CMSRN CMSRN - Medical-Surgical Nursing Cardiovascular and Hematological Care Questions and Answers 2 — Questions and Answers
Question 1: A patient with deep vein thrombosis (DVT) is started on a heparin drip. Which laboratory value should the nurse monitor to evaluate therapeutic effectiveness?
- Activated partial thromboplastin time (aPTT) (Correct answer)
- Prothrombin time (PT)
- Platelet count
- Fibrinogen level
Correct answer: Activated partial thromboplastin time (aPTT)
aPTT is the primary lab value used to monitor the therapeutic effectiveness of unfractionated heparin therapy.
Question 2: A nurse is caring for a patient with heart failure who develops frothy, pink-tinged sputum and severe dyspnea. What is the priority nursing intervention?
- Position the patient upright and administer oxygen (Correct answer)
- Administer a scheduled beta-blocker
- Encourage deep breathing exercises
- Restrict oral fluids immediately
Correct answer: Position the patient upright and administer oxygen
Frothy pink-tinged sputum indicates pulmonary edema, and the priority is to position upright to reduce preload and administer supplemental oxygen.
Question 3: Which assessment finding in a patient receiving a blood transfusion requires the nurse to immediately stop the transfusion?
- Fever with chills and flank pain (Correct answer)
- A slight increase in temperature of 0.5°F
- Mild urticaria on one arm
- The patient reports feeling anxious
Correct answer: Fever with chills and flank pain
Fever with chills and flank pain suggests an acute hemolytic transfusion reaction, which requires immediately stopping the transfusion.
Question 4: A patient with peripheral arterial disease (PAD) reports intermittent claudication. Which patient statement indicates a need for further teaching?
- I soak my feet in hot water every evening to improve circulation (Correct answer)
- I inspect my feet daily for any cuts or sores
- I wear well-fitting shoes when walking
- I stop and rest when my legs start to hurt during exercise
Correct answer: I soak my feet in hot water every evening to improve circulation
Patients with PAD should avoid soaking feet in hot water due to impaired sensation and risk of thermal injury.
Question 5: A nurse is reviewing the lab results of a patient with suspected disseminated intravascular coagulation (DIC). Which combination of findings is most consistent with this diagnosis?
- Elevated D-dimer, decreased fibrinogen, prolonged PT and aPTT (Correct answer)
- Elevated fibrinogen, decreased D-dimer, normal PT
- Decreased D-dimer, elevated platelet count, shortened aPTT
- Normal PT, elevated fibrinogen, increased platelet count
Correct answer: Elevated D-dimer, decreased fibrinogen, prolonged PT and aPTT
DIC is characterized by consumption of clotting factors resulting in elevated D-dimer, decreased fibrinogen, and prolonged clotting times.
Question 6: A patient with a new diagnosis of atrial fibrillation asks why anticoagulation therapy is necessary. What is the nurse's best response?
- Atrial fibrillation causes blood to pool in the atria, increasing the risk of clot formation and stroke (Correct answer)
- Anticoagulants will help convert your heart rhythm back to normal
- The medication prevents your heart rate from becoming too fast
- Anticoagulants strengthen the heart muscle to pump more effectively
Correct answer: Atrial fibrillation causes blood to pool in the atria, increasing the risk of clot formation and stroke
In atrial fibrillation, ineffective atrial contraction causes blood stasis, increasing thrombus formation risk and subsequent stroke.
CMSRN CMSRN - Medical-Surgical Nursing Cardiovascular and Hematological Care Questions and Answers 2
A patient with deep vein thrombosis (DVT) is started on a heparin drip.
Which laboratory value should the nurse monitor to evaluate therapeutic effectiveness?