Nokea
The nurse recognizes that patients with von Willebrand disease are at risk for prolonged bleeding times for which reason?
- A. Adequate platelet production.
- B. Deficiency in intrinsic clotting system factor.
- C. Impairment of the thrombin fibrinogen reaction.
- D. Variable factor VIII deficiencies and platelet dysfunction.
Correct Answer: D
Rationale: Von Willebrand disease involves variable factor VIII deficiencies and platelet dysfunction, leading to prolonged bleeding times due to impaired clot formation.
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Which finding will the nurse expect in a patient who is hospitalized with stage I Hodgkin lymphoma?
- A. Skeletal pain.
- B. Enlarged lymph nodes.
- C. T-cell blasts in the lymph node.
- D. Lymphoblasts in the cerebrospinal fluid.
Correct Answer: B
Rationale: Enlarged lymph nodes are a characteristic feature of stage I Hodgkin lymphoma, where the disease is localized to one group of lymph nodes.
The nurse notes that there is a difference in a patient's blood pressure (BP) and heart rate (HR) when the patient changes position from supine to standing. The differences are a decrease of 20 mm Hg in systolic BP, a decrease of 10 mm Hg in diastolic BP, and an increase in the HR of 20 beats/minute. Which interpretation would the nurse make about the patient's condition?
- A. Hypertensive crisis.
- B. An auscultatory gap.
- C. Resistant hypertension.
- D. Enlarged lymph nodes.
Correct Answer: B
Rationale: The described changes suggest an auscultatory gap, a phenomenon during BP measurement that can lead to inaccurate readings, requiring careful technique.
Which instruction would the nurse include in the teaching plan for a patient newly diagnosed with microcytic hypochromic anemia?
- A. Take enteric-coated iron with each meal.
- B. Take cobalamin with green, leafy vegetables.
- C. Take the iron with orange juice 1 hour before meals.
- D. Decrease the intake of the antiseizure medications to improve anemia.
Correct Answer: C
Rationale: Taking iron with orange juice 1 hour before meals enhances absorption due to vitamin C, optimal for treating microcytic hypochromic anemia.
A patient's arterial blood gas (ABG) values include a pH of 7.48, a PaCO2 of 38, and an HCO3- of 30. Around which acid-base imbalance would the nurse plan the patient's care?
- A. Metabolic acidosis.
- B. Metabolic alkalosis.
- C. Respiratory acidosis.
- D. Respiratory alkalosis.
Correct Answer: B
Rationale: Metabolic alkalosis is indicated by a high pH (7.48) and elevated HCO3- (30 mEq/L), with normal PaCO2, suggesting no respiratory involvement.
The nurse notes that a patient has a smooth and shiny tongue surface. The nurse would attribute these findings to which condition?
- A. The patient has neutropenia.
- B. The patient has polycythemia.
- C. The patient has pernicious anemia.
- D. The patient has elevated estrogen levels.
Correct Answer: C
Rationale: Pernicious anemia causes glossitis, leading to a smooth and shiny tongue surface due to vitamin B12 deficiency.