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Which laboratory report finding would support the nurse's conclusion that a patient has thalassemia major? Select all that apply.
- A. Increased bilirubin levels.
- B. Increased reticulocyte level.
- C. Increased mean corpuscular volume.
- D. Increased total iron-binding capacity.
Correct Answer: A,B,D
Rationale: Increased bilirubin, reticulocyte levels, and total iron-binding capacity are seen in thalassemia major due to hemolysis, bone marrow response, and increased iron absorption.
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A patient reports episodic chest pain lasting a few minutes that is provoked by exertion and relieved within 10 minutes upon resting. Which cause of the patient's symptoms would the nurse suspect?
- A. Spasm of a major coronary artery.
- B. Exposure of the thrombogenic surface to plaque.
- C. Myocardial ischemia due to coronary artery disease.
- D. Myocardial ischemia secondary to microvascular disease.
Correct Answer: C
Rationale: Myocardial ischemia due to coronary artery disease causes chest pain provoked by exertion and relieved by rest, characteristic of stable angina.
The nurse provides education to a patient about the symptoms of uncontrolled hypertension. Which symptom would the nurse include? Select all that apply.
- A. Fatigue.
- B. Dizziness.
- C. Palpitations.
- D. Cluster headaches.
Correct Answer: A,B,C
Rationale: Fatigue, dizziness, and palpitations are symptoms of uncontrolled hypertension due to cardiovascular strain and vascular effects; cluster headaches are not directly related.
Which strategy is most important for a nurse to include when planning care for a patient who has neutropenia?
- A. Restricting all visitors.
- B. Placing the patient in a private room.
- C. Advising the patient to use only an electric shaver.
- D. Wearing a gown and gloves when in direct contact with the patient.
Correct Answer: B
Rationale: Placing the patient in a private room is crucial for a neutropenic patient to minimize exposure to pathogens, reducing infection risk due to their compromised immune system.
The nurse receives information about the assigned patients during shift report. Which patient would the nurse assess first?
- A. A patient who reports dizziness with a blood pressure (BP) of 150/92 mm Hg.
- B. A patient who reports a severe headache and has begun vomiting.
- C. A patient with a hip fracture who reports a pain level of 2 on a 1-to-10 scale.
- D. A patient who received an angiotensin-converting enzyme (ACE) inhibitor 30 minutes previously and reports fatigue.
Correct Answer: B
Rationale: A severe headache and vomiting could be indicative of a serious neurological condition such as a stroke, intracranial bleeding, or increased intracranial pressure. This patient needs urgent assessment and intervention to prevent potential complications.
A patient with chronic obstructive pulmonary disease (COPD) has the following arterial blood gas (ABG) results: a blood pH of 7.29, a partial pressure of carbon dioxide (PaCO2) level of 49 mm Hg, and a bicarbonate ion (HCO3) level of 25 mEq/L. Which condition would the nurse have in mind when developing the patient's plan of care?
- A. Metabolic acidosis.
- B. Metabolic alkalosis.
- C. Respiratory acidosis.
- D. Respiratory alkalosis.
Correct Answer: C
Rationale: Respiratory acidosis is indicated by low pH (7.29) and high PaCO2 (49 mm Hg), common in COPD due to impaired CO2 elimination.