ATI RN

1. The nurse is caring for a patient who is being discharged after an emergency splenectomy following a motor vehicle crash. Which instructions should the nurse include in the discharge teaching?

• A. Check often for swollen lymph nodes.
• B. Watch for excess bleeding or bruising.
• C. Take iron supplements to prevent anemia.
• D. Wash hands and avoid persons who are ill.

Correct Answer: D

Rationale: Splenectomy increases the risk for infection, especially with gram-positive bacteria.

2. The nurse assesses a patient who has numerous petechiae on both arms. Which question should the nurse ask the patient?

• A. Are you taking any oral contraceptives?
• B. Have you been prescribed antiseizure drugs?
• C. Do you take medication containing salicylates?
• D. How long have you taken antihypertensive drugs?

Correct Answer: C

Rationale: Salicylates interfere with platelet function and can lead to petechiae and ecchymoses.

3. A nurse reviews the laboratory data for an older patient. The nurse would be most concerned about which finding?

• A. Hematocrit of 35%
• B. Hemoglobin of 11.8 g/dL
• C. Platelet count of 400,000/μL
• D. White blood cell (WBC) count of 2800/μL

Correct Answer: D

Rationale: A low WBC count in this patient would indicate that the patient's immune function may be compromised.

4. A patient with pancytopenia has a bone marrow aspiration from the left posterior iliac crest. Which action would be important for the nurse to take after the procedure?

• A. Elevate the head of the bed to 45 degrees.
• B. Have the patient lie on the left side for 1 hour.
• C. Apply a sterile 2-inch gauze dressing to the site.
• D. Use a half-inch sterile gauze to pack the wound.

Correct Answer: B

Rationale: To decrease the risk for bleeding, the patient should lie on the left side for 30 to 60 minutes.

5. The nurse assesses a patient with pernicious anemia. Which assessment finding would the nurse expect?

• A. Yellow-tinged sclerae
• B. Shiny, smooth tongue
• C. Numbness of the extremities
• D. Gum bleeding and tenderness

Correct Answer: C

Rationale: Extremity numbness is associated with cobalamin (vitamin B12) deficiency or pernicious anemia.