21-24
A client has sought care because his gums began bleeding when he was flossing his teeth and they have now been bleeding for several hours. Laboratory testing has revealed a platelet count of 60 x 103/μL (60 x 109/L) and a diagnosis of thrombocytopenia. Which of the nurse's assessment questions addresses the possible etiology of this health problem? "Have you ever used recreational drugs?" "Are your immunizations current?" "What medications are you currently taking?" "Do you know your blood type?"
"What medications are you currently taking?"
Which type of lymphocyte is involved with humoral-mediated immunity? Natural killer cells (NKC) Helper T cells B lymphocytes T lymphocytes
B lymphocytes
After birth, red blood cells are normally made in which location? Bone marrow Liver Kidneys Spleen
Bone marrow
A nurse is caring for a client receiving heparin therapy who has developed heparin-induced thrombocytopenia. Which nursing intervention does the nurse anticipate? Administration of platelets Monitoring the client's blood pressure every 2 hours Switching the client to warfarin therapy Discontinuation of heparin therapy
Discontinuation of heparin therapy
Which colony-stimulating factor (CSF) is given to clients with end-stage renal disease to help with chronic anemia? Interleukin Thrombopoietin (TPO) Filgrastim Erythropoietin (EPO)
Erythropoietin (EPO)
A client has been diagnosed with inherited hypercoagulability. Select the most likely cause. Prolonged immobility Myocardial infarction Hyperestrogenic state Factor V gene mutation
Factor V gene mutation
The pathologist notes that the client has Reed-Sternberg cells. He knows that these cells are a diagnostic hallmark for which disorder? Burkitt lymphoma Follicular lymphoma Non-Hodgkin lymphoma Hodgkin lymphoma
Hodgkin lymphoma
A nurse is monitoring a client with anemia and low oxygen levels. The nurse knows that which condition stimulates the secretion of erythropoietin? Tachycardia Hypoxia Low blood pressure Inflammation
Hypoxia
A 75-year-old client with a history of heart valve replacement arrives at the outpatient clinic with multiple red pinpoint lesions. The nurse identifies the lesions as: Erythema Purpura Petechiae Ecchymoses
Petechiae
When a 3-day-old full-term infant has an elevated bilirubin level of 18 mg/dL (307.87 μmol/L), the nurse will expect to support which intervention? Decreasing or holding breast-feeding Exchange blood transfusion Phototherapy Retesting again in 4 hours
Phototherapy
Progenitor cells, or parent cells, for the production of myeloid and lymphoid cells are derived from: Myeloproliferative cells Pluripotent stem cells Unipotent cells Multipotential progenitor cells
Pluripotent stem cells
A client presents to his physician with a red face, hands, feet, and ears; a headache; and drowsiness. A blood smear reveals an increased number of erythrocytes. Based on the laboratory results, the nurse prepares teaching material for which disease process? Thrombocytopenia Anemia Leukemia Polycythemia
Polycythemia
The nurse is planning care for a client with pancytopenia. Which aspects of the care plan should the nurse prioritize? Select all that apply. Promote mobility including active range of motion. Protect the client from exposure to pathogens. Instruct the client about energy conservation techniques. Protect the client from falls. Encourage a minimum of 3 L (12 glasses) of fluid per day
Protect the client from falls. Protect the client from exposure to pathogens. Instruct the client about energy conservation techniques.
The practitioner carefully monitors his client who exhibits hemoglobin S (HbS) genes. The practitioner know that the client is predisposed to life-threatening infection due to damage by HbS to which organ? Heart Lungs Pancreas Spleen
Spleen
Select the first stage of hemostasis. Clot dissolution Formation of the platelet plug Clot retraction Vessel spasm
Vessel spasm
To form a platelet plug, platelets are attracted to the damaged vessel. What then occurs within the blood vessel? Adhesion of the platelets Thrombosis Fibrinolysis Thromboxane A2
Adhesion of the platelets
A client with right lower quadrant abdominal pain is suspected to have acute appendicitis. When assessing the laboratory studies, what results would the nurse know indicate this client has an acute infection? An increase in T lymphocytes An increase in bands A decrease in eosinophils A decrease in platelet count
An increase in bands
A client was involved in an auto accident and suffered massive internal injuries that resulted in a large blood loss. Select the type of anemia the client is at greatest risk to develop. Iron deficiency Aplastic Hemolytic Blood loss
Blood loss
What are the components of blood? Select all that apply. Electrolytes Ascites Enzymes Bile
Electrolytes Enzymes
The nurse is working with a client awaiting a kidney transplant. The nurse teaches the client about what testing to determine an organ match (histocompatibility)? Bone marrow matching Chromosomal studies Tissue morphology examination Human leukocyte antigen typing
Human leukocyte antigen typing
A client's bone marrow study report reveals the findings of blast cells in the bone marrow. What does the nurse interpret this as indicating? Neutropenia Leukemia Hodgkin disease Non-Hodgkin disease
Leukemia
A young adult is preparing to begin treatment for non-Hodgkin lymphoma (NHL), a disease that has disseminated widely. What is the most likely treatment regimen for this client? Radiation, chemotherapy, and biotherapy Antiviral medications Surgery, whole-blood transfusion, and chemotherapy Bone marrow or stem cell transplantation
Radiation, chemotherapy, and biotherapy
A 26-year-old client has an absolute neutrophil count of less than 500 cells/mm3 (0.50 x 109/L) Which interpretation of this lab value is accurate? Mild neutropenia Slight neutropenia Normal neutrophil count Severe neutropenia
Severe neutropenia
A nurse is reviewing laboratory data for an older adult client. Which laboratory value should the nurse be most concerned about? White blood cell (WBC) count 3500/mL Hematocrit 37% Hemoglobin 11.8 g/dL (118 g/L) Platelets 400,000/mL (400,000 x 109/L)
White blood cell (WBC) count 3500/mL
A nurse is caring for a client who has sustained severe trauma and has developed disseminated intravascular coagulation (DIC). The nurse will explain this complication to the family based on which physiologic principle? Widespread coagulation and bleeding in the vascular compartment Impaired platelet function due to vitamin K deficiency Bleeding due to structurally weak vessels resulting from vitamin C deficiency Thrombocytosis as a result of widespread infection
Widespread coagulation and bleeding in the vascular compartment
The nursing caring for a 62-year-old client with diffuse large B-cell lymphoma plans care based on the knowledge that this client's lymphoma is: indolent. rare. encapsulated. aggressive.
aggressive.
The nurse is planning a prevention program for infectious mononucleosis. The best target audience for the program is: employees of a large factory. college students living in a dorm. parents of preschool children. older adults living in a senior apartment building.
college students living in a dorm.
A client who is being treated for small-cell lung cancer has been placed in protective isolation due to neutropenia. The most likely cause of this client's neutropenia is: the effects of chemotherapy on white blood cell development. the effects of tumor necrosis factor (TNF) on immature neutrophils. chromosomal disruption caused by the client's tumor. tumor invasion into the bone marrow and destruction of progenitor cells. SUBMIT ANSWER
the effects of chemotherapy on white blood cell development.
A client who takes daily sodium warfarin states a desire to start exercising daily. What is the best advice for the nurse to give the client? "Exercise is not recommended while taking any medication." "Exercise is not usually tolerated while taking warfarin." "Exercise can cause your medication to stop working." "Exercise will be beneficial to you, just be careful not to injury yourself or fall."
"Exercise will be beneficial to you, just be careful not to injury yourself or fall."
A client is newly diagnosed with impaired platelet function, thrombocytopathia. Which question is most appropriate for the nurse to ask in order to determine the possible cause of this problem? "Do you have a family history of hemophilia?" "Have you recently been exposed to any organic pesticides?" "Have you recently vacationed out of the country?" "Have you been taking aspirin or any nonsteroidal anti-inflammatory drugs (NSAIDs)?"
"Have you been taking aspirin or any nonsteroidal anti-inflammatory drugs (NSAIDs)?"
While taking a history on a pediatric client who appears to have Burkitt lymphoma, which question to the client and/or the family is likely to correlate with this diagnosis? "Have you recently traveled to Asia or eastern Europe?" "How long have you had swollen joints and painful walking?" "Have you kissed someone with known HIV infection?" "Have you recently been diagnosed with Epstein-Barr virus (EBV)?"
"Have you recently been diagnosed with Epstein-Barr virus (EBV)?"
The mother of a newborn infant questions why her baby needs a vitamin K injection immediately after birth. The best response by the nurse would be: "The infant was exposed to high levels of heparin upon birth." "Infants have a higher body fat content, which prohibits the absorption of vitamin K." "Infants are not born with the normal intestinal bacteria that synthesize vitamin K for clotting." "It is hospital policy to administer the injection to newborns."
"Infants are not born with the normal intestinal bacteria that synthesize vitamin K for clotting."
A client refuses to take the 81 mg of aspirin ordered by the physician, stating, "I do not have any pain." The best response by the nurse would be: "The 81 mg of aspirin daily will help protect you from a stroke or a heart attack." "This dose of aspirin will break apart the blood clot that you have in your leg." "Low-dose aspirin will help prevent you from having increased bleeding after surgery." "The doctor wants you to take the medication to prevent you from experiencing pain." SUBMIT ANSWER
"The 81 mg of aspirin daily will help protect you from a stroke or a heart attack."
Which statement about natural killer (NK) cells is the best explanation of their function when reviewing laboratory work for a 10-year-old child? "The natural killer (NK) cells are located primarily in the thymus." "The primary job of natural killer (NK) cells is to hunt down and destroy foreign cells in the body." "Natural killer cell values will be high if you are having an allergy attack." "Natural killer cells form antibody-producing plasma cells when there is an infection in the body."
"The primary job of natural killer (NK) cells is to hunt down and destroy foreign cells in the body."
A mother brings her child to the pediatric clinic because of irritability, loss of appetite, low-grade fever, pallor, and leg pain. Blood tests reveal anemia, thrombocytopenia, and an elevated leukocyte count with atypical lymphocytes. A diagnosis of acute lymphocytic leukemia (ALL) is confirmed with bone marrow studies. The child undergoes aggressive, high-dose chemotherapy with plans for a possible stem cell transplant. Which question is most appropriate for the nurse to ask the mother? "When your child was born, did you save the umbilical cord blood in a blood bank?" "This procedure is very expensive; will your insurance cover the cost?" "Would you be willing to donate your stem cells to transplant to your child?" "Is there any history of stem cell disease in your family?"
"When your child was born, did you save the umbilical cord blood in a blood bank?"
Normal red blood cells live an average of about how many days? 12 90 3 120
120
What is the typical life span of mature red blood cells? 90 days 30 days 10 days 120 days
120 days
The nurse is reviewing the client's laboratory report. Select the report that represents a normal value for leukocytes. 13,500 cells/mL (13.5 ×109/L) 12,000 cells/mL (12.0 ×109/L) 6500 cells/mL (6.5 ×109/L) 2000 cells/mL (2.0 ×109/L)
6500 cells/mL (6.5 ×109/L)
In which client would diagnostic investigations be most likely to reveal increased thrombopoietin production? An 81-year-old woman with a diagnosis of chronic obstructive pulmonary disease. A 55-year-old man who has been taking large amounts of acetaminophen for migraines. A 21-year-old woman awaiting bone marrow transplant for myelogenous leukemia. A 26-year-old woman who has just given birth to an infant.
A 21-year-old woman awaiting bone marrow transplant for myelogenous leukemia.
In which client would a clinician most suspect multiple myeloma as a diagnosis? A 68-year-old former coal miner who has white cell levels exponentially higher than normal ranges. A 70-year-old woman whose blood work reveals large numbers of immature granulocytes. An 81-year-old male resident of a long-term care home who has an uncommon bacterial pneumonia and who is unable to produce a fever. A 40-year-old man who has had three broken bones over the past 6 months and whose serum calcium and creatinine levels are elevated.
A 40-year-old man who has had three broken bones over the past 6 months and whose serum calcium and creatinine levels are elevated.
The nursing is reviewing assessment data of four clients. Which client is at greatest risk for developing pernicious anemia? A client who has undergone partial gastrectomy A client who is recovering from a laproscopic surgical procedure A client diagnosed with a neoplastic disorder A client of Italian heritage who had a colonoscopy
A client who has undergone partial gastrectomy
The nurse evaluating a client's blood work determines that a client has an increased risk for infection based on which lab result? Absoulute neutrophil count of 1000/μL (1.0 x 109/L) Absolute neutrophil count of 800/μL (0.80 x 109/L) Absolute neutrophil count of 1100/μL (1.1 x 109/L) Absolute neutrophil count of 1200/μL (1.2 x 109/L)
Absolute neutrophil count of 800/μL (0.80 x 109/L)
The nurse is caring for a client with chronic myelogenous leukemia (CML) and notes that the client has splenomegaly and an increased basophil count as well as night sweats, bone pain, and a low grade fever. The nurse interprets the symptoms as indicating that the client is in which phase of the clinical course of CML? Remissive Chronic Terminal Accelerated
Accelerated
A client diagnosed with systemic lupus erythematosus (SLE) has been experiencing a low neutrophil count. How would this type of neutropenia be classified? Acquired, drug-related neutropenia Congenital, cyclic neutropenia Congenital, alloimmune neonatal neutropenia Acquired, autoimmune secondary neutropenia
Acquired, autoimmune secondary neutropenia
A client with a diagnosis of hemophilia A has been admitted with bilateral knee pain. The nurse should anticipate performing what intervention during the client's treatment? Protective isolation and daily administration of subcutaneous vitamin K to prevent bleeding Passive range of motion exercises and transfusion of platelets Administration of factor VIII and implementation of fall prevention measures Administration of corticosteroids and desmopressin acetate (DDAVP)
Administration of factor VIII and implementation of fall prevention measures
Which plasma protein is considered the most abundant type? Fibrinogens Globulins Albumin Beta globulin
Albumin
A client comes to the clinic with a runny nose and scratchy throat. The nurse is evaluating the white blood cell count, which shows an elevated number of white blood cells and an increased percentage of eosinophils. What is the most likely cause of the symptoms? Viral infection Allergic reaction Bacterial infection Fungal infection
Allergic reaction
Anticoagulant drugs prevent thromboembolic disorders. How does warfarin, one of the anticoagulant drugs, act on the body? Alters vitamin K, reducing its ability to participate in the coagulation of the blood Increases vitamin K-dependent factors in the liver Increases procoagulation factors Increases prothrombin
Alters vitamin K, reducing its ability to participate in the coagulation of the blood
The globulins that make up part of the plasma of the blood have three distinct purposes. What are the gamma globulins? Autoantibodies of the immune system Antibodies of the immune system Transporters of iron and copper Transporters of bilirubin and steroids
Antibodies of the immune system
In primary immune thrombocytopenia purpura (ITP), the client has which type of disorder that primarily destroys which blood component? Autoimmune; platelets Alloimmune; factor VIII Allergic; fibrinogen Immunoglobulin; B cells
Autoimmune; platelets
Pernicious anemia is thought to be an autoimmune disease that destroys the gastric mucosa. This results in chronic atrophic gastritis and the production of antibodies that interfere with which vitamin's ability to bind to intrinsic factor? B6 Folate Vitamin C B12
B12
Which type of white blood cells are related to the connective tissue mast cells and respond in allergic and hypersensitivity reactions? Granulocytes Basophils B lymphocytes Neutrophils
Basophils
The nurse reviews the lab results of a client who has a thrombocyte count of 60 ×103/µL (60 ×109/L). The client is at risk for: Hypercoagulation Deep vein thrombosis Bleeding Disseminated intravascular coagulation
Bleeding
The nurse is assessing an 83-year-old adult client for signs and symptoms of anemia. What normal, age-related change increases this client's risk for anemia? Gastrointestinal "microbleeds" are common after age 75. Up to 20% of the RBCs in older adults are incapable of carrying oxygen. Blood cells are not replaced as quickly as they are in younger clients. Aplastic anemia is common in older adults and the risks increase with each decade.
Blood cells are not replaced as quickly as they are in younger clients.
Select the option that best describes the production of T lymphocytes. Bone marrow → thymus → lymph nodes Plasma cells → lymph nodes → arteries Bone marrow → plasma cells → lymph nodes Myocardial tissue → bone marrow → lymph nodes
Bone marrow → thymus → lymph nodes
Select the option that best describes the production of T lymphocytes. Myocardial tissue → bone marrow → lymph nodes Bone marrow → thymus → lymph nodes Plasma cells → lymph nodes → arteries Bone marrow → plasma cells → lymph nodes
Bone marrow → thymus → lymph nodes
The nurse caring for a client in the early stage of multiple myeloma would anticipate the client to report which symptom? Hypercalcemia Pathologic fractures Kidney failure Bone pain
Bone pain
A client's laboratory report indicates neutropenia, most likely drug induced. The nurse should frequently assess for which complication related to neutropenia? Plantar fasciitis Bronchial infection Bone fracture Vomiting
Bronchial infection
Which is considered a function of plasma? Producing waste products Manufacturing hormones Eliminating plasma proteins Carrying nutrients
Carrying nutrients
An older adult client arrives with garbled speech, unilateral facial drooping, and weakness and unfortunately dies. Laboratory work reveals hematocrit of 54% (0.54). Which complication of polycythemia could most likely be associated with this client's death? Infection and sepsis Cerebral thrombosis Acute leukemia Anaphylactic reaction
Cerebral thrombosis
In which conditions are Bence Jones proteins not found in the lab analysis? Select all that apply. Multiple myeloma Chronic lymphocytic leukemia Hodgkin lymphoma Chronic myelogenous leukemia SUBMIT ANSWER
Chronic lymphocytic leukemia Chronic myelogenous leukemia Hodgkin lymphoma
A client's laboratory report shows the presence of the Philadelphia chromosome. Which diagnosis should the nurse suspect the client has developed? Hairy cell leukemia Non-Hodgkin lymphoma Chronic lymphocytic leukemia (CLL) Chronic myelogenous leukemia (CML)
Chronic myelogenous leukemia (CML)
Which client is most susceptible to experiencing the effects of inadequate erythropoiesis? Client with renal failure as a result of longstanding hypertension Client with alcohol use disorder and a diagnosis of pancreatitis Client with ischemic stroke who remains bedridden Surgical client whose estimated blood loss during the procedure was 700 mL
Client with renal failure as a result of longstanding hypertension
The nurse's review of a client's laboratory results indicates that inflammation is absent and platelet levels are low. Which test was performed to provide the platelet count? Bone marrow aspiration Sedimentation rate Complete blood count Hematocrit
Complete blood count
Normally, there is a relatively constant number of each type of circulating blood cell. What regulates the number of each type of blood cell? Cytokines Hematopoietic system Pluripotent stem cells Immune system
Cytokines
Increased platelet function, and consequently hypercoagulability, can be caused by which physiologic process? Damage to the vascular endothelium Platelet insensitivity Factor V mutation Decreased platelet numbers
Damage to the vascular endothelium
Although the usual site for a bone marrow test is the posterior iliac crest, other sites include the anterior iliac crest and the sternum. What are the dangers of using the sternum for a bone marrow test in children? Potential for infection in the chest cavity Danger of perforating the mediastinum and heart Danger of perforating the lungs Potential for hemorrhage
Danger of perforating the mediastinum and heart
The nurse is caring for a client who has a low level of T lymphocytes. The nurse plans care for a client with: Infection Decreased hematocrit Anemia Decreased immune response
Decreased immune response
A nurse is caring for a newborn that has developed a low platelet count. What could be the cause? Increased pluripotent stem cell division Decreased spleen function Increased megakaryocytes Decreased thrombopoietin (TPO)
Decreased thrombopoietin (TPO)
A nurse working in an ambulatory care unit is working with a client who has recently been diagnosed with a V Leiden mutation. The nurse tells the client the importance of smoking cessation to avoid: Pulmonary hypertension Essential hypertension Coronary artery disease Deep vein thrombosis (DVT)
Deep vein thrombosis (DVT)
A newborn has a clotting disorder that results in the body being unable to produce fibrin. Which of the following could be the cause? Deficiency of fibrinogen Iron deficiency Increase in the number of megakaryocytes Decreased spleen function
Deficiency of fibrinogen
A week after starting atorvastatin for high cholestrol, the client returns reporting bleeding from the mouth (mucous membranes) and nose. What priority intervention should the health care provider perform? Request prescription for a good blood thinner to interrupt the coagulation. Discontinue the atorvastatin immediately. Apply an ice bag to the mouth and nose. Send the client to see an ears, nose, throat (ENT) specialist.
Discontinue the atorvastatin immediately.
A client has been placed on sulfamethoxazole/trimethoprim as treatment for community-acquired methicillin-resistant Staphylococcus aureus (MRSA) for 10 days. After taking the medication for 8 days, the client comes to the health care provider's office complaining of multiple nosebleeds over the past day. Laboratory work shows a platelet count of 80,000/μL. The nurse practitioner suspects which condition? Drug-induced thrombocytosis Hypersplenic thrombocytopenia Antiphospholipid syndrome Drug-induced thrombocytopenia
Drug-induced thrombocytopenia
The nurse is conducting a staff in-service program on non-Hodgkin lymphomas. The nurse should include that essentially all people with Burkitt lymphoma have evidence of infection with: HIV Helicobacter pylori HTLV-1 EBV
EBV
An adult client with good overall health has reported headaches and dizziness in recent weeks. The nurse's assessment reveals blood pressure of 158/99 mm Hg, which is unprecedented for the client. On observation, the client's skin appears reddened, though he denies feeling warm. The nurse should anticipate what further diagnostic finding? Elevated RBC, hemoglobin, and hematocrit. Normal RBC, hemoglobin, and hematocrit with alterations in morphology. Abnormal RBC indices coupled with low platelets. Further signs and symptoms of internal hemorrhage.
Elevated RBC, hemoglobin, and hematocrit.
Infectious mononucleosis is a lymphoproliferative disorder caused by the Epstein-Barr virus (EBV) that is usually self-limiting and nonlethal. Which complication can arise during this mostly benign disease? Rupture of the lymph nodes Peripheral nerve palsies Severe bacterial infections Enlarged spleen
Enlarged spleen
A nurse is evaluating laboratory results of a client diagnosed with a parasitic infection. The tests reveal a large group of cells that are membrane-bound with granules in their cytoplasm that are aiding in the destruction of the parasite. Which cell is the nurse evaluating? Lymphocyte Eosinophil Macrophage Monocyte
Eosinophil
Which leukocyte is correctly matched with its function within the body? Monocyte—releases heparin Eosinophil—allergic reaction Lymphocyte—phagocytosis Basophil—engulfs antigens
Eosinophil—allergic reaction
Endemic Burkitt lymphoma occurs in regions of Africa where what other infections are common? Herpes zoster and Epstein-Barr Epstein-Barr and malaria Herpes zoster and streptococcal Malaria and streptococcal
Epstein-Barr and malaria
Hemophilia A is a hereditary blood disorder caused by inadequate activity or absence of which blood component? von Willebrand complex Prothrombin Factor VIII Intrinsic factor
Factor VIII
A client has developed disseminated intravascular coagulation (DIC), which the health care providers think was initiated by the intrinsic pathway, requiring which substance to begin the step-wise coagulation cascade? Factor XII Protein C Thrombin Tissue factor
Factor XII
The nurse is teaching a client about the signs and symptoms of anemia. If the client has a diminished oxygen-carrying capacity of hemoglobin (Hgb), then which manifestation should be assessed? Bleeding Pale skin Fatigue Bone pain
Fatigue
The nurse's plan of care for a client with multiple myeloma should include interventions to prevent: Urinary tract infections Diarrhea GI bleed Fractures
Fractures
The nurse's plan of care for a client with multiple myeloma should include interventions to prevent: Urinary tract infections Fractures Diarrhea GI bleed
Fractures
A client being treated for polymyalgia rheumatica (PMR) comes to the clinic for a follow-up visit. The current erythrocyte sedimentation rate (ESR) rate has decreased from 60 mm/hour to 30 mm/hour and the client is afebrile, denies any headaches, and reports a decrease in joint pain and fatigue. Based on these findings, the nurse anticipates which change to the treatment plan? Gradually decrease the current dosage of prednisone and repeat ESR in 2 weeks. Discontinue the current prednisone prescription and start an anti-inflammatory drug such as naproxen. Repeat ESR in 2 weeks. No change of treatment; continue to monitor the client with a follow-up visit in 1 month. The client is cured, and no further treatment is necessary.
Gradually decrease the current dosage of prednisone and repeat ESR in 2 weeks.
The nurse caring for a client with myelogenous leukemia anticipates the client will have abnormalities in which type of blood cell? Select all that apply. Granulocytes Erythocytes Thrombocytes Albumin
Granulocytes Erythocytes Thrombocytes
Which substance, when deficient, results in a diagnosis of anemia? Hemoglobin Platelets Blood plasma Folic acid
Hemoglobin
The client is an average-sized adult and has abnormal microcytic hypochromic red blood cells due to a long-term, chronic disease. Which complete blood count (CBC) result is characteristic of this type of anemia? Hemoglobin 7.8 g/dL (78 g/L) Band cells 700/µL (0.7 ×109/L) Hematocrit 44% (0.44) Reticulocytes 1.5% (0.015)
Hemoglobin 7.8 g/dL (78 g/L)
When an Rh-negative mother gives birth to an Rh-positive infant, the mother usually produces antibodies that will attack any subsequent pregnancies in which the fetus is Rh positive. When subsequent babies are Rh positive, erythroblastosis fetalis occurs. What is another name for erythroblastosis fetalis? Macrocytic disease of the newborn Hemolytic iron deficiency anemia Microcytic disease of the newborn Hemolytic disease of the newborn
Hemolytic disease of the newborn
The emergency department nurse is concerned that the client's snake bite may trigger disseminated intravascular coagulation (DIC). If this should occur, which clinical manifestations would be seen? Hypertension Headaches Hemorrhage Platelet loss
Hemorrhage
A nurse is caring for a client receiving heparin therapy. Five days after the start of therapy the nurse notices a sudden decrease in the platelet count. Which complication of heparin therapy can cause platelets to decrease? Disseminated intravascular coagulation Heparin-induced thrombocytopenia Thrombotic microangiopathies Anaphylaxis
Heparin-induced thrombocytopenia
A client reports a general deterioration in his health over the past several weeks. Which assessment and laboratory findings would be most closely associated with acute leukemia? Decreased oxygen partial pressure shortness of breath and weight loss Increased serum potassium and sodium levels and small spleen Increased blood urea nitrogen and bone pain High blast cell counts and fever
High blast cell counts and fever
A client with acute leukemia has developed gout and asks the nurse, "Why did this happen?" Which response is most accurate? Diet with too many carbohydrates Anorexia and muscle wasting Too much alcohol consumption High uric acid levels
High uric acid levels
A client is preparing to undergo a bone marrow biopsy to verify a diagnosis of acute leukemia. Which information should the nurse report to the health care provider prior to the procedure? Select all that apply. Increase white blood cells as indicated on morning lab work Erythrocyte sedimentation rate of 15 mm/hour History of anemia History of hemophilia Low platelet count as indicated on morning lab work
History of hemophilia Low platelet count as indicated on morning lab work
The nurse assessing a client diagnosed with multiple myeloma should assess for which clinical manifestation associated with this diagnosis? Low vitamin D levels Hypercalcemia Hyperparathyroidism Hepatomegaly
Hypercalcemia
Which lab results are frequent clinical manifestations of multiple myeloma? Select all that apply. Elevated erythrocyte sedimentation rate Elevated hematocrit Hypercalcemia Elevated blood urea nitrogen
Hypercalcemia Elevated erythrocyte sedimentation rate Elevated blood urea nitrogen
The client presents with a reduction in red blood cells, white blood cells, and platelets. The practitioner is unable to determine the cause of the client's condition. Which type of anemia does the client have? Extrinsic hemolytic Intrinsic hemolytic Idiopathic aplastic Acquired hemolytic
Idiopathic aplastic
The nurse is caring for a pediatric client who will be having bone marrow aspiration from the posterior iliac crest. The parent asks why the sternum is not used to obtain the sample as this is the site used for another relative. How does the nurse respond? In children, the sternal bone marrow cavity is much more shallow, increasing risk for damage to underlying organs. Although the sternum is often used in adults, we avoid it in children as we do not want them to see the needle. The health care provider makes a decision based on test results, so the iliac crest was determined best for your child. Children tend not to be cooperative for the procedure and may grab the equipment, so using the iliac crest is safer.
In children, the sternal bone marrow cavity is much more shallow, increasing risk for damage to underlying organs.
A client is admitted to the emergency department with a diagnosis of polycythemia. The nurse plans to assess for symptoms related to which problem? Inability to form blood clots Decreased ability to carry oxygen to the cells Increased blood viscosity Increased risk of infection
Increased blood viscosity
A client has been admitted for immune thrombocytopenic purpura. The client has not responded to corticosteroid treatment. The priority nursing intervention for this client would include which treatment measure? Place the client in isolation, so the skin rashes will not spread to other clients. Insert an intravenous catheter, so immune globulin can be administered in a timely manner. Insert a Foley catheter to monitor hourly urine output. Prepare a surgical permit for an emergency splenectomy.
Insert an intravenous catheter, so immune globulin can be administered in a timely manner.
The rate at which hemoglobin is synthesized depends on availability of which substance? Glucose Iron Calcium Oxygen
Iron
A client was recently diagnosed with iron deficiency anemia. The nurse anticipates which treatment to be prescribed? Red blood cell transfusion Iron supplementation and dietary teaching Steroid therapy Bone marrow transplant
Iron supplementation and dietary teaching
A client with Hodgkin lymphoma is exhibiting some central nervous system (CNS) involvement. Which treatment measures will the health care provider likely prescribe? Antiseizure therapy Irradiation and chemotherapy Antibiotic therapy Antiviral prophylaxis
Irradiation and chemotherapy
Which type of macrophages are found in the liver? Histiocytes Kupffer cells Monocytes Microglial cells
Kupffer cells
The nurse caring for a client with Hodgkin lymphoma notes the existence of anergy on the client's medical records. The nurse explains this information on the handoff report as which physiologic response? Susceptibility to viral infections Uncontrolled hiccups Lack of positive response to skin testing Petechia-like rash over sternum
Lack of positive response to skin testing
A nurse educator is explaining to a group of students the differences between leukemias and lymphomas. With respect to classification of these diseases, which explanation is mostaccurate? Leukemia arises from precursors in marrow, and lymphomas originate in peripheral lymphoid structures. Leukemia arises from precursors in marrow, and lymphomas originate in spleen or bone marrow. Leukemias originate in lymph nodes, and lymphomas originate in peripheral lymphoid structures. Leukemia arises from peripheral lymphoid structures, and lymphomas originate in precursors in marrow.
Leukemia arises from precursors in marrow, and lymphomas originate in peripheral lymphoid structures.
A nurse educator is explaining to a group of students the differences between leukemias and lymphomas. With respect to classification of these diseases, which explanation is mostaccurate? Leukemia arises from precursors in marrow, and lymphomas originate in spleen or bone marrow. Leukemia arises from peripheral lymphoid structures, and lymphomas originate in precursors in marrow. Leukemias originate in lymph nodes, and lymphomas originate in peripheral lymphoid structures. Leukemia arises from precursors in marrow, and lymphomas originate in peripheral lymphoid structures.
Leukemia arises from precursors in marrow, and lymphomas originate in peripheral lymphoid structures.
Which factor differentiates chronic leukemias from acute leukemias? They are cancers of the hematopoietic progenitor cells. Leukemic cells are disseminated throughout the body by the circulatory system. Leukemic cells are more fully differentiated in chronic than in acute leukemias. The prevalence among individuals with Down syndrome is high.
Leukemic cells are more fully differentiated in chronic than in acute leukemias.
The destruction of old blood cells is facilitated by a group of large phagocytic cells found in which anatomic location? Select all that apply. Kidneys Lungs Bone marrow Liver Lymph nodes
Liver Bone marrow Lymph nodes
A young adult client presents with an enlarged, firm cervical lymph node on the right side of the neck. Palpation of the node is painless. The nurse should document this assessment finding and anticipate preparing the client for which diagnostic procedure to confirm diagnosis? Bone marrow transplant (BMT) Watchful waiting and close monitoring of the node over the following weeks Lymph node biopsy Radioactive isotope insertion
Lymph node biopsy
The nurse is conducting education for a client who is scheduled to undergo diagnostic testing for non-Hodgkin lymphoma (NHL). The nurse includes information on: Blood cultures Lymph node biopsy Diagnostic X-ray White blood cell counts
Lymph node biopsy
A client has been diagnosed with non-Hodgkin lymphoma (NHL), a form of malignancy that originates in which body site? Lymph nodes Thymus Spleen Bone marrow
Lymph nodes
When collecting a client's history the client states that he is receiving treatment to maintain remission from leukemia. What does the nurse document that the client is receiving? Lysis therapy Induction therapy Maintenance therapy Intensification therapy
Maintenance therapy
During chronic blood loss, iron deficiency anemia occurs. Most clients are asymptomatic until their hemoglobin falls below 8 g/dL (80 g/L). The red blood cells that the body does produce have too little hemoglobin. What is the term for the resulting anemia? Microcytic hypochromic Macrocytic hyperchromic Microcytic hyperchromic Macrocytic hypochromic
Microcytic hypochromic
An adult client's blood work and biopsies indicate that he has proliferating osteoclasts that are producing large amounts of IgG. What is the man's most likely diagnosis? Multiple myeloma Acute myelogenous leukemia Acute lymphocytic leukemia Hodgkin lymphoma
Multiple myeloma
A 12-year-old child has contracted a bacterial infection at school and the body has responded by increasing leukocyte production. Place the following components of white blood cell production in the correct chronological order. Use all the options. Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. 1Myeloid stem cell 2Neutrophilic band cells 3Myeloblast 4Promyelocyte 5Metamyelocyte
Myeloid stem cell Myeloblast Promyelocyte Metamyelocyte Neutrophilic band cells
A student nurse is taking microbiology and reviewing various types of cells. From which cell type are granulocytes derived? Macrophage stem cells Myocyte stem cells Lymphoid stem cells Myeloid stem cells
Myeloid stem cells
A nurse sends a blood sample to the lab for analysis. Assuming the sample is normal, the nurse anticipates which white blood cells (WBCs) will account for the highest percentage? Monocytes Eosinophils Neutrophils Lymphocytes
Neutrophils
Which type of cell is the most common leukocyte in normal blood? Neutrophils Monocyte Platelet Lymphocyte
Neutrophils
A client is admitted to the hospital with an elevated temperature and flank pain. When reviewing the complete blood count (CBC), which level is the most important for the nurse to communicate to the health care provider? Neutrophils 85% Platelets 150,000/mL (150,000 x 109/L) Hemoglobin 12.6 g/dL (126 g/L) Monocytes 3%
Neutrophils 85%
The nurse is evaluating a client's blood work results. Which lab result should the nurse recognize as outside of the normal limits? Leukocytes 4600 cells/μL (4.60 x 109/L) Neutrophils 950/μL (0.95 x 109/L) Leukocytes 8200 cells/μL (8.20 x 109/L) Neutrophils 1600 cells/μL (1.60 x 109/L)
Neutrophils 950/μL (0.95 x 109/L)
When a white blood cell with differential count reveals an acute infection, which statement is correct regarding the client's neutrophils? Neutrophils are only responsive in an allergic or parasitic infection. Neutrophils are the first white blood cell to elevate in an acute infection. There are fewer neutrophils in the blood than other white blood cells. Neutrophils are not present during an acute infection that produces fever.
Neutrophils are the first white blood cell to elevate in an acute infection.
A nurse orienting to the surgical suite is studying medications that affect platelet function and notes that the most common medications are: Antibiotics and antihistmines Aspirin and proton pump inhibitors NSAIDs and acetaminophen Nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin
Nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin
A female adolescent is reporting general malaise and lethargy. Which clinical assessment should the nurse perform in an effort to confirm or rule out infectious mononucleosis? Assessing the client's cranial nerve reflexes Assessing the client for bone pain Auscultating the client's lungs Palpating the client's lymph nodes
Palpating the client's lymph nodes
Which intervention would be most appropriate by the nurse caring for a client in the neutropenic phase of cyclic neutropenia? Give client several warm blankets Reposition client as needed Perform/assist with oral care Assist client to ambulate
Perform/assist with oral care
A nurse performing a skin assessment on an older adult notes small pinpoint hemorrhages and purple areas of bruising over the lower extremities. The nurse documents these as the presence of which abnormality? Petechiae and purpura Hyperpigmentation and lentigines Senescence and skin tags Macular rash with keratosis
Petechiae and purpura
A parent has brought her 2-week-old infant to the emergency department due to the infant's persistent and increasing jaundice. Laboratory testing reveals indirect bilirubin level is 28 mg/dL (479 µmol/L), but otherwise a normal physical assessment. Which intervention will mostlikely be prescribed for this infant? Phototherapy Phlebotomy Intravenous antibiotics Packed red blood cell transfusion
Phototherapy
A nurse is reviewing a client's complete blood count (CBC) which indicates thrombocytopenia. Based on this result, which action should the nurse include in the plan of care? Encourage increased oral fluids. Increase intake of iron-rich foods. Place the client on bleeding precautions. Place the client on contact isolation.
Place the client on bleeding precautions.
The nurse is caring for a client with leukemia who is having difficulty with blood clotting after having several transfusions with packed red blood cells. What does the nurse anticipate infusing for this client to assist with controlling the bleeding? Albumin Ringer's lactate solution Whole blood Platelets
Platelets
A client presents to the clinic with symptoms of elevated blood pressure, dizziness, red face, pain in fingers and toes, headache, and difficulty concentrating. A blood smear reveals an increased number of erythrocytes. Based on these findings, the nurse anticipates which diagnosis? Leukemia Polycythemia vera Hemolytic anemia Hyperbilirubinemia
Polycythemia vera
A client tells the nurse that the doctor told her she has too many red blood cells accompanied by elevated white cells and platelet counts. The nurse recognizes this as: Aplastic anemia Polycythemia vera Pernicious anemia Hemolytic anemia
Polycythemia vera
Which anatomical site would the nurse expect to monitor when caring for an adult client who has just had a bone marrow aspiration performed? Antecubital space Head of the femur Radial artery Posterior iliac crest
Posterior iliac crest
A client is admitted with a suspected diagnosis of Hodgkin lymphoma (HL). Which diagnostic test would the nurse look for to confirm the diagnosis? Presence of Reed-Sternberg cells Positive Bence Jones proteins H. pylori infection Epstein-Barr virus
Presence of Reed-Sternberg cells
Following peripheral blood testing and a bone marrow biopsy, a client has been diagnosed with chronic myelogenous leukemia. Which abnormality is most likely to have preceded the client's diagnosis? Presence of a Philadelphia chromosome Exposure to the Epstein-Barr virus Radiation exposure Down syndrome
Presence of a Philadelphia chromosome
A client is diagnosed with anemia. Which laboratory test will the nurse evaluate to assist in determining the type of anemia involved? Hematocrit Hemoglobin Red blood cell indices White blood cell differential
Red blood cell indices
What of these would be tested by a complete blood count (CBC)? Lymphocytes and neutrophils Red blood cells and platelets Size and shape of blood cells Sodium and potassium
Red blood cells and platelets
A client with chronic myelogenous leukemia (CML) has been diagnosed with terminal blast crisis. Which clinical manifestations should the nurse focus the assessment on for this client? Select all that apply. Low temperature of 96°F (35.5°C) Shortness of breath and progressive dyspnea Bleeding from the gums Increasing confusion Headache and lethargy
Shortness of breath and progressive dyspnea Headache and lethargy Increasing confusion
A client's history and physical documents the presence of an indolent lymphoma. The nurse plans care for which type of lymphoma? Slow-growing Aggressive Encapsulated Diffuse
Slow-growing
The nurse planning care for a client with acute lymphoblastic leukemia (ALL) should include the use of: Increased potassium diet Decreased sodium diet Secure dressings with strong adhesive tapes Soft bristle toothbrush
Soft bristle toothbrush
When red blood cells age, which organ is responsible for their destruction? Red bone marrow Spleen Liver Kidneys
Spleen
A client diagnosed with pancytopenia due to aplastic anemia is scheduled for which treatment that can correct bone marrow deficiencies? Bone marrow biopsy Whole blood transfusion Stem cell transplant Complete blood count (CBC)
Stem cell transplant
When assessing the mouth of a client receiving chemotherapy, which of the following should the nurse interpret as a possible indicator of neutropenia? Beefy red tongue Dry mucous membranes Stomatitis Blue-tinged lips
Stomatitis
A client with iron-deficiency anemia asks, "What does this low mean corpuscular volume (MCV) level mean?" Which response by the nurse is most accurate? This means your blood will thicken rapidly. This means that you have a lot of fluid in your vessels diluting your red blood cells. This means that your red blood cells are pale in color. The MCV is one red blood cell (RBC) index that indicates your RBCs are small cells.
The MCV is one red blood cell (RBC) index that indicates your RBCs are small cells.
A nurse is preparing a client for coronary bypass surgery the following week and asks the client to discontinue daily aspirin intake. Which response is best to explain the effect aspirin has on the platelets and potential bleeding problems? The effect is not reversible for the life of the platelet. The effect is very similar to that of nonsteroidal anti-inflammatory drugs. The effect lasts as long as its half-life. The effect is only reversible in some cases.
The effect is not reversible for the life of the platelet.
The nurse is caring for a 2-day-old newborn infant who appears lethargic and has a yellowish tint to the skin. Select the most likely cause of this newborn's signs and symptoms. Cirrhosis of the liver The inability of a newborn to produce bilirubin The inability of the immature liver to conjugate bilirubin A decrease in the breakdown of red blood cells
The inability of the immature liver to conjugate bilirubin
When it is determined that a client's red blood cells (RBCs) have a biconcave shape, what will be the nurse's reaction? The nurse will immediately notify the client's health care provider of this serious finding. The nurse will be pleased, as that shape allows for increased oxygen diffusion. The nurse will arrange for bedside oxygen for the client to use as needed. The nurse will be concerned, as this is an indication of sickle cell anemia.
The nurse will be pleased, as that shape allows for increased oxygen diffusion.
The parents of a newborn are concerned because the infant's skin has a yellow color. What education should the nurse discuss with the parents? The parents need to be taught about hyperbilirubinemia and common treatment modalities. The parents need to learn to assess their child for brain damage. The parents need to know about liver failure. The parents need to watch the infant's diet to avoid too many fats.
The parents need to be taught about hyperbilirubinemia and common treatment modalities.
The nurse is teaching a client about how a vaccine can help create immunity to a virus. What information does the nurse provide? The vaccine attaches to DNA of lymphocytes, making them attack the virus. The vaccine causes B lymphocytes to create antibodies against the virus. Vaccines affect T lymphocytes, which then attack the virus at the cellular level. The vaccine lays dormant in the body until exposed to the virus; it is then activated.
The vaccine causes B lymphocytes to create antibodies against the virus.
A 6-year-old child is having a stem cell transplant using umbilical cord blood. What benefit does the nurse understand that this type of transplant will have for the child? The child will not have to take any form of chemotherapy. This type of transplant creates less risk of graft versus host disease This type of transplant does not require an inpatient stay in the hospital. There are no side effects to this type of transplant.
This type of transplant creates less risk of graft versus host disease
A client has an impaired platelet function that may have developed from inheritance, drugs, disease, or extracorporeal circulation. The health care provider would document this as: Fibrinolysis Plasmapheresis Disseminated intravascular coagulation Thrombocytopathia
Thrombocytopathia
A nurse is assessing a client and finds these results: Areas of bruising (purpura) on the client's arms and legs Pinpoint hemorrhages (petechiae) on the legs Pinpoint hemorrhages (petechiae) in the mouth Platelets level of 90,000/μL (90 ×109/L) What condition should the nurse suspect the client is exhibiting? Neutropenia Thrombocytopenia Thrombocytosis Leukopenia
Thrombocytopenia
A nurse is treating a client with aplastic anemia. Due to the replacement of normal bone marrow with malignant cells, the nurse teaches the client to prevent scratches, scrapes, and cuts. What root cause likely underlies the client's increased risk for hemorrhage? Neutrophilia Polycythemia Thrombocytopenia Disseminated intravascular coagulation (DIC)
Thrombocytopenia
A normally healthy client is diagnosed with polycythemia vera. The nurse should prioritize assessments aimed at the early identification of which complication associated with this diagnosis? Orthostatic hypotension Hyperventilation Vasculitis Thromboembolism
Thromboembolism
A nurse assessing a client with an acute exacerbation of polycythemia vera notes coolness to the right leg and foot, pale color, and an absent right pedal pulse. Based on these findings the nurse suspects that the client has developed which complication? Thrombosis in the right leg Infection in the right leg Compartment syndrome in the right leg Edema in the right leg
Thrombosis in the right leg
What is the reason why bed rest and analgesics are expected treatments for infectious mononucleosis? To relieve fever, headache, and sore throat To decrease the risk of neutropenia To eliminate the causative organism To increase the white blood count
To relieve fever, headache, and sore throat
Thalassemia can be classed as major or minor. If therapy for thalassemia major is not started in infants who present with this disease, severe growth retardation will occur. At 6 months of age, which therapy must be started? Transfusion Water Infusion Vitamin
Transfusion
Drug-induced neutropenia is a disease that has significantly increased in incidence over the last several decades. What is the attributing factor in the increased incidence of drug-induced neutropenia? Treatment of cancer by chemotherapeutic drugs The decrease in the use of street drugs The new drugs developed to treat autoimmune diseases The destruction of tissue cells by cocaine
Treatment of cancer by chemotherapeutic drugs
A client diagnosed with autosomal dominant von Willebrand factor disease (vWF) is experiencing mild to moderate bleeding. The health care provider would classify the diagnosis as: Type 2 Type 4 Type 3 Type 1
Type 2
Stem cell transplantation has been shown to provide potential cures for diseases such as aplastic anemia and the leukemias. What are the sources of stem cells used for transplant? Umbilical cord blood and bone marrow Bone marrow and immature neural cells Peripheral blood cells and immature embryonic cells Peripheral blood and yellow bone marrow
Umbilical cord blood and bone marrow
The nurse is caring for a client who is a strict vegetarian; the client is at greatest risk for the development of: Folic acid deficiency anemia Microcytic anemia Blood loss anemia Vitamin B12 deficiency anemia
Vitamin B12 deficiency anemia
A client with an apparent clotting disorder is admitted to hospital. His health record reveals that he has been treated for complications of chronic alcoholism for the past 10 years. The nurse should suspect what cause of his clotting disorder? Immune thrombocytopenic purpura (ITP) Hemophilia Vitamin K deficiency Von Willebrand disease
Vitamin K deficiency
To form a platelet plug, platelets must adhere to the vessel inner layer. For this to occur, which protein molecule is required? Thromboxane A2 Plasminogen Von Willebrand factor Lipoprotein SUBMIT ANSWER
Von Willebrand factor
The nurse is providing a client with education on taking the medication clozapine. The nurse includes the importance of: Elimination of caffeine Daily weights Weekly blood work Decreased sodium diet
Weekly blood work
A nurse is reviewing the laboratory data for a hospitalized client. The nurse would be mostconcerned about which finding? Eosinophils 1.5/µL White blood cell (WBC) count of 2800/µL (2.80 x 109/L) Red blood cells 4.0/µL Platelet count of 200,000/µL (200,000 x 109/L)
White blood cell (WBC) count of 2800/µL (2.80 x 109/L)
The process of clot retraction squeezes serum from the clot, thereby joining the edges of the broken vessel. Through the action of actin and myosin, filaments in platelets contribute to clot retraction. Failure of clot retraction is indicative of: a high platelet count. absence of factor Xa. a low platelet count. an overabundance of factor Xa.
a low platelet count.
A client has been experiencing anemia and thrombocytopenia. Subsequent diagnostic testing has revealed the presence of immature granulocyte types and the Philadelphia chromosome. This client is likely to experience: a prolonged chronic phase of leukemia. hyperuricemia. a high risk of pathologic bone fractures. a self-limiting infection with the Epstein-Barr virus.
a prolonged chronic phase of leukemia.
The nursing caring for a 62-year-old client with diffuse large B-cell lymphoma plans care based on the knowledge that this client's lymphoma is: encapsulated. rare. aggressive. indolent.
aggressive.
A 10-month-old infant has begun to take his first steps and his mother has brought him for assessment because of swelling in his ankles and knees. The mother also states that he was eager to walk but has now regressed and cries when she tries to encourage it. The clinician should: assess the child for signs and symptoms of hemophilia A. administer vitamin K STAT. order testing to rule out disseminated intravascular coagulation (DIC). prescribe a trial of desmopressin acetate (DDAVP) to rule out von Willebrand disease.
assess the child for signs and symptoms of hemophilia A.
A young woman diagnosed with prostacyclin deficiency is admitted to the hospital with recurrent deep vein thrombosis and an ovarian infarction asks the nurse why she keeps having these problems. Understanding the role of prostacyclin in hemostasis, the nurse explains that prostacyclin enables: blood vessel vasoconstriction and platelet adhesion. platelet aggregation and adhesion. blood vessel vasodilation and inhibition of platelet aggregation. blood vessel vasodilation and enhancement of platelet adhesion.
blood vessel vasodilation and inhibition of platelet aggregation.
The nurse evaluating the blood work of a client with chronic lymphocytic leukemia (CLL) notes the following: white blood count 22,000/μL (22 x 109/L); lymphocytes 90% (0.90); and hemoglobin 6 g/dL (60 g/L). The nurse should: note the results as expected in a client with CLL. communicate to the physician an unexpected high percentage of lymphoctyes. communicate to the physician an unexpected high white blood cell count. communicate to the physician an unexpected low hemoglobin.
communicate to the physician an unexpected low hemoglobin.
A client is prescribed the recumbent granulocyte colony-stimulating factor (CSF) filgrastim. The nurse evaluates the effectiveness by monitoring which laboratory value? Prothrombin time (PT)/partial thromboplastin time (PTT) international normalized ratio (INR) complete blood count (CBC)/differential hemoglobulin and hematocrit (H&H)
complete blood count (CBC)/differential
A client is prescribed the recumbent granulocyte colony-stimulating factor (CSF) filgrastim. The nurse evaluates the effectiveness by monitoring which laboratory value? complete blood count (CBC)/differential international normalized ratio (INR) Prothrombin time (PT)/partial thromboplastin time (PTT) hemoglobulin and hematocrit (H&H)
complete blood count (CBC)/differential
The nurse evaluating a client's blood work notes that the client's white blood cells are 9000/μL (9.0 x 109/L). The nurse should: continue to monitor the client's blood work results. contact the physician because of elevated white blood cell count. contact the physician because of decreased white blood cells. prepare to administer 2 units of packed red blood cells.
continue to monitor the client's blood work results.
A nurse on an oncology floor is treating a client who is anemic following chemotherapy. The drugs being administered are designed to increase the number of red blood cells in circulation. These drugs are likely agonists of: trophic hormones. secondary hormones. lymphokines. cytokines.
cytokines.
A 53-year-old man presents with inability to concentrate, itching in his fingers and toes, elevated blood pressure, and unexplained weight loss. He is diagnosed with primary polycythemia. The primary goal of his treatment will be to: reduce the viscosity of his blood. reduce the mean size of his red blood cells. increase the amount of oxygen distributed by his red blood cells. control his hypertension.
reduce the viscosity of his blood.
A 42-year-old male client recently diagnosed with liver cancer is noted as at high risk for bleeding abnormalities. The nurse recognizes this risk as a result of: increased amounts of vitamin K being produced in the liver. a vitamin C deficiency in the diet. weakening of the organ walls as a result of inflammation. the reduction of clotting factors synthesized in the liver.
the reduction of clotting factors synthesized in the liver.
A nurse is working with an 8-year-old client diagnosed with AML. The nurse plans the client's care in the knowledge that thrombocytopenia and associated bleeding are risks because: increases in blood volume due to large numbers of circulating transformed cells result in hypertension. the transformed B cells or T cells disrupt capillary integrity. the undifferentiated blast cells accumulate in the bone marrow, suppressing the remaining progenitor cells. neutropenia, which also results, allows for the development of sepsis and increased vascular permeability.
the undifferentiated blast cells accumulate in the bone marrow, suppressing the remaining progenitor cells.
All cells of the body age and are replaced in a natural order. When RBCs age, they are destroyed in the spleen. During this process, the iron from their hemoglobin is released into the circulation and returned: to the muscles to be stored for strength. to the bone marrow for incorporation into new RBCs. to the lungs to bind with oxygen. to the liver to bind with oxygen.
to the bone marrow for incorporation into new RBCs.
Many different proteins, enzymes, and hormones are involved in maintaining hemostasis. Which protein is required for platelet adhesion? Growth factors Platelet factor 4 von Willebrand factor Ionized calcium
von Willebrand factor