1. 1. Question After cardiac surgery, a client’s blood pressure measures 126/80 mm Hg. Nurse Katrina determines that mean arterial pressure (MAP) is which of the following? o A. 46 mm Hg o B. 80 mm Hg o C. 95 mm Hg o D. 90 mm Hg Correct Answer: C. 95 mm Hg Use the following formula to calculate MAP MAP = systolic + 2 (diastolic) MAP = 126 mm Hg + 2 (80 mm Hg) MAP = 286 mm Hg MAP = 95 mm Hg o Option A: 46 mmHg is according to the calculations. o Option B: 80 mmHg is inadequate according to the formula used in the computation. o Option D: 90 mmHg is according to the computation using the formula of mean arterial pressure.  2. Question A female client arrives at the emergency department with chest and stomach pain and a report of black tarry stool for several months. Which of the following orders should the nurse Oliver anticipate? o A. Cardiac monitor, oxygen, creatine kinase and lactate dehydrogenase levels o B. Prothrombin time, partial thromboplastin time, fibrinogen and fibrin split product values o C. Electrocardiogram, complete blood count, testing for occult blood, comprehensive serum metabolic panel o D. Electroencephalogram, alkaline phosphatase, and aspartate aminotransferase levels, basic serum metabolic panel Correct Answer: C. Electrocardiogram, complete blood count, testing for occult blood, comprehensive serum metabolic panel. An electrocardiogram evaluates the complaints of chest pain, laboratory tests determine anemia, and the stool test for occult blood determines blood in the stool. o Option A: Cardiac monitoring, oxygen, and creatine kinase, and lactate dehydrogenase levels are appropriate for a cardiac primary problem. A basic metabolic panel and alkaline phosphatase and aspartate aminotransferase levels assess liver function. o Option B: Prothrombin time, partial thromboplastin time, fibrinogen and fibrin split products are measured to verify bleeding dyscrasias. o Option D: An electroencephalogram evaluates brain electrical activity.  3. Question Olivia had coronary artery bypass graft (CABG) surgery 3 days ago. Which of the following conditions is suspected by the nurse when a decrease in platelet count from 230,000 ul to 5,000 ul is noted? o A. Pancytopenia o B. Idiopathic thrombocytopenic purpura (ITP) o C. Disseminated intravascular coagulation (DIC) o D. Heparin-associated thrombosis and thrombocytopenia (HATT) Correct Answer: D. Heparin-associated thrombosis and thrombocytopenia (HATT) HATT may occur after CABG surgery due to heparin use during surgery. o Option B: ITP is a bleeding condition of unknown cause in which the blood fails to clot adequately because of a low circulating platelet count and a shortened platelet lifespan. o Option C: Although DIC causes platelet aggregation and bleeding, it is common in a client after revascularization surgery. o Option A: Pancytopenia is a reduction in all blood cells.  4. Question Which of the following drugs would be ordered by the physician to improve the platelet count in a male client with idiopathic thrombocytopenic purpura (ITP)? o A. Acetylsalicylic acid (ASA) o B. Corticosteroids o C. Methotrexate o D. Vitamin K Correct Answer: B. Corticosteroids Corticosteroid therapy can decrease antibody production and phagocytosis of the antibody-coated platelets, retaining more functioning platelets. o Option A: ASA blocks prostaglandin synthesis. Inhibition of COX-1 results in the inhibition of platelet aggregation for about 7-10 days (average platelet lifespan). o Option C: Methotrexate inhibits enzymes responsible for nucleotide synthesis which prevents cell division