Anemia
True or false: A surgical treatment for thalassemia is splenectomy. 1) True 2) False
1) True
The type of anemia causes pancytopenia. 1) Blood loss anemia 2) Aplastic anemia 3) Folic acid deficiency 4) B-12 deficiency
Aplastic anemia
A nurse is assessing a client who has pernicious anemia. Which of the following findings should the nurse expect? Thick, white coating on the clients tongue. Decreased pulse rate. Paresthesias in the hands and feet. Joint pain in the extremities.
Paresthesias in the hands and feet.
This word means "destruction of red blood cells" 1) Macrocytic 2) Microcytic 3) Hemolysis 4) Cheilosis
Hemolysis
The nurse is caring for a 17-year-old client with blood loss anemia. Which independent nursing intervention would be appropriate for this client? (Select all that apply.) A.Assess vital signs. B.Encourage periods of rest. C.Supplement iron as ordered. D.Administer supplemental oxygen as ordered. E.Transfuse blood as soon as hemoglobin level falls below normal.
A.Assess vital signs. B.Encourage periods of rest. C.Supplement iron as ordered. D.Administer supplemental oxygen as ordered.
A nurse is caring for an eight-year-old child who has sickle cell anemia. Which of the following actions should the nurse take? Apply cool compresses to the painful area. Initiate contact isolation precautions. Give the child flavored Popsicles. Administer phytondione.
Give the child flavored Popsicles.
This type of anemia is the most common form? Folic acid deficiency. Iron deficient anemia. Vitamin B 12. G6PD anemia
Iron deficient anemia.
A nurse is teaching a client who has iron deficiency anemia. The nurse should encourage the client to increase their consumption of which of the following foods? Lentils. Avocados. Cabbage. Broccoli.
Lentils
The nurse understands that the client with pernicious anemia will have which of the following distinguishing laboratory findings? A. Schilling's test elevated B. Intrinsic factor, absent C. Sedimentation rate, 16 mm/hour D. RBCs 5.0 million
B. Intrinsic factor, absent
Select ALL the signs and symptoms that can present in pernicious anemia: A. Erythema B. Paresthesia of hands and feet C. Racing thoughts D. Extreme hunger E. Depression F. Unsteady gait G. Shortness of breath with activity
B. Paresthesia of hands and feet E. Depression F. Unsteady gait G. Shortness of breath with activity
The nurse is assessing a client's activity intolerance by having the client walk on a treadmill for 5 minutes. Which of the following indicates an abnormal response? A. Pulse rate increased by 20 bpm immediately after the activity. B. Respiratory rate decreased by 5 breaths/minute. C. Diastolic blood pressure increased by 7 mm Hg. D. Pulse rate within 6 bpm of resting phase after 3 minutes of rest.
B. Respiratory rate decreased by 5 breaths/minute.
This type of anemia may required stem cell transplant as part of the treatment plan. 1) Aplastic anemia 2) Pernicious anemia 3) Thalassemia 4) G6PD anemia
1) Aplastic anemia
This age group has a high need for iron due to physical growth periods putting them at risk for anemia. 1) Infants 2) Adolescents 3) Young adults 4) Older adults
1) Infants
Which of the following blood components is decreased in anemia? A. Erythrocytes B. Granulocytes C. Leukocytes D. Platelets
A. Erythrocytes
A client with anemia may be tired due to a tissue deficiency of which of the following substances? A. Carbon dioxide B. Factor VIII C. Oxygen D. T-cell antibodies
C. Oxygen
A client is admitted with a diagnosis of blood loss anemia after having outpatient surgery earlier in the day. The nurse reviews the healthcare provider's orders and places which order at highest priority? A.Intravenous normal saline at 250 mL/hr B.Regular diet C.Oxygen at 2 L via nasal cannula D.Bed rest with bathroom privileges
C.Oxygen at 2 L via nasal cannula
The nurse has just admitted a 35-year-old female client who has a serum B12 concentration of 800 pg/ml. Which of the following laboratory findings would cue the nurse to focus the client's history on the specific drug or alcohol abuse? A. Total bilirubin, 0.3 mg/dL B. Serum creatinine, 0.5 mg/dL C. Hemoglobin, 16 g/dL D. Folate, 1.5 ng/mL
Correct Answer: D. Folate, 1.5 ng/mL The normal range of folic acid is 1.8 to 9 ng/mL, and the normal range of vitamin B12 is 200 to 900 pg/mL. A low folic acid level in the presence of a normal vitamin B12 level is indicative of a primary folic acid-deficiency anemia. Factors that affect the absorption of folic acid are drugs such as methotrexate, oral contraceptives, antiseizure drugs, and alcohol.
A client comes into the health clinic 3 years after undergoing resection of the terminal ileum complaining of weakness, shortness of breath, and a sore tongue. Which client statement indicates a need for intervention and client teaching? A. "I have been drinking plenty of fluids." B. "I have been gargling with warm salt water for my sore tongue." C. "I have 3 to 4 loose stools per day." D. "I take a vitamin B12 tablet every day."
D. "I take a vitamin B12 tablet every day."
The nurse is caring for a 10-year-old client with thalassemia who had a splenectomy. Which nursing diagnosis is a priority for this client? A.Activity Intolerance B.Fatigue C.Self Neglect D. Sepsis: Risk for
D. Sepsis: Risk for
The nurse is caring for a client with anemia who is receiving intravenous iron supplementation. The nurse knows to monitor for which complication? A.Nausea B.Black, tarry stools C.Respiratory failure D.Anaphylaxis
D.Anaphylaxis
A nurse is providing teaching to a client who has anemia and has a new prescription for exporting Alfa. Which of the following pieces of information should the nurse include in the teaching? Hospitalization is required when administering each treatment. The maximum effect of the medication will occur in six months. Hypertension is a common adverse effect of this medication. Blood transfusions are needed with each treatment.
Hypertension is a common adverse effect of this medication.
Nurse nurse is creating a plan of care for a child who has aplastic anemia. Which of the following intervention should the nurse include? Initiate protective environment isolation for the child. Apply pressure for 1 to 2 minutes at the puncture site following a blood specimen collection. Mix the trials for ferrous sulfate elixir twice per day into a glass of milk for administration. Check the child's blood glucose out level every four hours
Initiate protective environment isolation for the child.
A nurse is assessing a client for manifestations of aplastic anemia. Which of the following findings should the nurse expect? Plethoric appearance of facial skin. Glossitis and Weight loss. Jaundice with enlarged liver Petechiae and evchymosis.
Petechiae and evchymosis.
A nurse is caring for a school age child who has sickle cell anemia. Which of the following actions should the nurse plan to take to help decrease the risk of a vaso-occlusive crisis? Provide adequate fluid intake throughout the day. Provide oxygen at 2 L per minute via nasal cannula. Administer a blood transfusion. Give ibuprofen to manage pain.
Provide adequate fluid intake throughout the day.
Which of the following symptoms is expected with hemoglobin of 10 g/dl? a.None b.Pallor c.Palpitations d.Shortness of breath
a.None Mild anemia usually has no clinical signs.
A nurse is planning care for a client who has Pernicious anemia. Which of the following intervention should the nurse include in the care plan? Administer ferrous sulfate supplement. Increase dietary intake of folic acid. Initiate weekly injections of vitamin B 12 Initiate a blood transfusion.
Initiate weekly injections of vitamin B 12
A client is beginning a regimen of ferrous sulfate or iron. As you prepare to administer the medication, it is important for you to advise the client that a.Her urine will turn a dark orange b.Her bowel movements will be dark and tarry c.Her appetite will be diminished d.Her vision will become slightly blurred
b.Her bowel movements will be dark and tarry
Which of the following foods would the nurse encourage the mother to offer to her child with iron deficiency anemia? a.Rice cereal, whole milk, and yellow vegetables b.Potato, peas, and chicken c.Macaroni, cheese, and ham d.Pudding, green vegetables, and rice
b.Potato, peas, and chicken
When discussing appropriate food choices with a patient who has iron-deficiency anemia and follows a low-cholesterol diet, the nurse will encourage the patient to increase the dietary intake of? a.eggs and muscle meats. b.nuts and cornmeal. c.milk and milk products. d.legumes and dried fruits
d. legumes and dried fruits
A client with iron deficiency anemia is scheduled for discharge. Which instruction about prescribed ferrous gluconate therapy should the nurse include in the teaching plan? a."Take the medication with an antacid." b."Take the medication with a glass of milk." c."Take the medication with cereal." d."Take the medication on an empty stomach."
d."Take the medication on an empty stomach."
A nurse in a providers office is reviewing the medical records of a group I have clients. Which of the following clients is at risk for iron deficiency? select all that apply A client who is postmenopausal A client who is a vegetarian A middle at age adult male A client who is pregnant A toddler who is overweight
A client who is postmenopausal A client who is a vegetarian A toddler who is overweight
Select the patient below who is at MOST risk for pernicious anemia: A. A 75 year old male who recently had surgery on the ileum. B. A 25 year old female who reports craving ice and clay. C. A 66 year old male whose peripheral blood smear showed hypochromic red blood cells. D. All the patients above are at risk for pernicious anemia.
A. A 75 year old male who recently had surgery on the ileum.
When a client is diagnosed with aplastic anemia, the nurse monitors for changes in which of the following physiological functions? A. Bleeding tendencies B. Intake and output C. Peripheral sensation D. Bowel function
A. Bleeding tendencies
The client is being admitted with Folic acid deficiency anemia. Which would be the most appropriate referral? A.Alcoholics anonymous B.Leukemia society of America C.A hematologist D.A social worker
A.Alcoholics anonymous
Which nursing intervention is appropriate to include in the plan of care for a client with anemia? (Select all that apply.) A.Assess for signs of hypoxia. B.Provide rest periods as needed. C.Place the client in the supine position. D.Administer medications as ordered. E.Administer supplemental oxygen as ordered.
A.Assess for signs of hypoxia. B.Provide rest periods as needed. D.Administer medications as ordered. E.Administer supplemental oxygen as ordered.
The nurse devises a teaching plan for the patient with aplastic anemia. Which of the following is the most important concept to teach for health maintenance? A. Eat animal protein and dark leafy vegetables each day. B. Avoid exposure to others with acute infection. C. Practice yoga and meditation to decrease stress and anxiety. D. Get 8 hours of sleep at night and take naps during the day.
B. Avoid exposure to others with acute infection.
The nurse is caring for a client and notes that the client has a history of rib and vertebral fractures, splenic enlargement, and bronze skin discoloring. The nurse prepares a referral for the client to which specialist? A.Orthopedist B.Genetic counselor C.Dermatologist D.Gastroenterologist
B.Genetic counselor
A vegetarian client was referred to a dietitian for nutritional counseling for anemia. Which client outcome indicates that the client does not understand nutritional counseling? The client: A. Adds dried fruit to cereal and baked goods. B. Cooks tomato-based foods in iron pots. C. Drinks coffee or tea with meals. D. Adds vitamin C to all meals.
C. Drinks coffee or tea with meals.
In pernicious anemia, intrinsic factor is not being secreted by the _______ cells which are found in the gastric mucosa. A. Visceral B. Langerhan C. Parietal D. Chief
C. Parietal
A 52-year-old patient has a new diagnosis of pernicious anemia. After teaching the patient about pernicious anemia, the nurse determines that the patient understands the disorder when the patient states. a."I will need to have cobalamin (B12) injections regularly for the rest of my life." b."I will stop having a glass of wine with dinner." c."The numbness in my feet will go away once my hemoglobin level returns to normal." d."My diet should include more red meat or liver."
I will need to have cobalamin (B12) injections regularly for the rest of my life.
When a client is diagnosed with aplastic anemia, the nurse monitors for changes in which of the following physiological functions? a.Bleeding tendencies b.Intake and output c.Peripheral sensation d.Bowel function
a. Bleeding tendencies
What nursing intervention is most appropriate for the client with anemia who is experiencing activity intolerance? A.Administer medications to the client as ordered. B.Ensure that the client walks the halls twice daily to prevent lung infection. C.Provide the client adequate rest periods. D.Assess the client's vital signs and apical pulse.
C.Provide the client adequate rest periods.
The nurse is informing a client that a test has been ordered to diagnose aplastic anemia. Which test will the client have? A.Complete blood count B.Schilling test C.Iron levels D.Bone marrow examination
D.Bone marrow examination
A nurse is caring for a client who has a new diagnosis of pernicious anemia. The nurse should expect the clients provider to prescribe which of the following medications for this client? Ferrous Sulfate Epoetin Alfa Vitamin B 12 Folic acid.
Vitamin B 12
A nurse is caring for a client who has pernicious anemia. Which of the following factors should the nurse identify with this condition? Iron deficiency. Hemolytic blood loss. Folic acid deficiency. Vitamin B 12 deficiency.
Vitamin B 12 deficiency.
The type of anemia causes pancytopenia. 1) Blood loss anemia 2) Aplastic anemia 3) Folic acid deficiency 4) B-12 deficiency
2) Aplastic anemia
You're providing discharge teaching to a patient about pernicious anemia. Which statement by the patient indicates they did NOT understand the discharge teaching? A. "Pernicious anemia is caused by not consuming enough Vitamin B12." B. "Pernicious anemia causes the red blood cells to appear very large and oval." C. "Treatment for pernicious anemia includes a series of intramuscular injections of Vitamin B12." D. "A red, smooth tongue can be a sign of pernicious anemia."
A. "Pernicious anemia is caused by not consuming enough Vitamin B12."
A client was admitted with iron deficiency anemia and blood-streaked emesis. Which question is most appropriate for the nurse to ask in determining the extent of the client's activity intolerance? A. "What activities were you able to do 6 months ago compared to the present?" B. "How long have you had this problem?" C. "Have you been able to keep up with all your usual activities?" D. "Are you more tired now than you used to be?"
A. "What activities were you able to do 6 months ago compared to the present?"
The nurse anticipates that vitamin B12 supplementation may be ordered for a client with which condition? A.Thalassemia B.Aplastic anemia C.Iron deficiency anemia D.Pernicious anemia
D.Pernicious anemia
A client is to receive epoetin (Epogen) injections. What laboratory value should the nurse assess before giving the injection? a.Hematocrit b.Partial thromboplastin time c.Hemoglobin concentration d.Prothrombin time
a. Hematocrit Epogen is a recombinant DNA form of erythropoietin, which stimulates the production of RBCs and therefore causes the hematocrit to rise. The elevation in hematocrit causes an elevation in blood pressure; therefore, the blood pressure is a vital sign that should be checked. The PTT, hemoglobin level, and PT are not monitored for this drug.
The nurse is admitting a 24 year old American American female client with a dx of rule-out anemia. The client has a hx of gastric bypass surgery for obesity 4 years ago. Current assessment findings include height 5'5, wt. 75 kg, P 110, R 27, and BP 104/66; pale mucous membranes and dyspnea on exertion. Which type of anemia would the nurse suspect the client has developed? A.Vitamin B12 deficiency B.Folic acid deficiency C.Iron deficiency D.Sickle cell anemia
A.Vitamin B12 deficiency
A home health nurse is visiting an older adult client who has anemia. Which of the following foods should the nurse recommend to increase the clients iron intake? Greek yogurt. Bran muffin. Peanut butter sandwich. Dried fruit.
Dried fruit.
A nurse is caring for an adolescent who has sickle cell anemia. Which of the following manifestations is/are the result of chronic vaso-occlusive phenomena? SATA Enlarged heart. Enuresis Leg ulcers Extrahepatic Cholestasis Retinal detachment
Enlarged heart. Enuresis Leg ulcers Retinal detachment
This medication helps stimulates the production of red blood cells and is used to treat anemia associated with chronic renal failure? Erythropoietin Erythromycin Filgrastim Calcitrol
Erythropoietin