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1. A healthcare professional is caring for a client with coronary artery disease (CAD) who is prescribed aspirin. Which of the following findings should the healthcare professional report to the provider?
- A. A history of gastrointestinal bleeding
- B. A history of hypertension
- C. A platelet count of 180,000/mm³
- D. A prothrombin time (PT) of 12 seconds
Correct answer: A
Rationale: The correct answer is A: A history of gastrointestinal bleeding. Patients with a history of gastrointestinal bleeding are at increased risk of complications when taking aspirin due to its effects on platelet function and the gastrointestinal tract. Reporting this finding to the provider is crucial to ensure patient safety. Choices B, C, and D are not directly related to the increased risk associated with aspirin use in patients with a history of gastrointestinal bleeding, making them less relevant in this scenario. While monitoring platelet count and PT are important in patients taking aspirin, a history of gastrointestinal bleeding takes precedence as it directly impacts the safety and effectiveness of aspirin therapy in this client.
2. A nurse is assisting with an in-service about hepatitis A for a group of staff nurses. The nurse should include that hepatitis A is transmitted through which of the following methods?
- A. Airborne droplets
- B. Sexual contact
- C. Contact with contaminated surfaces
- D. Consumption of contaminated food
Correct answer: D
Rationale: The correct answer is D: Consumption of contaminated food. Hepatitis A is primarily transmitted through the ingestion of contaminated food or water. Airborne droplets and sexual contact are not common modes of transmission for hepatitis A. While contact with contaminated surfaces can play a role in the spread of some infections, hepatitis A is not typically transmitted through this route.
3. A healthcare professional is collecting data from a client who has iron deficiency anemia. Which of the following findings should the healthcare professional expect?
- A. Increased energy
- B. Easy bruising
- C. Pale conjunctiva
- D. Weight gain
Correct answer: C
Rationale: Pale conjunctiva is a common sign of iron deficiency anemia due to reduced hemoglobin levels. This results in decreased oxygen-carrying capacity, leading to tissue hypoxia and pallor. 'Increased energy' (choice A) is not typically associated with iron deficiency anemia, as fatigue and weakness are common symptoms. 'Easy bruising' (choice B) is more characteristic of platelet disorders or vitamin deficiencies rather than iron deficiency anemia. 'Weight gain' (choice D) is not a typical finding in iron deficiency anemia; in fact, weight loss is more common due to decreased appetite and overall weakness.
4. What are the key components of a respiratory assessment?
- A. Inspection, Palpation, Percussion, Auscultation
- B. Inspection, Observation, Auscultation, Percussion
- C. Auscultation, Palpation, Observation, Percussion
- D. Observation, Palpation, Percussion, Auscultation
Correct answer: A
Rationale: The correct answer is A: Inspection, Palpation, Percussion, Auscultation. A focused respiratory assessment involves inspecting the chest for symmetry and signs of distress, palpating for tenderness or abnormal masses, performing percussion to assess underlying tissues, and auscultating lung sounds. Choice B is incorrect as observation is a broad term that can encompass both inspection and palpation. Choice C is incorrect as auscultation is usually performed after inspection and palpation. Choice D is incorrect as observation should be more specific, and auscultation is a key component that is typically done last in a respiratory assessment.
5. What are the key nursing interventions for a patient undergoing dialysis?
- A. Monitor fluid balance and administer heparin
- B. Monitor blood pressure and prevent clot formation
- C. Administer medications and monitor blood chemistry
- D. Provide dietary education and encourage protein intake
Correct answer: A
Rationale: The correct answer is A: Monitor fluid balance and administer heparin. For a patient undergoing dialysis, it is crucial to monitor fluid balance to prevent fluid overload or depletion. Administering heparin helps prevent clot formation during the dialysis process. Option B is incorrect as while monitoring blood pressure is essential, preventing clot formation is more directly related to heparin administration. Option C is incorrect because administering medications and monitoring blood chemistry are not the primary interventions for dialysis. Option D is incorrect as while dietary education and protein intake are important for overall health, they are not the key nursing interventions specifically for a patient undergoing dialysis.
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