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Explain what happens during anaphase I and why it is unique.

A patient with poorly controlled hypertension develops kidney dysfunction. Lab findings show sodium retention and increased blood volume. Which system is most likely contributing to this condition?

The most common cause of primary (essential) hypertension is:

A 65-kg client arrives at the emergency department with suspected septic shock secondary to community-acquired pneumonia. Assessment findings: BP: 86/50 mm Hg (MAP 62) HR: 122 bpm, sinus tachycardia RR: 28 Temp: 38.9°C (102.0°F) SpO₂: 92% on 4 L nasal cannula Capillary refill: 4 seconds Lactate: 4.2 mmol/L Mottled skin over the knees and lower extremities The provider orders an initial crystalloid fluid bolus per the Surviving Sepsis Campaign Hour-1 bundle. How many milliliters of IV crystalloid should the nurse administer for the initial fluid bolus? Round to the nearest whole number. (Enter the numeric value only — do not include units.)

A 62-year-old client is recovering on the cardiac step-down unit on post-op day 2 from a coronary artery bypass graft (CABG). At 0800, the client’s cardiac monitor alarms. The nurse enters the room and finds: Cardiac monitor: wide-complex rhythm at 180/min consistent with ventricular tachycardia Client: unresponsive to sternal rub, apneic, no palpable carotid or femoral pulse Airway: patent with no visible obstruction The nurse calls out for help; additional staff respond within 30 seconds with the code cart, defibrillator, and backup support. What is the nurse’s priority immediate action?

A nurse is precepting a new graduate in the ICU and is reviewing the five major categories of shock. The nurse explains that each shock state has a distinct hemodynamic and clinical profile driven by its underlying mechanism, and that recognizing these patterns is essential for selecting appropriate interventions. Match each type of shock to its most characteristic clinical feature.

A 74-year-old client with a history of type 2 diabetes is admitted to the medical ICU with fever, tachycardia, and suspected sepsis from a urinary source. Initial management included: 30 mL/kg of IV lactated Ringer’s completed 2 hours ago Blood cultures drawn before initiation of IV piperacillin-tazobactam Continuous cardiac monitoring and arterial line placement Two hours after the initial fluid bolus, the nurse notes the following changes: Which findings suggest the client is progressing from sepsis to septic shock? Select all that apply.

A 42-year-old client was recently diagnosed with acute myeloid leukemia (AML) and is being discharged home after initial workup. The client is scheduled to begin induction chemotherapy next week. The nurse has provided discharge teaching on infection prevention, bleeding precautions, nutrition, follow-up, and activity. Before discharge, the nurse asks the client to verbalize key teaching points to evaluate understanding. Which client statements indicate a need for further education? Select all that apply.

A 68-year-old client is being discharged home after a 4-day hospitalization for an acute exacerbation of chronic heart failure (HFrEF, EF 35%). The client lives alone, is cognitively intact, and is being discharged on: Furosemide 40 mg PO daily Lisinopril 10 mg PO daily Metoprolol succinate 50 mg PO daily Spironolactone 25 mg PO daily Potassium chloride 20 mEq PO daily The nurse is developing the client’s discharge teaching plan. Which topics should the nurse include in the discharge teaching plan? Select all that apply.

A 61-year-old client with end-stage liver failure secondary to chronic hepatitis C is admitted to the medical unit for evaluation of worsening symptoms. The client appears jaundiced, has mild abdominal ascites, and is reported by family to be “not acting like themselves” with episodes of confusion over the past 2 days. Laboratory results: Lab Value Reference Range Serum albumin 2.6 g/dL 3.5–5.0 AST 92 U/L 10–40 Ammonia 124 mcg/dL 15–45 Total bilirubin 4.0 mg/dL 0.1–1.2 INR 1.8 0.9–1.1 Platelets 88,000/μL 150,000–400,000 Which laboratory value is most concerning and requires immediate intervention?