PrepU Cellular Regulation

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 call the doctor if my stools turn black."

An intensive care nurse is aware of the need to identify patients who may be at risk of developing disseminated intravascular coagulation (DIC). Which ICU client most likely faces the highest risk of DIC?

A client who is being treated for septic shock

The sister of a 25-year-old female client has breast cancer, and genetic testing showed her to have the BRCA1 gene. The client asks the nurse how she can prevent developing breast cancer herself. Which prophylactic interventions might be considered in this situation? Select all that apply.

Breast magnetic resonance imaging (MRI) Bilateral mastectomy Bilateral oophorectomy

Two years after chemotherapy and radiation therapy for lung cancer, a 72-year-old client reports being extremely tired all the time. The physician suspects the client may have developed aplastic anemia. The nurse assessing the client will likely find which clinical manifestation of aplastic anemia? Select all that apply.

Complaints of weakness and fatigue Small spots of skin hemorrhages over entire body Excess bleeding from gums and nose

The nurse cares for a client with iron deficiency anemia. What findings will the nurse expect to find when reviewing the client's CBC results? Select all that apply.

Decreased MCV Decreased reticulocytes

Therapeutic radiation can be delivered by which methods? Select all that apply.

External beam Brachytherapy Systemic therapy

A patient with sickle cell anemia is to begin treatment for the disease with hydroxyurea. What does the nurse inform the patient will be the benefits of treatment with this medication? Select all that apply.

Fewer painful episodes of sickle cell crisis Lower incidence of acute chest syndrome Decreased need for blood transfusions

A nurse is reviewing the chart of a patient with megaloblastic anemia. What might be used in the treatment of this patient? (Select all that apply.)

Folic acid Vitamin B12

Splenic sequestration is diagnosed in a client admitted with splenomegaly. What is the priority of care for this client?

Hypovolemia

A nurse cares for a client with aplastic anemia. Which laboratory results will the nurse expect to find with this client? Select all that apply.

Neutrophil count 12,000/microliter Hemoglobin 7 g/dL Platelets 35,000 microliters

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?

Pernicious anemia

A patient with a diagnosis of immune thrombocytopenic purpura (ITP) is currently receiving IVIG for the treatment of her health condition. The nurse who is providing this patient's care is aware that ITP is a consequence of:

Platelet destruction and impaired platelet production resulting from an autoimmune process

A client with a diagnosis of acute myeloid leukemia (AML) is being treated with induction therapy on the oncology unit. What nursing action should be prioritized in the client's care plan?

Protective isolation and vigilant use of standard precautions

Place the clotting cascade in the correct order.

Prothrombin activator Prothrombin Thrombin Fibrinogen Fibrin

Place the following steps in order when determining the type and severity of a transfusion reaction. Use all options.

Stop the transfusion. Assess the client. Notify the health care provider. Notify the blood bank. Send the tubing and container to the blood bank.

A client who is receiving external beam radiation therapy as part of her treatment for breast cancer comes to the clinic for a follow-up visit. The nurse determines that the client is experiencing side effects of the treatment based on which findings? Select all that apply.

anorexia breast swelling

A patient with renal failure has decreased erythropoietin production. Upon analysis of the patient's complete blood count, the nurse will expect which of the following results?

decreased hgb and hct

A client is receiving radiation to the abdominal area as part of cancer treatment. Which assessments findings would the nurse expect to find? Select all that apply.

dermatitis (abdomen) diarrhea

The nurse is assessing a patient diagnosed with anemia. What symptoms does the nurse expect to assess in the patient? (Select all that apply.)

elevated HR and fatigue

The couple with the lowest risk of having a child with sickle cell anemia disease is the one in which the:

father is HbA and mother is HbS

A patient's blood work reveals a platelet level of 17,000/mm3. When inspecting the patient's integumentary system, what finding would be most consistent with this platelet level?

petechiae

A patient's chart indicates a diagnosis of hemolytic anemia. The nurse understands that the patient has:

sickle cell anemia

An older adult client is to receive 2 units of packed red blood cells. During the transfusion of the first unit at 125 mL/hour, the client reports shortness of breath 30 minutes into the process. The client exhibits the vital signs shown in the accompanying table. What is the nurse's best intervention?

slow the rate of the transfusion and obtain an order for furosemide

A client was admitted to the hospital with the following laboratory values: hemoglobin 5 g/dL, leukocyte count 2000/mm3, and a platelet count of 48,000/mm3; abnormally shaped erythrocytes and hypersegmented neutrophils were seen. The platelets appear abnormally large. A bone marrow biopsy was competed and revealed hyperplasia. Based on this information, the nurse determines that client most likely has which diagnosis?

folic acid deficiency

A patient comes into the clinic complaining of fatigue. Blood work shows an increased bilirubin concentration and an increased reticulocyte count. What would the nurse suspect the patient has?

hemolytic anemia

A client is receiving epoetin alfa for anemia. Which adjunctive therapy is imperative with epoetin alfa?

iron supplementation

For a client with Hodgkin disease who has developed neutropenia, what is an appropriate nursing intervention to include in the care plan?

monitoring temp every 4 hours

The nurse is caring for an older adult client who has a hemoglobin of 9.6 g/dL and a hematocrit of 34%. To determine where the blood loss is coming from, what intervention can the nurse provide?

observe stools for blood

A child with acute lymphoblastic leukemia (ALL) is receiving methotrexate for therapy. Which nursing diagnosis would best apply during therapy?

Risk for impaired skin integrity related to oral ulcerations associated with chemotherapy

A client with breast cancer will have radiation therapy and then begin chemotherapy. Drug therapy will consist of a combination of doxorubicin, cyclophosphamide, and paclitaxel. What should the nurse include in the client's teaching plan concerning the drug therapy? Select all that apply.

Take special care when shaving or when brushing the teeth. Avoid large crowds and public places whenever possible.

A client is being treated in the ICU after a medical error resulted in an acute hemolytic transfusion reaction. What was the etiology of this client's adverse reaction?

The donor blood was incompatible with that of the client.

A client is diagnosed with pernicious anemia. The nurse completes an assessment and finds severe pain on palpation at T12. The nurse would inform the health care provider because the nurse knows that which complication of pernicious anemia may be present?

Vitamin B12 deficiency causing pernicious anemia, progressing for more than three months, can cause degenerative lesions of the spinal cord.

A male client, age 68 years, presents to the primary care office for follow-up for pernicious anemia. The nurse takes a history and finds that the client had the anemia for six months before starting treatment. Based on the history, which body system would the nurse include in the assessment?

The neurological system with a focus on the spinal cord