Karch Anemia questions

A 22-year-old female client is seen in the primary care provider's office for follow-up. The client was diagnosed six weeks ago with iron deficiency anemia and has been taking the prescribed iron supplement when she notices that her stool has turned black. She tells the nurse that she fears that she is bleeding to death inside her belly. The nurse teaches the client about which expected outcome? A. "Don't worry, iron supplements can cause black or dark stools because of the iron composition." B. "Don't worry, black stool is not a sign of internal bleeding." C. "Iron supplements may cause bleeding but this is nothing to worry about." D. "Don't worry, iron supplements cannot cause bleeding."

A. "Don't worry, iron supplements can cause black or dark stools because of the iron composition."

A client prescribed epoetin alfa asks how the medication works. Which is the nurse's best response? A. "Increases the release of cells to increase the hemoglobin and hematocrit levels." B. "Decreases release of reticulocytes, which inhibits red blood cell (RBC) production." C. "Stimulates the growth and development of white blood cells (WBC) to prevent neutropenia." D. "Releases erythropoiesis from the kidneys to increase the number of platelets."

A. "Increases the release of cells to increase the hemoglobin and hematocrit levels."

All hematopoietic and immune blood cells are derived from which cells in the bone marrow? A. Stem cells B. Beta cells C. Alfa cells D. Theta cells

A. Stem cells

A 50-year-old female patient who has pernicious anemia asks you why vitamin B12 must be administered parenterally. What is the best response to her question? A. "Pernicious anemia causes changes in the mucous membrane lining and impairs absorption." B. "Oral forms of vitamin B12 will not be absorbed." C. "With severe deficiencies like yours, oral vitamin B12 is not effective." D. "Oral ingestion of vitamin B12 causes irritation and bleeding."

B. "Oral forms of vitamin B12 will not be absorbed."

Which patient will be at the greatest risk for anemia and be the most likely candidate for epoetin alfa therapy? A. A 30-year-old pregnant woman B. A 62-year-old male with cancer C. A 40-year-old male with a high white blood cell count D. A 20-year-old female

B. A 62-year-old male with cancer

What would be the priority nursing diagnosis for a patient who is prescribed epoetin alfa? A. Alteration in nutrition due to poor intake of iron B. Impaired tissue oxygenation related to anemia C. Altered skin integrity due to the disease process D. Alteration in bowel elimination due to side effects of the medication

B. Impaired tissue oxygenation related to anemia

A client is experiencing iron toxicity. Which agent would the nurse expect to be given? A. Dimercaprol B. Succimer C. Deferoxamine D. Edetate calcium disodium

C. Deferoxamine

Which symptom, if assessed after the administration of epoetin alfa (Epogen), would be cause for alarm? A. The patient is tired. B. The patient states the injection "hurts." C. The patient displays weakness on one side of the body. D. The patient reports "bone pain."

C. The patient displays weakness on one side of the body.

Which client would likely be the most appropriate candidate for treatment with filgrastim? A. A client who developed acute renal failure secondary to rhabdomyolysis B. A client with acquired immune deficiency syndrome (AIDS) who has been diagnosed with Kaposi's sarcoma C. A client who has undergone a mastectomy for the treatment of breast cancer D. A client whose acute myelogenous leukemia necessitated a bone marrow transplant

D. A client whose acute myelogenous leukemia necessitated a bone marrow transplant

The component of the red blood cell that is not recycled is bilirubin. False True

True

The nurse is caring for a patient with chronic kidney disease who is receiving epoetin alfa. Which assessment finding would be of greatest concern for the nurse? A. A rash under the breast B. Reports of calf pain on dorsiflexion of the foot C. Dry, nonproductive cough D. 1 pound weight gain in 1 week

B. Reports of calf pain on dorsiflexion of the foot

A patient who is HIV positive is receiving zidovudine 4,2000 mg/week and has an endogenous erythropoietin level of 350 mU/mL. What does the nurse anticipate will be administered for this patient? A. Erythropoietin B. An increased dose of zidovudine C. A blood transfusion D. Rocephin 1 GM IV

A. Erythropoietin

After teaching a group of students about the types of anemia, the instructor determines that the teaching was successful when the students identify which anemia results from an inability to produce the intrinsic factor? A. Pernicious anemia B. Iron deficiency anemia C. Sickle cell anemia D. Folic acid deficiency anemia

A. Pernicious anemia

Sickle cell anemia is an inherited disorder marked by the characteristic sickling of red blood cells. What are triggers of an episode of sickling? Select all that apply. A. inflammatory responses B. acute infections C. immune response D. heat E. alkalosis

A. inflammatory responses B. acute infections C. immune response

A nursing instructor is teaching students about the myelin sheath of the central nervous system (CNS). The nurse knows that teaching has been effective when a student identifies which vitamin as necessary for the formation of the myelin sheath in the CNS? A. Vitamin D B. Vitamin B12 C. Vitamin C D. Folic acid

B. Vitamin B12

The mature red blood cell contains a nucleus. True False

false

The pharmacology class learns that epoetin alfa is an immunosuppressant drug that is designed to have what expected outcome? A. Decreased RBC count B. Increased RBC count C. Increased WBC count D. Decreased WBC count

B. Increased RBC count

A nurse preparing to administer an erythropoiesis-stimulating drug is aware that the drug can be given by which routes? Select all that apply. A. Intradermal B. Intravenous (IV) C. Subcutaneous D. Transdermal E. Oral

B. Intravenous (IV) C. Subcutaneous

The nurse would contact the prescriber immediately if interferon was prescribed for which client? A. 11-month-old female with HIV acquired from her mother B. 72-year-old male with AIDS-related Kaposi's sarcoma C. 48-year-old female with hepatitis C D. 34-year-old male with chronic hepatitis B

A. 11-month-old female with HIV acquired from her mother

When describing the function of vitamin B12, what would be appropriate to include? A. Prevention of neural tube defects B. Maintenance of myelin sheath C. Oxygen transport to the tissues D. Important role in cell division

B. Maintenance of myelin sheath

When assessing a patient with anemia, the nurse notes that the patient has developed peripheral numbness and poor coordination. The patient's family states that the patient appears to be confused at times at home. Neurologic symptoms most often accompany which type of anemia? A. Folic acid deficiency B. Pernicious anemia C. Iron deficiency anemia D. Thalassemia major

B. Pernicious anemia

A 69-year-old client has been diagnosed with malignant melanoma. The care team has collaborated with the client and her family and agreed on a plan of care that includes administration of interferon alfa-2b. After administering interferon alfa-2b, the oncology nurse should anticipate that the client may develop which adverse effect? A. Cyanosis and pallor B. Profound diaphoresis C. Decreased level of consciousness D. Flulike symptoms

D. Flulike symptoms