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ISPN考试模拟试题(四十九)

Questions

1.What specifically should the nurse monitor when a client is receiving a platelet aggregation inhibitor such as clopidogrel (Plavix)?

A.Nausea

B.Epistaxis

C.Chest pain

D.Elevated temperature


2.A client is receiving warfarin (Coumadin). Which test result should the nurse use to determine if the daily dose of this anticoagulant is therapeutic?

A.INR

B.APTT

C.Bleeding time

D.Sedimentation rate


3.What should the nurse teach a client to expect when preparing for discharge after surgery for a coronary artery bypass graft?

A.Mild fever and extreme fatigue for several weeks after surgery

B.Cessation of drainage from the incisions after hospitalization

C.Mild incisional pain and tenderness up to three weeks after surgery

D.Some edema in the leg used for the donor graft is expected with activity


4.A client with left ventricular heart failure is taking digoxin (Lanoxin) 0.25 mg daily. What changes does the nurse expect to find if this medication is therapeutically effective? Select all that apply.

A.Diuresis

B.Tachycardia

C.Decreased edema

D.Decreased pulse rate

E.Reduced heart murmur

F.Jugular vein distention


5.A nurse identifies signs of electrolyte depletion in a client with heart failure who is receiving bumetanide (Bumex) and digoxin (Lanoxin). What does the nurse determine is the cause of the depletion?

A.Diuretic therapy

B.Sodium restriction

C.Continuous dyspnea

D.Inadequate oral intake

Rationales

1.B 

The high vascularity of the nose, combined with its susceptibility to trauma (e.g., sneezing, nose blowing), makes it a frequent site of hemorrhage.

A, C, D,This response usually is not associated with anticoagulant therapy.

Client Need:Pharmacological and Parenteral Therapies;

Cognitive Level:Application;

Nursing Process:Evaluation/Outcomes;

Reference:Ch6,Related Pharmacology,Anticoagulants


2.A 

Warfarin (Coumadin) initially is prescribed day by day, based on international normalized ratio (INR) blood test results. This test provides a standard system to interpret prothrombin times.

B,APTT (accelerated partial thromboplastin time) is used to evaluate the effects of heparin, which acts on the intrinsic pathway.

C,Bleeding time is the time required for blood to cease flowing from a small wound;it is not used for warfarin dosage calculation.

D,Sedimentation rate is a test used to determine the presence of inflammation or infection;it does not indicate clotting ability.

Client Need:Reduction of Risk Potential;

Cognitive Level:Analysis;

Nursing Process:Evaluation/Outcomes;

Reference:Ch6,Related Pharmacology,Anticoagulants


3.D 

The client is up more at home, so dependent edema usually increases.

A,These should not be expected and are, in fact, signs of postpericardiotomy syndrome.

B,Serosanguineous drainage may persist after discharge.

C,These symptoms will persist longer.

Client Need:Physiological Adaptation;

Cognitive Level:Application;

Integrated Process:Teaching/Learning;

Nursing Process:Planning/Implementation;

Reference:Ch6,Cardiac Surgery,Nursing Care


4.Answer: A,C, D.

A,Digoxin increases kidney perfusion, which results in urine formation and diuresis.

B,Digoxin increases the force of contractions (inotropic effect) and decreases the heart rate (chronotropic effect).

C,Because of digoxin’s inotropic and chronotropic effects, the heart rate will decrease.

D,The urine output increases because of improved cardiac output and kidney perfusion, resulting in a reduction in edema.

E,Digoxin does not affect a heart murmur.

F,This is a specific sign of right ventricular heart failure;it is treated with diuretics to reduce the intravascular volume and venous pressure.

Client Need:Pharmacological and Parenteral Therapies;

Cognitive Level:Analysis;

Nursing Process:Evaluation/Outcomes;

Reference:Ch6,Related Pharmacology,Cardiac Glycosides


5.A

Diuretic therapy that affects the loop of Henle generally involves the use of drugs (e.g,bumetanide [Bumex])that directly or indirectly increase urinary sodium,chloride,and potassium excretion.

B,Sodium restriction does not necessarily accompany administration of bumetanide.

C,Dyspnea does not directly result in a depletion of electrolytes.

D,Unless otherwise ordered,oral intake is unaffected.

Client Need:Pharmacological and Parenteral Therapies;

Cognitive Level:Analysis;

Nursing Process:Evaluation/Outcomes;

Reference:Ch6,Related Pharmacology,Diuretics


小编寄语:越努力,越幸运!Fighting!


时间:2019-07-18 15:19:20
 
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