prep u chapter 30
A schilling test has been ordered for a client suspected of having pernicious anemia. What will the nurse include when explains the procedure?
Radioactive vit B12 is given orally, followed in 1 hour by an injection of non radioactive B12
50. Which is not a candidate fo blood donation according to the American heart association?
26 year old female with hemoglobin 11.0 g/dL
21. Using a penlight and tongue blade, the nurse inspects the clients tonsils for size and appearance. Tonsils are present and touch the uvula. How should the nurse grade this?
3
45. An instructor asks students approximately how long platelets last? What would the students correctly identify?
7.5 days
63. A nurse is discussing the difference btwn blood and plasma with a client. Which best represents the components of plasma?
90%water, 10% proteins, blood cells, clothing factors, hormones, enzymes
41. A client with Hodgkin disease had a bone marrow biopsy yesterday and reports aching at the biopsy site, rated 5 (on a 1-10 scale). After assessing the biopsy site, which nursing intervention is most appropriate?
Administer acetaminophen 500 mg po, as ordered
23. The nurse recognizes that the most common cause of iron deficiency anemia in an adult is
Bleeding
54. A patient with chronic kidney disease is being examined by the nurse practitioner for anemia. The nurse has reviewed the laboratory data for hemoglobins and RBC count. What other test results would the nurse anticipate observing?
Decreased level of erythropoietin
53. When conducting a health assessment on a client suspected for having a hematological disorder, the nurse should collect which data? Select all that apply
Dietary intake, Herbal supplements, Medication use, Ethnicity
25. An 8 year old is scheduled to undergo a tonsillectomy for chronic tonsillitis. The symptoms given below are related to tonsil disorders. The nurse caring for this client should know that which of the following symptoms is specifically related to tonsillitis?
Difficulty swallowing
16. A client needs increased production of RBCs. Which of the following drugs would the nurse expect to be prescribed for the client?
Epoetin alfa
46. Which of the nurse recognize as signs fo leukopenia? Select all that apply
Fever, Sore throat ,Chills
47. A nurse at a blood donation clinic has completed the collection of blood form a woman. The women states that she feels "lightheaded" and she appears visibly pale. What is the nurses most appropriate action?
Help her into a sitting position with her head lowered below her knees
24. The nurse is describing normal RBC physiology to a client who has diagnosis of anemia. The nurse should explain that the RBCs consist primarily of which of the following?
Hemoglobin
29. A nurse is caring for a patient has had a bone marrow aspiration with biopsy. What complication should the nurse be aware of and monitor the patient for?
Hemorrhage
18. The nurse is caring for a patient with hematologic disorder. The patient asks the nurse where the where the body forms blood cells. Where should the nurse tell the patient that blood cells are formed?
In the bone marrow
65. When the clients kidneys sense a low level of oxygen in circulation blood, what physiologic response is intimated?
Increased production of erythropoietin
59. Myeldoysplastic syndrom who requires PRBC transfusions. What blood component does the nurse recognize as being most harmful if accumulated in the tissues due to chronic blood transfusions?
Iron
67. The clients CBC with differential reveals small-shaped hemoglobin molecules. The nurse expects to administer which medication to this client?
Iron
9. A client in acute renal failure has been prescribed 2 units of packed RBCs. The nurse explains to the client that the blood transfusion is most likely needed for which reason?
Lack of erythropoietin
13. The nurse is preparing a patient for a bone marrow aspiration and biopsy form the site of the posterior superior iliac crease. What position will the nurse place the patient in?
Lateral position with one leg flexed
36. Which blood cell type is matched correctly with its function?
Leukocyte: fights infection
33. A nurse is reviewing a clients morning laboratory results and notes a left shift in the band cells. Based on this result, the nurse can interpret that the client.
May be developing an infection
57. A nurse is reviewing a client morning lab results and notes a left shift in the band cells. Based on this result, the nurse can interpret that the client
May be developing an infection
20. Which cell of hematopoiesis is responsible for the production of RBCs and platelets
Myeloid stem cell
6. Which type of WBC is the most numerous?
Neutrophil
10. The body responds by increasing the production of WBCs. The nurse should evaluate the differential count for what type of WBCs, which are the first WBCs to respond to an inflammatory event?
Neutrophils
61. ED needing an immediate blood transfusion, but there isn't time to perform a type and cross match. Which blood type can be safely transfused until lab results are obtained?
O, RH negative
A nurse for a client with iron deficiency anemia. Which tx will the nurse anticipate the client receiving?
Oral iron supplementation
31. Knowledge regarding hematopoiesis is essential in post surgical client care. Which statement about the variation in the normal number of erythrocytes is true?
People who engage in strenuous activity have an increased number of erythrocytes.
27. Which is a symptom of severe thrombocytopenia?
Petechiae
22. While hospitalized, a client accidentally injuries his finger and begins to bleed. What substance does the nurse recognize as naturally rushing to the site of injury before any other action takes place?
Platelets
37. Which cells have the lifespan of approx. 7.5 days, and one-third of their population remains in the spleen (unless needed to fight significant bleeding)?
Platelets
38. An individual has accidentally cut his hand, immediately initiating the process of hemostasis. Following Vasoconstriction, what event in the process of hemostasis will take place?
Platelets will aggregate at the injury site
52. An individual has accidentally cut his hand, immediately initiating the process of hemostasis. Following vasoconstriction, what event in the process of hemostasis will take place?
Platelets will aggregate at the injury site
62. Low albumin. This assessment finding should suggest the possibility of what nursing diagnosis.
Risk for imbalanced fluid volume related to low albumin
35. A nurse is caring for a client who is undergoing preliminary testing for a hematologic disorder. What sign or symptom most likely suggests a potential hematologic disorder?
Severe fatigue
7. A client is visiting the physician and has signs and symptoms consistent with anemia. Why would the nurse ask the client about recent travel to foreign countries
The agent that causes malaria following the bite of an infected mosquito invades erythrocytes and causes anemia
42. A client is being treated for the effects of a longstanding vitamin B 12 deficiency. What aspect of the clients health history most likely predispose her to this deficiency?
The client is a vegan
43. The nurse is administering a blood transfusion to a client over 4 hours. After 2 hours, the client reports chills and has a fever of 101 F, an increase form a previous temp of 99.2 F. What does the nursing is occurring with this client?
The client is having a febrile non hemolytic reaction
56. While caring for a client, the nurse notes petechiae not he clients truck and lower extremities. What precaution will the nurse take when caring for this client
Use an electric razor when assisting client with shaving
40. Which of the following reports form the client during the health history would lead the nurse to suspect that the client has disorder of the hematopoietic or lymphatic system?
[Feels fatigued with normal activities][Has unexplained blood also, as in rectal bleeding, nose bleedings, bleeding gums, or vomiting blood,] [Experiences prolonged bleeding form an obvious injury ]
14. A public health nurse is planning community teaching for a group of older adults regarding aging and hematological conditions. What condition will the nurse identify as most common among this population?
Anemia
58. The nurse is obtaining the health hx of a client suspected of having a hematological condition. The nurse notes the client has a hx of alcohol abuse. Which clinical presentation is related to alcohol consumption?
Anemia
A paint who has long-term packed RBC (prbc) transfusions has developed symptoms of iron toxicity that affect liver function. What immediate treatment should the nurse anticipate preparing the patient for that can hale prevent organ damage?
Iron chelation therapy
8. Which cells are called WBC?
Leukocytes
26. A client has a leukocyte count of 13,000/mm3. How would the nurse document the clients condition?
Leukocytosis
11. Albumin is important for the maintenance of fluid balance within the vascular system. Albumin is produced by which of the following?
Liver
A nurse I scaring for a client who has developed scar tissue in many of the areas that normally produce blood cells. What organs can become active in blood cell production by the process of extra medullary hematopoiesis?
Liver and spleen
48. The nurse is providing care for an older adult who has a hematologic disorder. What age-related change in hematologic function should the nurse integrate into care planning?
Older adults are less able to increase blood cell production when demand suddenly increases
64. Which is the major function of neutrophils?
Phagocytosis
30. A clean has undergone a bone marrow aspiration. Which of the following findings after the procedure would alert the nurse to the possibility of infection in the client? Select all that apply.
Purulent drainage at the site, Fever, Swelling at the site
39. An older adult client presents to the health care providers office and reports exhaustion. The nurse, aware of the most common hematologic condition affecting the elderly, knows that which laboratory values should be assessed?
RBC count
An older client presents to the health care providers office and reports exhaustion. The nurse, aware of the most common hematologic condition affecting the elderly, knows that which laboratory values should be assessed?
RBC count
34. A client suffers a leg wound which causes minor blood loss. As a result of bleeding, the process of primary hemostasis is activated. What will occur during the process?
Severed blood vessels constrict
32. Which type of lymphocyte is responsible for cellular immunity?
T lymphocyte
12. The health care provider believes that the client has a deficiency in the leukocyte responsible for cell-mediated immunity. What should the nurse check the WBC count for?
T lymphocytes
55. A nurse, caring for a client for a client with human immunodeficiency virus (HIV), reviews the clients differential WBC will the nurse check the level of?
T lymphocytes
17. When reviewing a clients chart, the nurse notes that the clients tonsils are listed as grade 3. How does the nurse interpret this findings?
The clients tonsils are touching the uvula.
51. The nurse is caring for a client with hypoxia.l what does the nurse understand is true regarding the clients oxygen level and the production of red blood cells?
The kidneys sense low oxygen levels in the blood and stimulate erythropoietin, stimulating the marrow to produce more red blood cells
49. A client is scheduled for a splenectomy. During discharge education, what teaching point should the nurse prioritize?
The need to report any signs of symptoms of infection promptly
19. A patient with a diagnosis of HIV exhibits a decreased level of T lymphocytes. Why consequence does this state present for this patient?
The patient is particularly susceptible to infection
15. A nurse working in hematology review the characteristics of stem cells and their role in disease. Which statements does the nurse understand is true regarding stem cells? Select all that apply.
There is a continuous supply throughout the life cycle, Lymphoid stem cells produce lymphocytes, Myeloid stem cells produce erythrocytes , They have the ability to self-replicate
66. Role of B lymphocytes?
Antibody production
28. An older adult client is exhibiting many o the characteristic signs and symptoms of iron deficiency. In addition to a complete blood count what diagnostic assessment should the nurse anticipate?
Stool for occult blood
60. Steps in order when determining the type and severity of a transfusion reaction.
Stop the transfusion , Assess the client, Notify the health care provider, Notify the blood bank, Send the tubing and container to the blood bank
