Chapter 29 Hinkle
Parents arrive to the clinic with their young child and inform the nurse the child has just been diagnosed with sickle cell disease. The parents ask the nurse how this could have happened and which one of them is the carrier. What is the best response by the nurse? "Most likely, the father is the carrier of the gene." "The trait is passed down through the mother." "The child must inherit two defective genes, one from each parent." "It is an acquired, not a hereditary disorder."
"The child must inherit two defective genes, one from each parent."
A clinical nurse specialist (CNS) is orienting a new graduate registered nurse to an oncology unit where blood product transfusions are frequently administered. In discussing ABO compatibility, the CNS presents several hypothetical scenarios. The new graduate knows that the greatest likelihood of an acute hemolytic reaction would occur when giving: O-positive blood to an A-positive client. A-positive blood to an A-negative client. O-negative blood to an O-positive client. B-positive blood to an AB-positive client.
A-positive blood to an A-negative client.
The nurse is caring for a client with an exacerbation of sickle cell disease (SCD). Which finding indicates to the nurse that the client is experiencing a liver complication from this condition? Glucose intolerance Abdominal pain Weakness Fatigue
Abdominal pain
A client with sickle cell disease informs the nurse that he is having chest pain. The nurse hears the client coughing, wheezing, and breathing rapidly. What does the nurse suspect is occurring with this client? Acute muscular strain Acute chest syndrome Pneumocystis pneumonia Vaso-occlusive crisis
Acute chest syndrome
A client is brought to the ED reporting fatigue, large amounts of bruising on the extremities, and abdominal pain localized in the left upper quadrant. A health history reveals the client has been treated for a sore throat three times in the past 2 months. Laboratory tests indicate severe anemia, significant neutropenia, and thrombocytopenia. Based on the symptoms, what could be the client's diagnosis? Hemolytic anemia Iron deficiency anemia Sickle cell anemia Aplastic anemia
Aplastic anemia
A client in end-stage renal disease is prescribed epoetin alfa and oral iron supplements. Before administering the next dose of epoetin alfa and oral iron supplement, what is the priority action taken by the nurse? Ensures the client has completed dialysis treatment Holds the epoetin alfa if the BUN is elevated Assesses the hemoglobin level Questions the administration of both medications
Assesses the hemoglobin level
The nurse is caring for a client with type 2 diabetes who take metformin to manage glucose levels. The nurse recognizes the client may be most at risk for which vitamin deficiency? A B12 C Folate
B12 Explanation: The medication metformin (Glucophage) increases the client's risk for developing B12 deficiency because the medication inhibits the absorption of B12.
Which of the following are assessment findings associated with thrombocytopenia? Select all that apply. Epistaxis Hypertension Bradypnea Hematemesis Bleeding gums
Bleeding gums Epistaxis Hematemesis
A client is found to have a low hemoglobin and hematocrit when laboratory work was performed. What does the nurse understand the anemia may have resulted from? Select all that apply. Inadequate formed white blood cells Destruction of normally formed red blood cells Infection Abnormal erythrocyte production Blood loss
Blood loss Abnormal erythrocyte production Destruction of normally formed red blood cells
A nurse working with clients diagnosed with sickle cell disease notices that sickle cell crisis cases increase in the winter months. What is the primary pathophysiological reason for this? Colder temperatures increases vessel pressures. Colder temperatures impairs oxygen uptake. Colder temperatures slows the blood flow. Colder temperatures worsens sickling.
Colder temperatures slows the blood flow.
A male client has been receiving a continuous infusion of weight-based heparin for more than 4 days. The client's PTT is at a level that requires an increase of heparin by 100 units per hour. The client has the laboratory findings shown above. What is the most important action for the nurse to take? Continue with the present infusion rate of heparin. Increase the heparin infusion by 100 units per hour. Begin treatment with the prescribed warfarin (Coumadin). Consult with the physician about discontinuing heparin.
Consult with the physician about discontinuing heparin. Explanation: Platelet counts may decrease with heparin therapy, and this client's platelet count has decreased. The client may have heparin-induced thrombocytopenia (HIT).
A nurse cares for a client with a hematological disorder and malnutrition. What is the nurse's best understanding of how the client's nutritional status may worsen the client's hematological condition? Decreased fat stores lead to decreased ability for red blood cells Decreased carbohydrates lead to decreased oxygen affinity of the hemoglobin Decreased calories lead to decreased immune response Decreased protein stores lead to decreased immune response
Decreased protein stores lead to decreased immune response
You are caring for a 13-year-old diagnosed with sickle cell anemia. The client asks you what they can do to help prevent sickle cell crisis. What would be an appropriate answer to this client? Avoid any activity that makes you short of breath. Drink at least 8 glasses of water every day. Stay on oxygen therapy 24/7. Avoid any sports that tire you out.
Drink at least 8 glasses of water every day.
The nurse is educating a patient with iron deficiency anemia about food sources high in iron and how to enhance the absorption of iron when eating these foods. What can the nurse inform the client would enhance the absorption? Eating leafy green vegetables with a glass of water Eating apple slices with carrots Eating calf's liver with a glass of orange juice Eating a steak with mushrooms
Eating calf's liver with a glass of orange juice
A thin client is prescribed iron dextran intramuscularly. What is most important action taken by the nurse when administering this medication? Rubs the site vigorously Uses a 23-gauge needle Employs the Z-track technique Injects into the deltoid muscle
Employs the Z-track technique Explanation: When iron medications are given intramuscularly, the nurse uses the Z-track technique to avoid local pain and staining of the skin.
The nurse observes the laboratory studies for a client in the hospital with fatigue, feeling cold all of the time, and hemoglobin of 8.6 g/dL and a hematocrit of 28%. What finding would be an indicator of iron-deficiency anemia? An increased number of erythrocytes Clustering of platelets with sickled red blood cells Erythrocytes that are macrocytic and hyperchromic Erythrocytes that are microcytic and hypochromic
Erythrocytes that are microcytic and hypochromic
The nurse is preparing to educate a group of students on the signs and symptoms of disseminated intravascular coagulation (DIC). The nurse knows that teaching was effective when the students are able to recognize which symptom as being associated with DIC? Select all that apply. Abdominal distention Tachypnea Cyanotic extremities Capillary refill 6 seconds Headache
Headache Cyanotic extremities Abdominal distention
A patient with End Stage Kidney Disease is taking recombinant erythropoietin for the treatment of anemia. What laboratory study does the nurse understand will have to be assessed at least monthly related to this medication? Potassium level Hemoglobin level Folate levels Creatinine level
Hemoglobin level
Which of the following describes a red blood cell (RBC) that has pale or lighter cellular contents? Hyperchromic Hypochromic Normocytic Microcytic
Hypochromic
While assessing a client, the nurse discovers the client has a history of restless leg syndrome. Which hematological condition does the nurse associate with this condition? Folate deficiency anemia Sickle cell disease Iron deficiency anemia Thalassemia
Iron deficiency anemia
The nurse observes a co-worker who always seems to be eating a cup of ice. The nurse encourages the co-worker to have an examination and diagnostic workup with the health care provider. What type of anemia is the nurse concerned the co-worker may have? Iron deficiency anemia Sickle cell anemia Megaloblastic anemia Aplastic anemia
Iron deficiency anemia Explanation: People with iron deficiency anemia may crave ice, starch, or dirt; this craving is known as pica.
A client admitted to the hospital in preparation for a splenectomy to treat autoimmune hemolytic anemia asks the nurse about the benefits of splenectomy. Which statement best explains the expected effect of splenectomy? It will remove the major site of red blood cell (RBC) destruction. It will reduce the destruction of platelets by macrophages. It will increase production of platelets by the bone marrow. It will increase red blood cell (RBC) production to compensate for blood loss.
It will remove the major site of red blood cell (RBC) destruction.
A nurse assesses a client diagnosed with megaloblastic anemia. Which clinical findings will the nurse most likely find? Select all that apply. Restless leg syndrome Smooth, red tongue Concave nails Jaundice Ulcerated corners of the mouth
Jaundice Ulcerated corners of the mouth Concave nails
During a routine assessment of a patient diagnosed with anemia, the nurse observes the patient's beefy red tongue. The nurse is aware that this is a sign of what kind of anemia? Folate deficiency Megaloblastic Autoimmune Iron deficiency
Megaloblastic
A client with a diagnosis of pernicious anemia comes to the clinic reporting of numbness and tingling in his arms and legs. What do these symptoms indicate? Severity of the disease Neurologic involvement Insufficient intake of dietary nutrients Loss of vibratory and position senses
Neurologic involvement Explanation: In clients with pernicious anemia, numbness and tingling in the arms and legs and ataxia are the most common signs of neurologic involvement.
A patient had gastric bypass surgery 3 years ago and now, experiencing fatigue, visits the clinic to determine the cause. The patient takes pantoprazole for the treatment of frequent heartburn. What type of anemia is this patient at risk for? Sickle cell anemia Iron deficiency anemia Aplastic anemia Pernicious anemia
Pernicious anemia
A nurse is developing a care plan for a client with disseminated intravascular coagulation (DIC). Which nursing intervention should the nurse include?
Place a pressure-reducing mattress on the client's bed.
While monitoring a client for the development of disseminated intravascular coagulation (DIC), the nurse should take note of which assessment parameters? Thrombin time, calcium levels, and potassium levels Fibrinogen level, WBC, and platelet count Platelet count, blood glucose levels, and white blood cell (WBC) count Platelet count, prothrombin time, and partial thromboplastin time
Platelet count, prothrombin time, and partial thromboplastin time
Which of the following is considered an antidote to heparin?
Protamine sulfate
A client who is diagnosed with hemophilia is admitted after sustaining an injury while playing outdoors with friends. Initially, the client presented with severe bleeding but has since stabilized. Which intervention(s) should the nurse include in the client's updated plan of care? Select all that apply. Educate to rinse the mouth with warm water between and after meals. Encourage the use a soft toothbrush for oral care. Support painful joints on pillows. Eliminate aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs). Obtain oral temperature at least once per shift.
Support painful joints on pillows. Encourage the use a soft toothbrush for oral care. Educate to rinse the mouth with warm water between and after meals. Eliminate aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs).
A client is prescribed 325 mg/day of oral ferrous sulfate. What does the nurse include in client teaching? Take with dairy products Decrease intake of fruits and juices Decrease intake of dietary fiber Take 1 hour before breakfast
Take 1 hour before breakfast Explanation: needs to be administered on an empty stomach
A client with chronic anemia has received multiple transfusions. Which client action would the nurse be concerned about relative to the client's condition? Takes a daily multiple vitamin pill Takes 60 grams of protein each day Eliminates use of alcohol Takes over-the-counter iron supplements
Takes over-the-counter iron supplements Explanation: When a client receives multiple transfusions and takes iron supplements, there may be a problem with iron overload.
Folate deficiency occurs in people who rarely eat which of the following?
Uncooked vegetables explanation: Folate is found in green vegetables and liver.
A client has a history of sickle cell anemia with several sickle cell crises over the past 10 years. What blood component results in sickle cell anemia? hemoglobin M hemoglobin A hemoglobin F hemoglobin S
hemoglobin S
A client with sickle cell anemia has a normal hematocrit. normal blood smear. low hematocrit. high hematocrit.
low hematocrit
A client admitted to the hospital with abdominal pain, anemia, and bloody stools reports feeling weak and dizzy. The client has rectal pressure and needs to urinate and move their bowels. The nurse should help them: onto the bedpan. to the bathroom. to a standing position so he can urinate. to the bedside commode.
onto the bedpan. Explanation: A client who's dizzy and anemic is at risk for injury because of his weakened state. Assisting him with the bedpan would best meet his needs at this time without risking his safety.
A client with megaloblastic anemia reports mouth and tongue soreness. What instruction will the nurse give the client regarding eating while managing the client's symptoms? "Eat cold, bland foods with a large amount of water." "Eat low-fiber blended foods only." "Eat small amounts of bland, soft foods frequently." "Eat larger amounts of bland, soft foods less frequently."
"Eat small amounts of bland, soft foods frequently."
After teaching a client about taking daily oral iron preparations for a moderate iron deficiency anemia, which statement by the client indicates to the nurse that additional instruction is needed? "I will occasionally take a stool softener if I feel constipated." "I will take the iron with orange juice about an hour before eating." "I will increase my fluid and fiber intake while I am taking the iron tablets." "I will call the doctor if my stools turn black."
"I will call the doctor if my stools turn black."
A few minutes after beginning a blood transfusion, a nurse notes that a client has chills, dyspnea, and urticaria. The nurse reports this to the health care provider immediately because the client probably is experiencing which problem? A hemolytic reaction caused by bacterial contamination of donor blood A hemolytic reaction to mismatched blood A hemolytic allergic reaction caused by an antigen reaction A hemolytic reaction to Rh-incompatible blood
A hemolytic allergic reaction caused by an antigen reaction
A complete blood count is commonly performed before a client goes into surgery. What does this test seek to identify? Potential hepatic dysfunction indicated by decreased blood urea nitrogen (BUN) and creatinine levels Low levels of urine constituents normally excreted in the urine Electrolyte imbalance that could affect the blood's ability to coagulate properly Abnormally low hematocrit (HCT) and hemoglobin (Hb) levels
Abnormally low hematocrit (HCT) and hemoglobin (Hb) levels
A client's low prothrombin time (PT) was attributed to low vitamin K levels and the client's PT normalized after administration of vitamin K. When performing discharge education in an effort to prevent recurrence, what should the nurse emphasize? Meticulous hygiene Avoidance of NSAIDs Adequate nutrition Constant access to clotting factor concentrates
Adequate nutrition
A client is hospitalized 3 days prior to a total hip arthroplasty and reports a high level of pain with ambulation. The client has been taking warfarin at home, which is now discontinued. To prevent the formation of blood clots, which action should the nurse take? Administer the prescribed enoxaparin (Lovenox). Have the client limit physical activity. Monitor partial thromboplastin (PTT) time. Encourage a diet high in vitamin K.
Administer the prescribed enoxaparin (Lovenox).
A nurse caring for a client who has hemophilia is getting ready to take the client's vital signs. What should the nurse do before taking a blood pressure? Ask if taking a blood pressure has ever produced bleeding under the skin or in the arm joints. Ask if taking a blood pressure has ever produced pain in the upper arm. Ask if taking a blood pressure has ever caused bruising in the hand and wrist. Ask if taking a blood pressure has ever produced the need for medication
Ask if taking a blood pressure has ever produced bleeding under the skin or in the arm joints.
A client reports feeling tired, cold, and short of breath at times. Assessment reveals tachycardia and reduced energy. What would the nurse expect the physician to order? CBC ECG antibiotic chest radiograph
CBC
A client is being treated for DIC and the nurse has prioritized the nursing diagnosis of Risk for Deficient Fluid Volume Related to Bleeding. How can the nurse best determine if goals of care relating to this diagnosis are being met?
Closely monitor intake and output.
A patient with end-stage kidney disease (ESKD) has developed anemia. What laboratory finding does the nurse understand to be significant in this stage of anemia? Magnesium level of 2.5 mg/dL Calcium level of 9.4 mg/dL Creatinine level of 6 mg/100 mL Potassium level of 5.2 mEq/L
Creatinine level of 6 mg/100 mL Explanation: The degree of anemia in patients with end-stage renal disease varies greatly; however, in general, patients do not become significantly anemic until the serum creatinine level exceeds 3 mg/100 mL.
A patient with chronic renal failure is examined by the health care provider for anemia. Which laboratory results will the nurse monitor? Increased mean corpuscular volume Increased reticulocyte count Decreased level of erythropoietin Decreased total iron-binding capacity
Decreased level of erythropoietin Explanation: As renal function decreases, erythropoietin, which is produced by the kidney, also decreases.
A client with severe anemia reports symptoms of tachycardia, palpitations, exertional dyspnea, cool extremities, and dizziness with ambulation. Laboratory test results reveal low hemoglobin and hematocrit levels. Based on the assessment data, which nursing diagnoses is most appropriate for this client? Fatigue related to decreased hemoglobin and hematocrit Imbalanced nutrition, less than body requirements, related to inadequate intake of essential nutrients Ineffective tissue perfusion related to inadequate hemoglobin and hematocrit Risk for falls related to complaints of dizziness
Ineffective tissue perfusion related to inadequate hemoglobin and hematocrit
Which iron-rich foods should a nurse encourage an anemic client requiring iron therapy to eat? Lobster and squash Cheese and bananas Lamb and peaches Shrimp and tomatoes
Lamb and peaches
During the review of morning laboratory values for a client reporting severe fatigue and a red, swollen tongue, the nurse suspects chronic, severe iron deficiency anemia based on which finding? Elevated red blood cell (RBC) count Enlarged mean corpuscular volume (MCV) Low ferritin level concentration Elevated hematocrit concentration
Low ferritin level concentration Explanation: The most consistent indicator of iron deficiency anemia is a low ferritin level, which reflects low iron stores.
For a client with Hodgkin disease who has developed neutropenia, what is an appropriate nursing intervention to include in the care plan? Omitting fresh fruits and vegetables from the diet Avoiding intramuscular (IM) injections Monitoring temperature every 4 hours Positioning the client to increase lung expansion
Monitoring temperature every 4 hours
A nursing instructor is evaluating a student caring for a neutropenic client. The instructor concludes that the nursing student demonstrates accurate knowledge of neutropenia based on which intervention? Monitoring the client's blood pressure and reviewing the client's hematocrit Monitoring the client's temperature and reviewing the client's complete blood count (CBC) with differential Monitoring the client's breathing and reviewing the client's arterial blood gases Monitoring the client's heart rate and reviewing the client's hemoglobin
Monitoring the client's temperature and reviewing the client's complete blood count (CBC) with differential explanation: Clients with neutropenia often do not exhibit classic signs of infection. Fever is the most common indicator of infection, yet it is not always present.
A nurse suspects that a patient may have aplastic anemia based on clinical manifestations and assessment. Which one of the following lab results would be consistent with this diagnosis? Erythrocyte count of 5.3 m/?L Hemoglobin level of 15 g/dL Neutrophil count of 50% Platelet level of 275,000/mm3
Neutrophil count of 50%
The nurse provides care for an older adult client, diagnosed with anemia, who has a hemoglobin of 9.6 g/dL and a hematocrit of 34%. To determine the cause of the client's blood loss, which is the priority nursing action? Monitor the client's blood pressure. Evaluate the client's dietary intake. Observe the client's stools for blood. Monitor the client's body temperature.
Observe the client's stools for blood. Explanation: Observing the stool for blood will determine if the source of the client's bleeding is in the GI tract.
A client with multiple myeloma is complaining of severe pain when the nurse comes in to give a bath and change position. What is the priority intervention by the nurse? Obtain the pain medication and delay the bath and position change until the medication reaches its peak. Inform the client that the position must be changed, and then you will give her pain medication and omit the bath. Inform the client that the bath and positioning is an important part of client care and will be done right after pain medication administration. Inform the client that she will feel better after receiving a bath and clean sheets.
Obtain the pain medication and delay the bath and position change until the medication reaches its peak.
A nurse is caring for a client with iron deficiency anemia. Which food or beverage will the nurse suggest to the client to eat or drink when taking supplemental iron? Kidney beans Leafy green vegetables Milk Orange juice
Orange juice Explanation: Vitamin C found in orange juice improves the absorption of iron.
A client diagnosed with systemic lupus erythematosus comes to the emergency department with severe back pain. The client is taking prednisone daily and reported feeling pain after manually opening the garage door. What adverse effect of long-term corticosteroid therapy is most likely responsible for the pain? Muscle wasting Hypertension Osteoporosis Truncal obesity
Osteoporosis
While assessing a client, the nurse will recognize what as the most obvious sign of anemia? Pallor Tachycardia Jaundice Flow murmurs
Pallor
A nurse is caring for a client admitted with pernicious anemia. Which set of findings should the nurse expect when assessing the client? Pallor, tachycardia, and a sore tongue Angina pectoris, double vision, and anorexia Pallor, bradycardia, and reduced pulse pressure Sore tongue, dyspnea, and weight gain
Pallor, tachycardia, and a sore tongue
A client has hereditary hemochromatosis. Laboratory test results indicate an elevated serum iron level, high transferrin saturation, and normal complete blood count (CBC). What is most important action for the nurse to take? Educate about precautions to follow after a liver biopsy. Instruct the client to limit iron intake in the diet. Remove the prescribed one unit of blood. Inform the client to limit ingestion of alcohol.
Remove the prescribed one unit of blood. Just get rid of the problem
A pregnant woman is hospitalized as the result of sickle-cell crisis. Which finding indicates the outcome has been achieved for this client? Exhibits a temperature more than 100.3°F Takes hydroxyurea during her pregnancy Describes the importance of staying cool Reports joint pain less than 3 on a scale of 0 to 10
Reports joint pain less than 3 on a scale of 0 to 10
A client at the clinic has just been diagnosed with iron deficiency anemia. What would you recommend the client consume to promote the absorption of iron? Rich sources of vitamin C Meat, egg yolks, oysters, and shellfish Sources of vitamin B12 Vitamin E
Rich sources of vitamin C Explanation: Sources of vitamin C such as citrus fruits and juices, strawberries, green peppers, and tomatoes enhance the absorption of nonheme iron.
The nurse is preparing the patient for a test to determine the cause of vitamin B12 deficiency. The patient will receive a small oral dose of radioactive vitamin B12 followed by a large parenteral dose of nonradioactive vitamin B12. What test is the patient being prepared for? Bone marrow aspiration Bone marrow biopsy Schilling test Magnetic resonance imaging (MRI) study
Schilling test
A client with a pulmonary embolism is being treated with a heparin infusion. What diagnostic finding suggests to the nurse that treatment is effective? The client's PT is within reference ranges. Arterial blood sampling tests positive for the presence of factor XIII. The client's activated partial thromboplastin time (aPTT) is 1.5 to 2.5 times the control value. The client's platelet level is below 100,000/mm3.
The client's activated partial thromboplastin time (aPTT) is 1.5 to 2.5 times the control value.
A patient is taking prednisone 60 mg per day for the treatment of an acute exacerbation of Crohn's disease. The patient has developed lymphopenia with a lymphocyte count of less than 1,500 mm3. What should the nurse monitor the client for? Diarrhea Abdominal pain Bleeding The onset of a bacterial infection
The onset of a bacterial infection
A client is treated for anemia. What is the nurse's best understanding about the correlation between anemia and the client's iron stores? There is an inverse relationship between iron stores and hemoglobin levels. There is a strong correlation between iron stores and hemoglobin characteristics. There is a weak correlation between iron stores and hemoglobin levels. There is a strong correlation between iron stores and hemoglobin levels.
There is a strong correlation between iron stores and hemoglobin levels.
A nurse is doing a physical examination of a child with sickle cell anemia. When the child asks why the nurse auscultates the lungs and heart, what would be best the response by the nurse? To detect the abnormal sounds suggestive of acute chest syndrome and heart failure To detect the motor strength and stroke-related signs and symptoms To detect the evidence of dehydration that might have triggered a sickle cell crisis To detect the evidence of infection such as fever and tachycardia
To detect the abnormal sounds suggestive of acute chest syndrome and heart failure
The nurse caring for an older adult with a diagnosis of leukemia would encourage the client to use an electric razor. What is the rationale for this statement by the nurse? The client is at risk for spontaneous and uncontrolled bleeding. The client is not at risk for infection from microorganisms. Trauma and microabrasions from a non-electric razor may contribute to anemia. Strong tissues and intact clotting mechanisms may prevent hemorrhage.
Trauma and microabrasions from a non-electric razor may contribute to anemia.
When evaluating a patient's symptoms that are consistent with a diagnosis of leukemia, the nurse is aware that all leukemias have which common feature? Compensatory polycythemia stimulated by thrombocytopenia Increased blood viscosity, resulting from an overproduction of white cells Reduced plasma volume in response to a reduced production of cellular elements Unregulated accumulation of white cells in the bone marrow, which replace normal marrow elements
Unregulated accumulation of white cells in the bone marrow, which replace normal marrow elements
A nurse on a hematology/oncology floor is caring for a client with aplastic anemia. Which would not be included in the client's discharge instructions? Plan for frequent periods of rest. Use a disposable razor when shaving. Encourage frequent handwashing. Avoid contact with family/friends who are sick.
Use a disposable razor when shaving.
A client is seen in the emergency department with severe pain related to a sickle cell crisis. What does the nurse understand is occurring with this client? Overhydration enlarges the red blood cells. The client has a decreased tolerance of pain related to the chronic nature of the illness. Bone marrow decreases the erythrocyte production causing decrease in hypoxia. Vascular occlusion in small vessels decreasing blood and oxygen to the tissues.
Vascular occlusion in small vessels decreasing blood and oxygen to the tissues.
During preparation for bowel surgery, a client receives an antibiotic to reduce intestinal bacteria. The nurse knows that hypoprothrombinemia may occur as a result of antibiotic therapy interfering with synthesis of which vitamin? Vitamin A Vitamin K Vitamin E Vitamin D
Vitamin K
Which medication is the antidote to warfarin? Clopidogrel Aspirin Vitamin K Protamine sulfate
Vitamin K
A client with pernicious anemia is receiving parenteral vitamin B12 therapy. Which client statement indicates effective teaching about this therapy? "I will receive parenteral vitamin B12 therapy for the rest of my life." "I will receive parenteral vitamin B12 therapy until my vitamin B12 level returns to normal." "I will receive parenteral vitamin B12 therapy monthly for 6 months to a year." "I will receive parenteral vitamin B12 therapy until my signs and symptoms disappear."
"I will receive parenteral vitamin B12 therapy for the rest of my life."
A client with anemia is prescribed an oral iron supplement. Which statement indicates that teaching about this supplement has been effective? "I will limit my intake of raw fruit and vegetables." "I will be sure to take this medication with food." "I will stop taking it if my stool turns black." "I will take it in the morning with orange juice."
"I will take it in the morning with orange juice."
A home care nurse visits a client diagnosed with atrial fibrillation who is ordered warfarin. The nurse teaches the client about warfarin therapy. Which statement by the client indicates the need for further teaching? "I'll use an electric razor to shave." "I'll report unexplained or severe bruising to my doctor right away." "I'll eat four servings of fresh, dark green vegetables every day." "I'll watch my gums for bleeding when I brush my teeth."
"I'll eat four servings of fresh, dark green vegetables every day." Explanation: Dark, green vegetables contain vitamin K, which reverses the effects of warfarin.
A client with idiopathic thrombocytopenic purpura (ITP) is admitted to an acute care facility. The nurse monitors the client's platelet count and observes closely for signs and symptoms of bleeding. The client is at greatest risk for cerebral hemorrhage when the platelet count falls below what number? 75,000/?l. 20,000/?l. 10,000/?l. 135,000/?l.
10,000/?l.
A health care provider prescribes one tablet of ferrous sulfate daily for a 15-year-old girl who experiences heavy blood flow during her menstrual cycle. The nurse advises the patient and her parent that this over-the-counter preparation must be taken for how many months before stored iron replenishment can occur? 3 to 5 months 1 to 2 months Longer than 12 months 6 to 12 months
6 to 12 months
A young client is diagnosed with a mild form of hemophilia and is experiencing bleeding in the joints with pain. In preparing the client for discharge, what instructions should the nurse provide? Undergo genetic testing and counseling if the client is male. Take warm baths to lessen pain. Take ibuprofen for joint pain. Wear a medical identification bracelet.
Wear a medical identification bracelet.
A nurse cares for clients with hematological disorders and notes that women are diagnosed with hemochromatosis at a much lower rate than men. What is the primary reason for this? Women lose iron through menstrual cycles Women rarely manifest the gene expression Women require greater folic acid supplementation Women have lower hemoglobin levels
Women lose iron through menstrual cycles