BAH Exam 5 (Workbook Questions)

A patient will need a blood transfusion for the replacement of blood lost from the GI tract. The patient states, "That isn't safe!" What is the best response?

"I understand your concern. The blood is carefully screened but is not completely risk free."

A pt with sickle cell is to begin treatment for the disease with hydroxyurea. What does the nurse inform the pt will be the benefits of treatment? SATA

- Fewer painful episodes of sickle cell crisis - Lower incidence of acute chest syndrome -Decreased need for other analgesic medications

The nurse is administering 2U of pRBCs to an older pt with a bleeding duodenal ulcer, The pt begins to experience difficulty breathing and the nurse assess crackles in the lung bases and jugular vein distention and increased BP. What action by the nurse is necessary if the reaction is severe? SATA

- Place the patient in an upright position with feet dependent -Administer diuretics as prescribed -D/C the transfusion -Administer O2

A patient receiving plasma develops transfusion-related acute lung injury (TRALI) 4 hours after the transfusion. What type of aggressive therapy does the nurse anticipate the pt will receive to prevent death from injury? SATA

- Supplemental O2 -Provision of IV fluids support -Intubation and mechanical ventilation

A pt is diagnosed with an intracerebral tumor. The nurse is aware that the diagnosis may include which form of tumor growth? SATA

-Astrocytoma (brain stem) -Ependymoma -Medulloblastoma

A patient develops a hemolytic reaction to a blood transfusion. What actions should the nurse take? SATA

-obtain appropriate blood specimens -collect urine sample to detect Hgb -document the reaction according to policy

Which patient does a nurse recognize as being most likely to be affected by sickle-cell disease?

A A 14-year-old African American Boy

A female patient has a Hgb of 6.4 g/dL and is preparing to have a blood transfusion. Why would it be important for the nurse to obtain information about pt history of pregnancy prior to transfusion?

A high # if pregnancies can increase the risk of reaction.

A pt is exhibiting seizure like movements localized to one side of the body. What type of brain tumor does the nurse determine the pt most likely has?

A motor cortex tumor

A pt with sickle cell is brought to the ER by a parent. The pt has a fever of 101.6, HR of 116 and RR of 32. The nurse auscultates bilateral wheezes in both lung fields. What does the nurse suspect?

Acute Chest syndrome

A pt with Parkinson's asks the nurse what can be done to prevent problems with bowel elimination. What intervention should the nurse include when developing the plan of care for this pt to assist with a regular stool pattern?

Adopt a diet with a moderate fiber intake

A patient describes numbness in arms and hands with a tingling sensation and frequent stumbling when walking. What vitamin deficiency does the nurse determine may contribute to some of these symptoms?

B 12

A pt with end-stage kidney disease has developed anemia. What lab findings does the nurse understand to be significant in this stage?

Creatinine level of 6 mg/100 mL

A patient with chronic kidney disease is being examined by a NP for anemia. The nurse has reviewed the laboratory data for Hgb and RBC count. What other test results would the nurse anticipate observing?

Decreased level of erythropoietin

A pt with Parkinson's Disease is exhibiting bradykinesia, rigidity, and tremors. These symptoms are directly related to what decreased neurotransmitter level?

Dopamine

The nurse is performing an assessment for a pt in the clinic with Parkinson's Disease. The nurse determines that the patients voice has changed since the last visit and now more difficult to understand. How should the nurse document this finding?

Dysphonia

The nurse is educating a pt with iron deficiency anemia about food sources high in iron and how to enhance absorption of iron when eating these foods. What can the nurse recommend?

Eating calf's liver with a glass of orange juice

A patient with chronic kidney disease has chronic anemia. What pharmacologic alternative to blood transfusion may be used for this pt?

Erythropoietin

A pt with chronic anemia has had many blood transfusions over the last 3 years. What type of transfusion reaction should the nurse monitor for that is commonly found in patients who frequently receive blood transfusions?

Febrile nonhemolytic reactions

The nurse is caring for a patient who has had a bone marrow aspiration with biopsy. What complication should the nurse monitor the patient for?

Hemorrhage

A pt with end-stage kidney disease is taking recombinant erythropoietin for the treatment of anemia. What lab study does the nurse determine will have to be assessed at least monthly related to this medication?

Hgb levels

The adult child of a pt with Huntington disease asks the nurse what the risk is of inheriting the disease. What is the best reponse by the nurse?

If one parent has the disorder, there is a 50% chance you will inherit the disease

A patient who has long-term pRBC transfusions has developed symptoms of iron toxicity that affect liver function. what immediate treatment should the nurse anticipate preparing the patient for that may help prevent organ damage?

Iron chelation therapy

The nurse observes a co-worker eating ice frequently. The nurse encourages the co-worker to have an exam. What type of anemia is the nurse concerned for?

Iron deficient anemia

The nurse is performing an assessment for a client with anemia admitted to the hospital to have blood transfusions administered. Why would the nurse need to include a nutritional assessment for this pt?

It may indicate deficiencies in essential nutrients

The nurse is preparing a pt for a bone marrow aspiration and biopsy from the site of the superior iliac crest. What position will the nurse place the patient in?

Lateral position with one leg flexed

The nurse is caring for a pt with Parkinson Disease and is preparing to give medication. what does the nurse give to the pt that is considered the most effective drug currently given for the tremor of Parkinson's?

Levodopa

An older adult pt is exhibiting clinical manifestations of a brain tumor is admitted to the hospital for testing. What tumor types does the nurse recognize are commonly seen in the older adult?

Medullablastoma

The nurse is assessing a patient who come to the clinic reporting feeling constantly tired and weak. The pt also has a sore tongue that is beefy red. What type of anemia does the nurse know these symptoms indicate?

Megaloblastic anemia

The nurse is assessing a pt who is a strict vegetarian. What type of anemia is the nurse aware the pt is at risk for?

Megaloblastic anemia

A pt had gatric bypass surgery 3 years ago and now experiencing fatigue. The pt takes pantoprazole for the treatment of frequent heartburn. What type of anemia is this pt at risk for?

Pernicious anemia

An older adult patient presents to the healthcare provider reporting exhaustion. The nurse, aware of the most common hematologic condition affecting older adults, assess for which lab values?

RBC count

A pt with ALS asks if the nurse has heard of a drug that will prolong the patient's life by 3-6 months. What medication is this?

Riluzole

The nurse is preparing the pt for a test to determine the cause of Vit B12 deficiency and will receive a small oral dose of radioactive B12 followed by a large parenteral dose of nonradioactive B12. What testing is the pt being prepared for?

Schilling test

A pt diagnosed with a spinal cord tumor and has had a course of radiation and chemo. 2 months after the completion of radiation, the pt reports severe pain in the back. What does this indicate?

Spinal metastasis

A patient with sickle cell comes to the ER reporting severe pain in the back, right hip, and right arm. What intervention is important for the nurse to provide?

Start an IV with Dextrose 5% in 0.24 NS

The healthcare provider believes that at patient has a deficiency in the leukocyte responsible for cell-mediated immunity. What should the nurse assess the WBC count for?

T Lymphocytes

A pt with Huntington disease is prescribed medication to reduce the chorea. What medications will the nurse give that is the only drug approved for the treatment of this symptom?

Tetrabenazine. (Chorea is non-voluntary jerking)

The patient is taking prednisone 60 mg/day for the treatment of an acute exacerbation of crohn's disease. The pt has developed lymphopenia with a lymphocyte count of <1500 mm3. What should the nurse monitor the client for?

The onset of a bacterial infection

The nurse is administering a blood transfusion to a pt over 4 hours. After 2 hours the pt reports chills and has a fever of 101 F, an increased from a prev temp of 99.2, What does the nurse recognize is occurring with this pt?

The pt is having a febrile nonhemolytic reaction

A pt with Parkinson's is experiencing an on-off syndrome. What does the nurse recognize that the patient's clinical symptoms will be?

The pt will have periods of near immobility, followed by a sudden return of effectiveness of the medication.

A pt is diagnosed with ALS, The nurse understands that the symptoms of the disease will begin in what way?

Weakness starting in the muscles supplied by the cranial nerves.

A pt with a brain tumor reports headaches that are worse in the morning. What explanation does the nurse give for the morning headache?

You may have an increase in intracranial pressure