A 71-year-old woman with a history of rheumatoid arthritis and chronic heart failure has been admitted to the hospital for the treatment of a suspected upper gastrointestinal bleed.
When performing an assessment of this patient, which of the following questions most directly addresses a likely cause of the woman's bleeding disorder?
A) How closely do you tend to monitor your blood pressure when you're at home?
B) Has your doctor prescribed a water pill for your heart failure?
C) Do you ever take aspirin to treat the pain of your arthritis?
D) Did either of your parents or siblings have problems with bleeding?
Question 2A patient with a diagnosis of immune thrombocytopenic purpura (ITP) is currently receiving IVIG for the treatment of her health condition. The nurse who is providing this patient's care is aware that ITP is a consequence of:
A) Inappropriate platelet aggregation on the walls of the great vessels
B) Impaired liver function and the sequestering of platelets by hepatocytes
C) Hemolysis of platelets in individuals who lack immunity to the Epstein-Barr virus
D) Platelet destruction and impaired platelet production resulting from an autoimmune process
Question 3An experienced medical nurse has provided care for patients who have immunodeficiencies that are primary, as well as for patients who have secondary immunodeficiencies.
Which of the following individuals is most clearly exhibiting secondary immunodeficiency?
A) A woman whose diagnosis of sepsis is attributable to her recent chemotherapy
B) An elderly resident of a long-term care facility who has been diagnosed with the Norwalk virus
C) A child who had an allergic reaction to a scheduled immunization
D) A man who developed deep vein thrombosis (DVT) after being immobilized during recovery from orthopedic surgery
Question 4A patient is being tested for HIV using enzyme immunoassay (EIA). The EIA shows antibodies. The nurse expects the health care provider to order what test to confirm the EIA test results?
A) Another EIA test
B) Viral load test
C) Western blot test
D) CD4:CD8 ratio
Question 5A woman's routine complete blood count (CBC) revealed a highly elevated platelet level, and subsequent diagnostic testing has resulted in a diagnosis of primary thrombocythemia. The nurse has begun the relevant health education with the patient.
What should the nurse teach this woman about her health problem?
A) Primary thrombocythemia creates potential problems at both ends of the clotting spectrum: inappropriate clotting or inappropriate bleeding.
B) Your doctor will likely order a series of blood transfusions for you over the next several months.
C) It's very important that you try to adopt a diet that's high in organ meats and leafy green vegetables.
D) Primary thrombocythemia makes you quite vulnerable to hemorrhage, so you'll need regular injections of some important clotting factors.
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