Chapter 15 and 16 Test
Extreme care is use by the nursing staff when repositioning or transporting a pt with advanced multiple myeloma to prevent
Pathologic Factor
. The nurse cautions the 79 year old male who had gastrectomy a month ago that he is at risk for ___ anemia
Pernicious (Megaloblastic)
In completing an assessment of a pt with a bleeding disorder who has dark complexion, the nurse should check the palms of the hands and the soles of the feet for _____
Petechiae
A treatment often used for polycythemia versa is
Phlebotomy
The nurse explains that, in the event of a massive hemorrhagic episode, the ___ contracts and adds blood to the circulator volume
Spleen
The nurse is aware that a person with Hodgkin disease, who has two or more abnormal lymph nodes on the same side of the diaphragm and cancer extending locally from one lymph node area into a nearby organ, would be in:
Stage II
The nurse is conscientious in the care of the feet and legs of a pt with sickle cell anemia because
Stasis ulcers are a constant threat
The Home health nurse recommends to the mother of a 12-year-old child with leukemia that the child should have:
. An Annual influenza vaccine
Neutrophils release ____an enzyme that destroys certain bacteria
. lysozyme
A 23-year-old male pt with hemophilia A says, "how can I keep from having hemophilia A?" which of following is the most informative response?
"Your daughter may be a carrier and her children may have hemophilia A. Your son is not at risk"
The nurse reminds the pt with a bleeding disorder that the life span of the platelet is the shortest of all the blood cells, approximately ____ days.
10
What is the average lifespan of an erythrocyte
120 day
A nurse is monitoring the lab values of a child with leukemia who is receiving chemotherapy. The nurse prepares to implement bleeding precautions if the child becomes thrombocytopenic and the platelet count is less than
20,000
Blood infusions must be started within how many minutes of its arrival on the unit?
30 mins
A nurse provides instruction to the parents of a child with leukemia regarding measures related to monitoring for infection. Which statement by the parents indicates the need for further instruction?
I need to take my child's rectal temperature daily
The nurse evaluates the lab reports for the pt on the unit and recognizes the report the most immediate attention is for the pt with RBC_, WBC_, and Hg_.
4.2, 4500, 9.1
The nurse explains to a person that has undergone bone marrow transplant that engraftment takes up to ___ weeks
5 weeks.
Approximately how much blood is in the spleen that can be released in a hypovolemic emergency?
500ml
When the nurse observes melena, she is aware that the minimum of _ to _ ml of blood has been deposited into the GI tract
50;75
The pt who has purpura and blood in the urine and stool is being examined by the nurse. The nurse reviews the ordered blood work and suspects that the pt might be experiencing:
A decrease in thrombocytes
Activity intolerance and fatigue occur with some hematologic disorders because
A deficiency of hemoglobin decreases the oxygen-carrying capacity of the blood.
A nurse reinforces home-care instructions to the parents of a 3 year old child who has been hospitalized for hemophilia. Which statement by a parent indicates the need for further instruction
I will avoid immunization and dental hygiene treatments for my child.
When reviewing the hematologic system, the student nurse is correct when making which statement
African American have the highest incidence of sickle cell disease
The nurse notes a rise in the eosinophil count and suspects the pt has an...
Allergy
What would a nurse include in a teaching plan for a home health pt with a hemoglobin of 8.4 mg?
Alternating Activity with rest periods
The nurse reading a CBC note there is an abnormal number of "bands", or immature granulocytes. From this assessment, the nurse suspects...
An ongoing bacterial infection
The nurse assessing a differential sees and increase in immature neutrophils (bands) and is aware that this indicates:
An overwhelming bacterial infection
Aplastic anemia has its etiology in a variety of drugs, such as:
Antimetabolite cancer drugs, sulfonamides, phenylbutazone (Butazolidin), chloramphenicol (Chloromycetin)
Which nursing intervention is most appropriate following a bone marrow aspiration on the left posterior iliac crest from a pt with pernicious anemia
Apply pressure to the site for 5 min with an ice pack
. The pt with acute myelogenous leukemia (AML) asks why he is making more WBCs when he already has so many. The nurse clarified that the large number of leukemic white cells he already has:
Are not as effective as normal white cells would be
The nurse is aware that person of the Jehovah Witness faith accepts which types of blood transfusion?
Autologous Blood Transfusions
The information that the nurse recognizes as pertinent pt self-care with a sickle cell anemia is
Avoid dehydration and high altitudes.
The foods that the nurse would include in a nutrition teaching plan for an iron-deficiency anemia pt are:
Beans and Dried Fruits
The nurse explains why they are jaundice
Bilirubin
When assessing a complete blood count of a pt with all, the blood cells are called
Blasts
The elderly pt daughter ask why her dad seems to be catching so many colds. Which response by the nurse is the best.
Bone marrow activity decreases by 50% with aging which lowers the immune response
The mother of a 4 year old child with leukemia says to the nurse, "I don't understand why he is crying about his leg hurting." The nurse's most informative response would be based on the information that bone pain is related to:
Bone marrow congested with white cells
When the 14-year-old African American boy comes into the emergency room in sickle cell crisis, what should be the primary focus of care.
Pain control
The nurse is caring for a patient with anemia who has a past medical history of diabetes, hypertension, chronic kidney disease, and acid reflux. The nurse is aware the pt's anemia is likely related to which condition?
Chronic Kidney Disease
. The nurse is reviewing a pt assessment data upon admission to the acute care facility and observes signs of Iron deficiency anemia that include
Pale Conjunctivae
The nurse cautions that often confused and irritable older adults are thought to have dementia when the real underlying problem is a blood-related
Deficiency in RBC causes hypoxia
The nurse explains that a positron emission tomography (PET) has been ordered to:
Determine the extent of possible metastasis
The nurse explains that because it is a reliable and predictable indicator of the body's level of infection or recovery the _____ is a common diagnostic tool.
Differential
The pt with AML has a platelet count of 95,000. What interventions should the nurse include int eh pts care plan?
Electric razor, observe for melena and hematuria, apply ice and pressure to puncture sites, abd girth measures.
The nurse is reviewing a pt's intake data and observe signs of anemia that include
Pallor and fatigue
. The nurse is caring for a pt with sickle cell anemia. Based on the underlying pathophysiology of this disorder, the nurse should carefully perform which detailed assessment?
Examination for skin breakdown
A sign of spleen enlargement
Feeling of fullness in upper left abdomen
The nurse is monitoring a pt who is receiving a blood transfusion. Which findings would lead the nurse to stop the infusion?
Fever, Back pain, Headache, report of rash
To assess cyanosis in a pt with dark complexion, the nurse should inspect the:
Gums, Roof of mouth
A pt is being evaluated for anemia. The LPN expects to find the pt
Had decreased RBC
The nurse formulates the following expected outcomes for a pt admitted with hemarthrosis: "The pt will have no new hematomas or other evidence of bleeding." The most appropriate nursing intervention would be to:
Handle the patient very gently, protecting joints
The nurse makes a visual aid differentiating between mild, moderate, and severe anemia. Which signs and symptoms are manifestations of mild anemia?
Headache, Dyspnea on exertion
The pt who is taking radiation treatment has a platelet count of 100,000. The nurse should be alert for
Hematuria
Because of a deficiency of iron, the pt with iron deficiency anemia is unable to make sufficient...
Hemoglobin
. The nurse is assessing a pt with polycythemia vera. Which finding is correct with this disorder?
Hemoglobin of 17 mg/dL
Sam is a 16-year-old pt with an inherited bleeding disorder in which there is a lack in clotting factors. The LPN known that his likely diagnosis is
Hemophilia
The nurse explains that induction therapy for acute lymphatic leukemia is an...
Intensive protocol for chemotherapy to achieve remission
The home health nurse assesses the pt taking ferrous sulfate. Which pt statement alerts the nurse that reaching is necessary regarding this medication?
It taste better when I take my meds with milk
The nurse is assessing an 82 yr old AFM with sickle cell anemia and notes the sclera of his eyes to be yellow what does he have.
Jaundice
The nurse caring for a patient with pernicious anemia should make provisions for:
Lightweight blanket
The nurse is caring for a pt with iron deficiency anemia. The nurse should encourage intake of which foods?
Lima Beans, Prune Juice, Dried apricots, Liver
The nurse stresses to the pt with sickle cell anemia that one of the simplest interventions to help prevent sickle cell crisis is to ...
Maintain adequate fluid intake
The home health nurse caring for the pt with polycythemia vera will focus care on:
Maintenance of High fluid intake
The nurse is caring for a pt who is diagnosed with thrombocytopenia. The nurse expects the pt might be treated with:
Platelet transfusion
The most common cause of anemia in the elderly is due to
Poor nutrition
From which location would the bone marrow sample come in the aspiration of a 25-year-old pt?
Posterior Iliac Crest
Nursing Interventions for the pt with idiopathic thrombocytopenia purpura must include measures to:
Prevent spontaneous bleeding
Mr. Jones, age 52, is admitted with thrombocytopenia. The most important nursing intervention is to:
Prevent trauma and falling
The Pt who is taking radiation treatments has a platelet count of 60,000. The nurse should be alert for:
Prolonged bleeding after venipuncture
A pt with a nutritional anemia may lack with nutrients?
Proteins, Folic Acid, Iron
The nurse is caring for a pt with aplastic anemia. Which actions are most important for the nurse to take?
Provide a soft toothbrush and decrease clutter in the room.
In caring for a patient with multiple myeloma, what should the nurse include in the daily care?
Provisions for close supervision and assistance when ambulating
Which factors may be causative for leukemia?
Radiation exposure, Benzene exposure, Pesticide's exposure
The nurse assesses the abnormal blood value for a young woman as:
Red blood cells 2,000,000
In an adult, where are erythrocytes continuously produced?
Red bone marrow
The presence of excess bands in the peripheral blood that indicate severe infection is called
Shift to the left
When the pt with pernicious anemia says idk why I'm tired the nurse says
The lack of o2 being sent to the extremities
A pt with multiple myeloma has been stated on filgrastim (Neupogen) for treatment of neutropenia. The nurse identifies the drug is being effective when.
The pt white blood cell count increase.
The student nurse is preparing to administer an iron preparation via IM route. Which action by the student indicated to need for further instruction
The students choose a 1 ½ inch needle
The nurse instructs a 20-year-old female pt with sickle cell trait that
The trait can be passes on to all of her children
The pt with disseminated intravascular coagulation (DIC) is being treated with fresh frozen plasma and heparin therapy. The nurse explains to the family that the priority for this pt is:
To monitor for bleeding
What must a pt undergo before a bone marrow transplant
Total body irradiation to kill all the marrow cells
The 9-year-old child with leukemia who is on palliative care has drawn a picture of a boy under a huge black cloud that has lightning coming out of it. Which of the following would be an appropriate intervention for the nurse?
What is the picture about?
. The nurse takes into consideration that the patient with polycythemia vera will have a phlebotomy to thin the blood
every 2-3 months
The nurse frequently assesses a pt with aplastic anemia for signs of infection, bc the pt will not be able to produce and inflammatory response related to the low level of
leukocytes
A child with sickle cell anemia is places on the drug hydroxyurea. The nurse explains that this drug will:
produce a hemoglobin that resists sickling
At the end of a shift, a nurse documents the effectiveness of parent teaching concerning the transmission of hemophilia. Which of the following statements by mom shows she understands the teaching?
Hemophilia is a genetic disorder that my children will be carriers of.
The nurse assessing a patient with polycythemia vera would anticipate what
High hemoglobin
The nurse explains that in the event of an invasion of an allergen, the basophils release a strong vasodilator, which is:
Histamine
A pt with anemia is in the er. What is an appropriate question for the nurse to ask during her assessment?
How much meat do you eat in a week?
The nurse anticipates that the pt with iron deficiency anemia will have red cells that are...
Hypochromic and microcytic
The nurse evaluates a need for further instruction for the pt with sickle cell anemia when he say...
I am looking forward to my annual ski trip to Colorado
A pt with acute leukemia reports having nose bleeds throughout the night. Which of the following Nursing actions has the highest priority?
Report the nose bleeds to the physician
All the following are appropriate nursing interventions for the diagnosis of altered tissue perfusion related to a decreased number of RBC's and decrease oxygenation except:
Restrict fluid intake to avoid fluid overload
When the nurse administers a form of iron to an anemic pt, she keeps in mind that iron:
Should be given through a straw if in liquid oral form
