401 Hematology Quiz

During an interview, the nurse discovers that the spouse of a debilitated, chronically constipated client digitally removes stool from the client's rectum. What response to disimpaction is the nurse attempting to prevent by presenting other strategies to regulate the client's bowel movements?

2. Slowing of the heart

A nurse is teaching a client with Hodgkin disease about responses to whole-body radiation. Which clinical indicator increase should the nurse include? 1. Blood viscosity 2. Susceptibility to infection 3. Red blood cell production 4. Tendency for pathologic fractures

2. Susceptibility to infection

A nurse is advising a client about the risks associated with failing to seek treatment for acute pharyngitis caused by beta-hemolytic streptococcus. For what health problem is the client at risk?

3. Endocarditis

A client with left ventricular heart failure is taking digoxin 0.25 mg daily. what changes does the nurse expect to find if this medication is therapeutically effective? (SELECT ALL THAT APPLY)

1. Diuresis 3. Decreased edema 4. Decreased pulse rate

A nurse is caring for a client who is HIV(+) For. which complication associated with this diagnosis is it most important for the nurse to teach prevention strategies?

1. Infection

A nurse assesses a client recently admitted to an alcohol-detoxification unit. What common clinical manifestation should the nurse expect during the initial stage of alcohol detoxification?

1. Nausea

A client has a low hemoglobin level, which is attributed to nutritional deficiency, and the nurse provides dietary teaching. Which food choices by the client indicate that the nurse's instructions are effective? Select all that apply. 1. Raisins 2. Squash 3. Carrots 4. Spinach 5. Apricots

1. Raisins 4. Spinach

A client is recovering from an acute episode of alcoholism that included esophageal involvement. What are the components of a therapeutic diet that are MOST appropriate for the nurse to include in the teaching plan for this client? (SELECT ALL THAT APPLY)

1. Soft diet 4. High-protein diet 6. High-carbohydrate diet

A female client has a low hemoglobin level, which attributed to an iron deficiency. Which foods should the nurse recommend that the client increase in the diet? (select all that apply) 1. Spinach 2. Broccoli 3. Beef Liver 4. Baked Beans 5. Chicken Breast

1. Spinach 3. Beef Liver 4. Baked Beans

When an older client with heart failure is transferred from the ED to the medical service, what should the nurse on the unit do FIRST?

2. Assess the client's heart and lung sounds.

A nurse discusses the philosophy of AA with the client who has a history of alcoholism. What need must self-help groups such as AA meet to be successful?

3. Belonging

A nurse is caring for a client with a diagnosis of AIDS. The IV inflitrates and needs to be restarted. What is necessary to protect the nurse when restarting the IV? SELECT ALL THAT APPLY

3. Gloves 5. Hand hygiene

A nurse identifies signs of electrolyte depletion in a client whith heart failure who is reeiving bumetanide (Bumex) and digoxin (Lanoxin). What does the nurse determine is the cause of depletion?

1. Diuretic therapy

what change in pressure does the nurse conclude is responsible for the lower extremity pitting edema of a client with right ventricular heart failure?

1. Increase in plasma hydrostatic pressure

What should the nurse identify as the primary cause of the pain experienced by a client with a coronary occlusion?

2. heart muscle ischemia

A client who is to receive radiation therapy for cancer says to the nurse, "My family said I will get radiation burn." What is the BEST response? 1. "Your skin will look like a sunburn." 2. "A localized skin reaction usually occurs." 3. "A daily application of an emollient will prevent a burn." 4. "Your family must have experience with radiation therapy'"

2. "A localized skin reaction usually occurs."

A nurse is providing discharge instructions to a client who experienced an anterior septal MI. What statement by the client indicates to the nurse that there is a need for further teaching?

2. "I am not good at remembering to take medications."

A client admitted to the hospital has edematous ankeles. What should the nurse do to BEST reduce edema of the lower extremities?

2. Elevate the legs.

What is the priority nursing action when caring for a client with disseminated intravascular coagulation?

2. Avoid giving IM injections

A nurse is caring for a client with an infection caused by group A beta-hemolytic streptococci. The nurse should assess this client for responses associated with which illness?

2. Rheumatic fever

198. A client was treated with a radium implant for cancer of the cervix. What information is important for the nurse to teach the client when giving discharge instructions? 1. Limit daily fluid intake. 2. Return for follow-up care. 3. Continue a low-residue diet. 4. Take daily mineral supplements

2. Return for follow-up care.

A client is receiving epoetin (Epogen) for the treatment of anemia associated with chronic renal failure. Which client statements indication to the nurse that further teaching about this medication is necessary? 1. " I realize it is important to take this medication because it will cure my anemia." 2. "I know many way to protect my self from injury because I know I am at risk for seizures." 3 "I recognize I may still need a blood transfusion if my blood values are low." 4. "I understand that is will still need to take supplemental iron therapy with this medication."

1. " I realize it is important to take this medication because it will cure my anemia."

A client who had several episodes of chest pain is scheduled for an exercise electrocardiogram. Which explanation should the nurse include when teaching the client about this procedure?

1. "This is a noninvasive test to check your heart's response to physical activity."

A nurse is planning to provide discharge teaching to the family of a client with AIDS. Which statement should the nurse include in the teaching plan?

1. "Wash dishes in hot, soapy water."

A client with a history of alcohol abuse says to the nurse, "Drinking is a way out of my depression." Which strategy probably is MOST effective for the client at this time?

1. A self-help group

What is the most important nursing action when measuring a client's pulmonary capillary wedge pressure (PCWP)?

1. Deflate the baloon as soon as the PCWP is measured.

For which common complication of MI should the nurse monitor clients in the coronary care unit?

1. Dysrhythmia

195. Radium inserted in the vagina of a client is now being removed. What safety precaution should the nurse employ when assisting with the radium removal? 1. Clean the radium in ether or alcohol. 2. Wear foil-lined rubber gloves while handling the radium. 3. Ensure that long forceps are available for removing the radium. 4. Document how long the radium was in place and when it was removed.

3. Ensure that long forceps are available for removing the radium.

what should the nurse do to help alleviate the distress of a client with heart failure and pulmonary edema?

4. Place the client in the orthopneic position.

A client is diagnosed with Hodgkin disease. Which lymph nodes does the nurse expect to be affected first? I . Cervical 2. Axillary 3. Inguinal 4. Mediastinal

I . Cervical

A nurse is teaching a group of clients about risk factors for heart disease. Which factors increase a client's risk for a MI? (SELECT ALL THAT APPPLY.

1. Obesity 2. Hypertension

A nurse is leading a discussion in a senior citizen center about the risk factors for developing CHD for women versus men. What should the nurse respond when asked to identify the most significant risk factor?

2. Diabetes

While being prepared for surgery for a ruptured spleen, a client complains of feeling light-headed. The client's color is pale and the pulse is rapid. What should the nurse conclude about the client's condition?

2. Going into shock

A mother with the diagnosis of AIDS states that she has been caring for her baby even though she has not been feeling well. What important information should the nurse determine?

2. If the baby is breastfeeding

196. A nurse checking the perineum of a client with a radium implant for cervical cancer observes the packing protruding from the vagina. Why must the nurse notifr the health care provider to remove it immediately? 1. The radioactive packing will injure healthy tissue. 2. Removal of the packing will prevent excessive blood loss. 3. Flhe exposure of radium to the environment will diminish its effectiveness.

1. The radioactive packing will injure healthy tissue.

A client expresses concern about being exposed to radiation therapy because it can cause cancer. What should the nurse emphasize when informing the client about exposure to radiation? 1. The dosage is kept at a minimum. 2. Only a small part of the body is irradiated. 3. The client's physical condition is not a risk factor. 4. Nutritional environment of the affected cells is a risk factor.

2. Only a small part of the body is irradiated.

200. A postmenopausal woman who has cancer of the breast decides to have a lumpectomy followed by chemotherapy. After receiving chemotherapy for several weeks, she says to a nurse at the clinic, "I don't feel well." nurse reviews the chemotherapeutic medications the client is receiving, checks the laboratory results, and obtains the client's vital signs. Based on this information, what does the nurse conclude is the client's priority need? Client Chart Medications cyclophosphamide (Cytoxan) DOXOrubicin fluorouracil (5-FU) Laboratory Results RBC: 4.2 WBC: 3000 Hb: 12.5 g/dL Platelets: 190,000 Vital Signs Temperature (oral): 99.80 F Pulse: 88 beats/min Resp: 24 breaths/min Blood pressure: 126/88 mm Hg 1. Promoting rest 2. Preventing infection 3. Avoiding bodily harm 4. Maintaining fluid balance

2. Preventing infection

197. A nurse is caring for a client who has a radium implant for cancer of the cervix. What is the priority nursing action? 1. Store urine in lead-lined containers. 2. Restrict visitors to a ten-minute stay. 3. Wear a lead-lined apron when giving care. 4. Avoid giving injections in the gluteal muscle

2. Restrict visitors to a ten-minute stay.

What instructions about the use of nitroglycerin should the nurse provide to a client with angina?

3. "Before physical activity place 1 tablet under the tongue, and repeat the dose in 5 minutes if pain occurs"

A client asks asks the nurse, "Should I tell my partner that I just found out I'm HIV positive?" What is the nurse's most appropriate response?

3. "You are having difficulty deciding what to say."

112. A client is started on a continuous infusion of heparin. Which finding does the nurse use to conclude that the intervention is therapeutic? 1. INR is between 2 and 3 2. PT is 2 /21 times the control value 3. APTT is 2 times the control value 4. ACT is in the range of 70 and 120

3. APTT is 2 times the control value

A client who had a MI is in the coronary care unit on a cardiac monitor. The nurse observes ventricular irritability on the screen. What medication should the nurse prepare to administer?

3. Amiodarone

A client with heart failure is on a drug regimen of digoxin (Lanoxin) and furosemide (Lasix). The client dislieks oranges and bananas. Which fuit should the nurse encourage the client to eat?

3. Apricots

A client has a bone marrow aspiration performed. After the procedure, what is the first nursing action? 1. Position the client on the affected side. 2. Cleanse the site with an antiseptic solution. 3. Briefly apply pressure over the aspiration site. 4. Begin frequent monitoring of the client's vital signs

3. Briefly apply pressure over the aspiration site.

During an AIDS education class a client states, "Vaseline works great when I use condoms." Which conclusion about the client's knowledge of condom use can the nurse draw from this statement?

3. Ignorance related to correct condom use.

The family of a client with right ventricular heart failure expresses concern about the client's increasing abdominal girth. What physiologic change should the nurse consider when explaining the client's condition?

3. Increased pressure within the circulatory system

A client with upper GI bleeding develops mild anemia. What should the nurse expect to be prescribed for this client? 1. Epogen 2. Dextran 3. Iron Salts 4. Vitamin B12

3. Iron Salts

A client has edema in the lower extremities during the day, which disappears at night. With which medical problem does the nurse conclude this clinical finding is consistent?

3. Right ventricular heart failure

A transfusion of packed red blood cells is ordered for a client with anemia. List the following actions in the order in which they should be performed by the nurse. 1. Don a pair of clean gloves. 2. Run the transfusion slowly. 3. Determine the client's vital signs. 4. Ensure that the client signed a consent for the transfusion. 5. Compare the number on the blood product and the lab record.

4. Ensure that the client signed a consent for the transfusion. 3. Determine the client's vital signs. 5. Compare the number on the blood product and the lab record. 1. Don a pair of clean gloves. 2. Run the transfusion slowly.

A client is returned to the surgical unit immediately after placement of a coronary stent that was accomplished via access through the femoral artery. What response should the nurse consider the priority when assessing this client?

4. Hematoma formation

A nurse is caring for a client with a diagnosis of acute pancreatitis and alcoholism. The client asks, "What does my drinking have to do with my diagnosis?" What effect of alcohol should the nurse include when responding?

4. Increases enzyme secretion and pancreatic duct pressure that causes backflow of enzymes into the pancreas

A nurse prepares a client for insertion of a pulmonary artery catheter. What info can be obtained from monitoring the pulmonary artery pressure?

4. Left ventricular functioning

A client is receiving coumadin (warfarin). The nurse explains the need for careful regulation of dietary intake of vitamin K. What physiologic process does vitamin K promote that make this instruction essential? 1. Platelet aggreagtion 2. Ionization of blood calcium 3. Fibrinogen formation by the liver 4. Prothrombin formation by the liver

4. Prothrombin formation by the liver

What should the nurse teach a client to expect when preparing for discharge after surgery for a CABG?

4. Some edema in the leg used for the donor graft is expected with activity.

A client admitted with the diagnosis of possible MI, and a series of diagnostic tests is ordered. Which blood level should the nurse expect will increase first if this client has had a MI?

4. Troponin T

A client who abused IV drugs was diagnosed with HIV several years ago. The nurse explains that the diagnostic criterion for acquired AIDS has been met when the client:

4. has a CD4T lymphocyte level of less than 200 cells/uL

What clinical indicators is the nurse MOST likely to identify when taking the admission history of a client with right ventricular failure? (SELECT ALL THAT APPLY)

1, Edema 4. Dyspnea

What effect of anxiety makes it particularly important for the nurse to allay the anxiety of a client with heart failure?

1. Increases cardiac workload

A client is admited to the hospital with a diagnosis of alcohol withdrawal syndrome. What body organ should the nurse teach the client will be protected by the ingestion of a high-calorie diet fortified with vitamins?

1. Liver

A nurse is caring for a client with heart failure. The health care provider orders a 2 g sodium diet. What should the nurse include when explaining how a low-salt diet helps achieve a therapeutic outcome?

1. allows excess tissue fluid to be excreted.

A client is admitted with a higher than expected red blood cell count. What physiological alteration does the nurse expect will result from this clinical finding? 1. Increased serum pH 2. Decreased hematocrit 3. Increased blood viscosity 4. Decreased immune response

3. Increased blood viscosity

Thiamine (vitamin b1) and niacin (vitamin b3) are prescribed for a client with alcoholism. Which body function maintained by these vitamins should the nurse include in a teaching plan?

1. Neuronal activity

194. A nurse is caring for a client who had an insertion of radium for cancer of the cervix. For what radium reaction should the nurse assess the client? 1. Pain 2. Nausea 3. Excoriation 4. Restlessness

1. Pain

What dietary choices should the nurse instruct the client taking spironolactone (Aldactone) to avoid? (SELECT ALL THAT APPLY.)

1. Potatoes 3. Cantaloupe

Which signs cause the nurse to suspect cardiac tamponade after a client has cardiac surgery? Check all that apply. a. Tachycardia b. Hypertension c. Increased CVP d. Increased urine output e. Jugular vein distention

1. Tachycardia 3. Increased CVP 5. JVD

A client is in cardiogenic shock. What explanation of cardiogenic shock should the nurse include when responding to a family member's questions about the condition?

2. A failure of the circulatory pump.

After surgery for insertion of a CABG, a client develops a temp of 102. what priority concern related to elevated temperatures does a nurse consider when notifying the health care provider about the client's temperature?

2. A fever increases the cardiac output

A client who was in an automobile collision is admitted to the hospital with multiple injuries. Approximately 14 hours after admission, the client begins to experience signs and symptoms of withdrawal from alcohol. Which of these signs and symptoms should the nurse relate to alcohol withdrawal? (SELECT ALL THAT APPLY)

2. Anxiety 4. Diaphoresis 5. Psychomotor agitation

A nurse asks a cleint with ischemic heart disease to identify the foods that are most important ot restrict. the nurse determines that the client understands the dietary instructions when the client identifies the following foods. SELECT ALL THAT APPLY

2. Chicken broth 3. Enriched whole milk 4. Red meats, such as beef 6. Liver and other glandular organ meats

A nurse caring for a client with a diagnosis of polycythemia vera. The client asks, "Why do I have an increased tendency to develop blood clots?" Which effect of the polycythemia vera should the nurse explain increases the risk of blood clots? 1. Elevated blood pressure 2. Increased blood viscosity 3. Fragility of the blood cells 4. Immaturity of red blood cells

2. Increased blood viscosity

A client is admitted with chest pain unrelieved by nitroglycerin, an elevated temperature, decreased blood pressure, and diaphoresis. A MI is diagnosed. Which should the nurse consider as a valid reason for one of this client's physiologic responses?

2. Inflammation in the myocardium causes a rise in the systemic body temperature.

What group of clients should the nurse anticipate to have the highest incidence of non-Hodgkin lymphomas? 1. Children 2. Older adults 3. Young adults 4. Middle-aged persons

2. Older adults