Nokea
The nurse should expect single-donor platelets to be ordered for which of the following clients?
- A. A client who is receiving multiple platelet transfusions.
- B. A client who is deficient in coagulation factors.
- C. A client whose platelet count is greater than 50,000/mm³.
- D. A client who is refractory to random-donor platelets.
Correct Answer: D
Rationale: Single-donor platelets are used for clients refractory to random-donor platelets to reduce the risk of alloimmunization and improve transfusion efficacy.
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A nurse is caring for a client at home on hospice care for terminal renal cancer. People are calling the nurse to inquire about the client's condition. The nurse should tell the callers:
- A. Please call the oncologist.
- B. The client is in a coma now.
- C. Please call the client's sister.
- D. The client is not expected to live much longer.
Correct Answer: C
Rationale: Directing callers to the client's sister respects privacy and ensures consistent communication, aligning with the family's preferences in hospice care.
A client who has undergone a mitral valve replacement has persistent bleeding from the sternal incision during the early postoperative period. The nurse should do which of the following? Select all that apply.
- A. Begin Warfarin (Coumadin).
- B. Check the postoperative CBC, INR, PTT, & platelet levels.
- C. Confirm availability of blood products.
- D. Monitor the mediastinal chest tube drainage.
- E. Start a Dopamine (Intropin) drip for a systolic BP <100.
Correct Answer: B,C,D
Rationale: Checking lab values (B), confirming blood products (C), and monitoring chest tube drainage (D) address bleeding and ensure timely intervention. Warfarin and dopamine are inappropriate for acute bleeding.
A client with an ileal conduit has a rash around the stoma. The nurse should:
- A. Apply a antifungal cream.
- B. Clean with soap and water.
- C. Use a larger appliance.
- D. Cover with gauze.
Correct Answer: B
Rationale: Cleaning with soap and water removes irritants, promoting rash healing.
After returning home, a client who has had cataract surgery will need to continue to instill eye drops in the affected eye. The client is instructed to apply slight pressure against the nose at the inner canthus of the eye after instilling the eyedrops. The rationale that supports applying pressure is that it:
- A. Prevents the medication from entering the tear duct.
- B. Prevents the drug from running down the client's face.
- C. Allows the sensitive cornea to adjust to the medication.
- D. Facilitates distribution of the medication over the eye surface.
Correct Answer: A
Rationale: Applying pressure at the inner canthus (punctal occlusion) prevents the medication from draining into the tear duct, which could lead to systemic absorption or reduced effectiveness of the eye drops.
Which of the following factors would most likely contribute to the development of a client's hiatal hernia?
- A. Having a sedentary desk job.
- B. Being 5 feet, 3 inches tall and weighing 190 lb.
- C. Using laxatives frequently.
- D. Being 40 years old.
Correct Answer: B
Rationale: Obesity (e.g., 5'3†and 190 lb) increases intra-abdominal pressure, a major contributor to hiatal hernia development. The other factors are less directly related.