoma, or anemia.
A patient undergoing a hip replacement has autologous blood on standby if a transfusion is needed. What is the primary advantage of autologous transfusions?
- A. Safe transfusion for patients with a history of transfusion reactions
- B. Prevention of viral infections from another persons blood
- C. Avoidance of complications in patients with alloantibodies
- D. Prevention of alloimmunization
Correct Answer: B
Rationale: The primary advantage of autologous transfusions is the prevention of viral infections from another persons blood. Other secondary advantages include safe transfusion for patients with a history of transfusion reactions, prevention of alloimmunization, and avoidance of complications in patients with alloantibodies.