Which of the following blood products is most likely to be given to Joel?
- A. Factor VIII concentrate
- B. Fresh frozen plasma
- C. Factor II, Vll, IX, X complex
Correct Answer: A
Rationale: Joel most likely requires Factor VIII concentrate. Factor VIII deficiency is characteristic of hemophilia A, which is a condition where there is a deficiency in clotting factor VIII. Treatment for hemophilia A involves replacing the missing Factor VIII through Factor VIII concentrate infusions to assist in blood clotting. Fresh frozen plasma and Factor II, VII, IX, X complex are not specific treatments for Factor VIII deficiency.
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The spouse of a client with gastric cancer expresses concern that the couple's children may develop this type of cancer when they're older. When reviewing risk factors for gastric cancer with the client and family, the nurse explains that a certain blood type increases the risk by 10%. The nurse is referring to:
- A. Type A
- B. Type AB
- C. Type B
- D. Type O
Correct Answer: A
Rationale: Among the different blood types, individuals with blood type A have been found to have a slightly higher risk of developing gastric cancer. Research has shown that individuals with blood type A are associated with a 10% increased risk of gastric cancer compared to other blood types. This information is important to consider when discussing potential risk factors for gastric cancer with clients and their families.
A 3-week-old neonate is brought to the emergency department because of a three-day history of intermittent vomiting. His mother reports that he has not urinated for eight hours. On physical examination, his eyes are sunken. Which of the following will MOST likely require correction before surgery is performed?
- A. Hypochloremia
- B. Hyperkalemia
- C. Hypernatremia
- D. N/A
Correct Answer: A
Rationale: Hypochloremia is often associated with dehydration and metabolic alkalosis, which may need correction before surgery.
Idiopathic thrombocytopenic purpura (ITP) commonly results in what finding?
- A. Blood clots
- B. Pallor
- C. Dry membranes
- D. Bruising
Correct Answer: D
Rationale: Idiopathic thrombocytopenic purpura (ITP) is a condition characterized by a low platelet count, leading to an increased risk of bleeding and easy bruising. Platelets are responsible for blood clotting and when their count is low, it can result in purpura (bruising) due to small blood vessels leaking blood into the skin. For this reason, the most common finding in ITP is bruising rather than blood clots, pallor, or dry membranes.
If a patient has elevated pulmonary vascular pressures, the nurse understands that the patient is most likely to develop which of the ff. physiological cardiac changes?
- A. Left atrial atrophy
- B. Left ventricular hypertrophy
- C. Right atrial atrophy
- D. Right ventricular hypertrophy
Correct Answer: D
Rationale: Elevated pulmonary vascular pressures can lead to pulmonary hypertension, which causes increased pressure in the right side of the heart. The right ventricle has to work harder to pump blood against the increased resistance in the pulmonary circulation. Over time, this can result in the development of right ventricular hypertrophy as the muscle of the right ventricle thickens in response to the increased workload. This is a compensatory mechanism to try to maintain cardiac output despite the increased pressure in the pulmonary circulation. Left atrial atrophy, left ventricular hypertrophy, and right atrial atrophy are not typically associated with elevated pulmonary vascular pressures.
The twelve-year-old boy has fractured his arm because of a fall from his bike. After the injury has been casted, the nurse knows it is most important to perform all of the following assessments on the area distal to the injury except:
- A. capillary refill.
- B. radial and ulnar pulse.
- C. finger movement
- D. skin integrity
Correct Answer: B
Rationale: Assessing the radial and ulnar pulses is crucial in evaluating the circulation of blood to the hand. However, in this scenario of a fractured arm, the injury is distal to the hand (further away from the body). It is more critical to check capillary refill, finger movement, and skin integrity in the area distal to the injury to ensure there is no compromise to the blood flow, nerve function, or skin integrity following the injury. Checking the radial and ulnar pulse would be more relevant if the injury was closer to the wrist area, as it would directly impact these pulses.