Nokea
Which finding would the nurse expect to see in a patient with a hemoglobin level of 8 g/dL? Select all that apply.
- A. Palpitations.
- B. Conjunctival pallor.
- C. Sternal tenderness.
- D. Heart rate of 104 beats/min.
Correct Answer: B,D
Rationale: Conjunctival pallor and tachycardia (heart rate of 104 beats/min) are common in anemia, reflecting reduced hemoglobin and compensatory mechanisms.
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Which arterial blood gas (ABG) data corresponds with a patient's clinical manifestations of respiratory alkalosis?
- A. pH = 7.46, PaCO2 = 44 mm Hg, PaO2 = 95 mm Hg, and HCO3 = 36 mEq/L.
- B. pH = 7.27, PaCO2 = 70 mm Hg, PaO2 = 80 mm Hg, and HCO3 = 26 mEq/L.
- C. pH = 7.30, PaCO2 = 35 mm Hg, PaO2 = 70 mm Hg, and HCO3 = 20 mEq/L.
- D. pH = 7.52, PaCO2 = 24 mm Hg, PaO2 = 85 mm Hg, and HCO3 = 24 mEq/L.
Correct Answer: D
Rationale: Respiratory alkalosis is indicated by a high pH (7.52) and low PaCO2 (24 mm Hg), as seen in option D, with normal HCO3 indicating no metabolic compensation.
The nurse provides discharge teaching to a patient with venous leg ulcers. Which statement made by the patient indicates the need for further education?
- A. I will take a walk daily.
- B. I will try to lose at least 20 pounds.
- C. I will put on my stockings after I get out of bed each day.
- D. I will not wear knee-high socks that are tight around my calf.
Correct Answer: D
Rationale: Not wearing tight knee-high socks is correct, as tight clothing can impede circulation; the statement suggests misunderstanding, indicating a need for further education.
A patient reports leg pain that awakens the patient at night. The patient reports that the same pain develops in the legs when they are elevated and disappears when the legs are dangled. Which condition would the nurse suspect?
- A. Peripheral arterial disease.
- B. Lymphatic obstruction.
- C. Chronic venous insufficiency.
- D. Musculoskeletal abnormalities.
Correct Answer: A
Rationale: Peripheral arterial disease causes leg pain worsened by elevation and relieved by dangling, due to reduced blood flow from arterial narrowing.
Which information will the nurse include when teaching a patient who is receiving chemotherapy for leukemia?
- A. The treatment has severe side effects, some of which will be permanent.
- B. You need to use your call light to ask for help every time you get out of bed.
- C. Prevention and early detection of infection are important during leukemia treatment.
- D. Feeling isolated is a common and unavoidable consequence of leukemia treatment.
Correct Answer: C
Rationale: Prevention and early detection of infection are critical during leukemia chemotherapy due to immune suppression, a key patient education point.
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.