Physiological Integrity Practice Quiz 6

Answer: C – Blood type and crossmatch

Explanation: A blood type and crossmatch is necessary to ensure a match between the blood donor and the patient who is receiving the blood. An incompatible match could result in severe adverse events and possible death. CBC, differential, culture and sensitivity are unnecessary. Blood type and antigen screen is incorrect; the proper test is blood type and antibody screen, which will be performed as part of the crossmatch.

Answer: B – Grapefruit

Explanation: Grapefruit and its juice contain furanocoumarins, which block the enzyme cytochrome P450 enzyme CYP3A4, which is involved in metabolizing many drugs, including calcium channel blockers. Medication blood levels can increase, becoming toxic. The levels of calcium channel blockers are increased when grapefruit or grapefruit juice is consumed, potentially causing hypotension. Grapefruit can interfere with other drugs, as well, including statins (atorvastatin, lovastatin, simvastatin), some antibioti

Answer: D – I should expect my child’s peak expiratory flow to increase during attack.

Explanation: Peak expiratory flow rate measures how quickly a patient can exhale. Peak expiratory flow decreases during an asthma exacerbation due to restricted airways. Restlessness is often an early sign of hypoxia, which can occur during an asthma attack. Wheezing is often heard during an acute asthma attack, but is not always present. Early signs of an asthma attack include coughing that doesn’t stop; severe wheezing on both inhale and exhale; rapid breathing; neck and chest retractions; difficulty talki

Answer: D – Monitor insertion site and distal pulses.

Explanation: Because the catheter may cause trauma to the vessels, the healthcare provider will monitor for hematoma formation and interference of circulation distal to the insertion site. Bleeding at the site is the most common complication. Assessing level of consciousness is a routine post-op order, so it is not a priority. The extremity where the catheter was inserted will be immobilized initially, so the patient will not be allowed out of bed to use the bathroom. The patient will be on a cardiac monitor

Answer: D – 50% of the drug is available

Explanation: The percentage of drug NOT protein bound is the amount of drug that is free to work as expected. In this case, 50% is unable to be effective, because it is protein-bound. Protein binding has nothing to do with the destruction of protein, drug excretion, or protein in the diet.

Answer: D – Use a soft toothbrush and floss gently

Explanation: Platelets (thrombocytes) are important for blood clotting. The normal range for platelets is 150000-400000 mcL (150-400 x 10^9/L). This patient has thrombocytopenia and should be on bleeding precautions. Using a soft toothbrush, and flossing gently, can prevent the gum tissue from bleeding. An electric razor should be used for shaving to avoid cuts. Aspirin can interfere with clotting and should be discontinued. Multivitamins have no impact on platelet production.

Answer: A – Repeated vomiting

Explanation: Increased intra-cranial pressure (ICP) is caused by bleeding or swelling within the skull . Trauma is the most common cause. ICP can be life-threatening and must be monitored. Repeated vomiting can be an early sign of pressure as the vomit center within the medulla is stimulated. Other signs are headache, confusion, unresponsive pupils, double vision, increased blood pressure, shallow breathing, and seizures. The anterior fontanel is closed in a 4-year-old child.

Answer: A – Sunken fontanelle

Explanation: A sunken fontanelle (also spelled fontanel) is a sign of increasing dehydration, and is first noticed when dehydration progresses from mild to moderate. Mild dehydration may be evidenced by an increased thirst and decreased urine output. Anuria (no urine output) is a sign of severe dehydration. Other signs of dehydration in an infant are dry mucous membranes, fewer wet diapers than normal, strong urine, no tears when crying, lethargy, rapid breathing, and mottled extremities.

Answer: B – Your last shot was when you were 60, so a repeat vaccination is recommended.

Explanation: To help prevent pneumonia and its complications, a one-time repeat pneumococcal vaccination is recommended for individuals who were less than 65 years old when they received their first vaccination. Some high-risk groups receive an initial pneumonia vaccine of PCV13 (pneumococcal conjugate) before age 65. The CDC recommends a second vaccination of PCV23 (pneumococcal polysaccharide) at age 65 for these patients. Patients who are 65 and older should receive both vaccines, one year apart.

Answer: A – The 17-year-old with a left pleural effusion complaining of chest pain 9 on a 0 – 10 scale.

Explanation: The patient with a pleural effusion and chest pain is the priority. The patient is demonstrating an actual problem that requires immediate assessment and intervention. Though asthma and bronchitis are potential airway and breathing issues, the patients are stable.