Blood and Lymph

30. A nurse teaches a client who has iron- deficiency anemia. The nurse should encourage the client to increase her consumption of which of the following foods? A) Lentils B) Avocados C) Cabbage D) Broccoli

A) Lentils

A nurse is collecting data from a client who has pernicious anemia. Which of the following findings should the nurse expect? A) Paresthesia in the hands and the feet B) Thick, white coating on the tongue C) Decreased pulse rate D) Joint pain in extremities

A) Paresthesia in the hands and the feet

A nurse is reinforcing discharge teaching with a client who had a gastrectomy due to stomach cancer. Which of the following statements should the nurse make? (Select all that apply). A. "You will need a monthly injection of Vitamin B12 for the rest of your life" B. "Using the nasal spray form of vitamin B12 on a daily basis can be an option" C. "An oral supplement of vitamin B12 taken on a daily basis can be an option" D. "You should increase your intake of animal proteins, legumes, and dairy products to increase vitamin B12 in your diet" E. "Add soy milk fortified with vitamin B12 to your diet to decrease the risk of pernicious anemia"

A. "You will need a monthly injection of Vitamin B12 for the rest of your life" B. "Using the nasal spray form of vitamin B12 on a daily basis can be an option"

The home health nurse reads in the record that the patient has a medical diagnosis of Hodgkin's disease stage 1. Which sign/symptom would the nurse expect to see? A. Abnormal single lymph node B. Night sweats C. Weight loss D. Alcohol-induced pain

A. Abnormal single lymph node

A nurse is assisting with the care of a client who is scheduled to receive a transfusion of packed RBCs. Which of the following actions should the nurse take? (Select all that apply.) A. Check and document the client's vital signs B. Provide the RN with IV tubing that has a filter C. Make sure the blood type and Rh of the packed RBCs are checked by 2 nurses D. Ensure the client's IV site uses a 22- gauge needle E. Obtain a bag of lactated Ringer's IV solution

A. Check and document the client's vital signs B. Provide the RN with IV tubing that has a filter C. Make sure the blood type and Rh of the packed RBCs are checked by 2 nurses

29. A nurse is reinforcing teaching with a client who has pernicious anemia. The nurse should encourage the client to increase consumption of which of the following foods? A. Eggs B. Squash C. Kale D. Tofu

A. Eggs

When caring for patients who are Jehovah's Witnesses, which information applies for use of blood products? A. Some Jehovah's Witnesses may permit the use of certain blood volume expanders. B. It is not legal for this patient to refuse transfusions if the bleeding is truly life-threatening. C. Some Jehovah's Witnesses may consent to homologous blood transfusion. D. Jehovah's Witnesses believe that children are allowed to have blood in an emergency.

A. Some Jehovah's Witnesses may permit the use of certain blood volume expanders.

A nurse is caring for a client who is receiving a blood transfusion. Which of the following actions should the nurse take if an allergic transfusion reaction is suspected? (Select all that apply). A. Stop the transfusion B. Monitor for hypertension C. Maintain an IV infusion with 0.9% sodium chloride. D. Position the client in an upright position with the feet lower than the heart E. Administer diphenhydramine

A. Stop the transfusion C. Maintain an IV infusion with 0.9% sodium chloride. E. Administer diphenhydramine

The nurse is caring for a postoperative patient who is demonstrating early symptoms of hypovolemic shock. The nurse is awaiting a return call from the health care provider. Which task can be delegated to the UAP? (pg. 1485) Study guide chapter 47 A. Take and report the blood pressure, pulse, and respirations every 15 minutes. B. Reinforce the dressings for saturation of blood or drainage. C. Apply oxygen and monitor the pulse oximetry readings every 5 minutes. D. Place the patient in a supine position and monitor respiratory effort.

A. Take and report the blood pressure, pulse, and respirations every 15 minutes.

A nurse is caring for a client who recently had chemotherapy and now has myelosuppression. Which of the following interventions should the nurse initiate? (Select all that apply.) A.) Prohibit bringing fresh flowers and plants into the client's room B.) Encourage frequent visits from family and friends C.) Ensure thorough cleaning of the client's room and bathroom daily D.) Replace wound dressings every other day E.) Use dedicated equipment items such as stethoscopes

A.) Prohibit bringing fresh flowers and plants into the client's room C.) Ensure thorough cleaning of the client's room and bathroom daily E.) Use dedicated equipment items such as stethoscopes

A nurse is planning care for a client who has Hgb 7.5 g/dL and Hct 21.5%. Which of the following actions should the nurse include in the plan of care? (Select all that apply.) A.Aassist with ambulation B. Monitor O2 saturation C. Weigh client weekly D. Obtain stool specimen for occult blood E. Schedule daily rest periods

A.Aassist with ambulation B. Monitor O2 saturation D. Obtain stool specimen for occult blood E. Schedule daily rest periods

A nurse is providing for a client who is scheduled for a bone marrow biopsy of the iliac crest. Which of the following statements made by the client indicates an understanding of the teaching? A. "This test will be performed while I am lying flat on my back." B. "I will need to stay in bed for about an hour after the test." C. "This test will determine which antibiotic I should take for treatment." D. "I will receive general anesthesia for the test."

B. "I will need to stay in bed for about an hour after the test."

Which patient has the greatest risk for developing a complication related to the penetration of underlying structures during a bone marrow biopsy or aspiration? A. An older patient had a bone marrow biopsy from the posterior iliac crest B. A very thin patient had a bone marrow aspiration from the sternum C. A child had a bone marrow aspiration from the posterior iliac crest D. An obese patient had a bone marrow aspiration from the tibia

B. A very thin patient had a bone marrow aspiration from the sternum

A nurse in an oncology clinic is collecting data from a client who has early stage Hodgkin's lymphoma. Which of the following findings should the nurse expect? A. Bone and joint pain B. Enlarged lymph nodes C. Intermittent hematuria D. Productive cough

B. Enlarged lymph nodes

The patient has a very low platelet count. Which instruction will the nurse give to the UAP about the care of the patient? A. Always wear a mask to prevent spreading respiratory droplets. B. Handle the patient very gently to avoid bruising and injury. C. Encourage the patient to take fluids to prevent dehydration. D Assist the patient with hygiene to prevent undue fatigue.

B. Handle the patient very gently to avoid bruising and injury

The patient has a very low platelet count. Which instruction will the nurse give to the UAP about the care of this patient? A. Always wear a mask to prevent spreading respiratory droplets B. Handle the patient very gently to avoid bruising and injury C. Encourage the patient to take fluids to prevent dehydration D. Assist the patient with hygiene to prevent undue fatigue

B. Handle the patient very gently to avoid bruising and injury

Which clinical sign/symptom noted in a patient with pernicious anemia would indicate that the patient has been nonadherent with B12 injections? A. Weight gain of 5 pounds in 1 week B. Paresthesia of hands and feet C. Hyperactivity in the evening hours D. Diarrhea stools several times per day

B. Paresthesia of hands and feet

A nurse is collecting data from a client who has anemia. Which of the following integumentary findings should the nurse expect? A. Absent Turgor B. Spoon-shaped nails C. Shiny, hairless legs D. Yellow mucous membranes

B. Spoon-shaped nails

The laboratory calls to inform the nurse that the patient has a white cell count of 1000/mm3 with a differential neutrophil count less than 200/mm3. Which is the most important for the nurse to initiate while waiting for the health care provider to respond to the phone message? A. Review current medication list B. Start neutropenic precaution C. Check for S/S of infection D. Teach the importance of hand hygiene

B. Start neutropenic precaution

What health promotion points should be emphasized for patients who have sickle cell disease? Select all that applies ...(select all that apply) A. Drink large amounts of ice fluids B. Stay current with vaccinations C. Maintain very cold room temperature D. Stop smoking and alcohol consumptions E. Avoid high altitudes

B. Stay current with vaccinations D. Stop smoking and alcohol consumptions E. Avoid high altitudes

A nurse in a clinic receives a phone call from a client seeking information about a new prescription for erythropoietin. Which of the following information should the nurse review with the client? A. The client needs an erythrocyte sedimentation rate test weekly B. The client should have his hemoglobin checked twice a week C. Oxygen saturation levels should be monitored D. Folic acid production will increase

B. The client should have his hemoglobin checked twice a week

The health care provider has recommended that the patient with sickle cell disease have a splenectomy. Which medication is likely to be discontinued for several days prior to the surgery? A. Folic acid supplement B. Hydroxyurea C. Blood thinner D. Antibiotic

Blood thinner

A nurse is reinforcing discharge teaching with a client who had a sickle cell crisis. Which of the following statements should the nurse identify as an indication that the client understands the instructions? A. "I should try to drink at least 2 liters of fluid per day" B. "I can still fly out to visit my sister in Colorado for a while" C. "Physical activity is good for me, but I need to avoid overexertion" D. "I can still go Skiing during the cold winter months"

C. "Physical activity is good for me, but I need to avoid overexertion"

A client who has thrombocytopenia asks the nurse why platelets are so important. Which of the following responses should the nurse make? A. "Platelets help the body fight infection" B. "Platelets help break down blood clots" C. "Platelets plug breaks in blood vessels" D. "Platelets produce the molecules that carry oxygen"

C. "Platelets plug breaks in blood vessels"

The patient had a major abdominal surgery yesterday, He reported abdominal pain and the nurse gave him an opioid pain medication as directed; 2 hours later, he reports that the pain is worse. What should the nurse do first? A. Check the medication administration record for other pain or adjunctive medication. B. Explain to the patient that pain medication can only be given as prescribed every 4-6 hours. C. Assess the abdomen and ask the patient to describe the pain to the best of his ability. D. Call the health care provider and obtain an order for laboratory studies or x ray studies.

C. Assess the abdomen and ask the patient to describe the pain to the best of his ability.

A nurse is teaching a client who has a new prescription for ferrous Sulfate. Which of the following info should the nurse include in the teaching? A. Stools will be dark red B. Take with a glass of milk is GI distress occurs C. Foods high in vitamin C promote absorption D. Take for 14 days

C. Foods high in vitamin C promote absorption

Which objective finding indicates that the healthy adult's body is compensating for a blood loss of less than 750mL? A. Urine output is scant B. Blood pressure is low C. Has slight increase in pulse D. Is stuporous and confused

C. Has slight increase in pulse

During physical assessment, the nurse detects swelling in the cervical lymph nodes and the patient's skin feels hot to touch. Which question is the nurse most likely to follow up on the assessment findings? A. Do you have a personal or family history of cancer? B. Have you ever been told that you are anemic? C. Have you been exposed to any infectious disorders? D. Do you take any anticoagulant medications?

C. Have you been exposed to any infectious disorders?

34. The nurse is caring for a trauma patient who must be observed for signs and symptoms of occult bleeding and injury. Which signs/symptoms is an early manifestation of hypovolemic shock? A. Orthostatic blood pressure B. Decrease red blood cell count C. Restlessness D. Decrease urine output

C. Restlessness

. Which patient is most likely to require testing for anti-D antibodies and/or an injection of Rh immunoglobulin? A. Rh-positive mother who is at 28 weeks gestation B. Any woman who has an ectopic pregnancy C. Rh-negative mother who had a miscarriage D. Rh-positive mother impregnated by an Rh-negative father

C. Rh-negative mother who had a miscarriage

A nurse is assisting in the preparation of a unit of packed red blood cells (RBCs) for a client who has anemia. which of the following actions should the nurse first take? A. Hang an IV infusion of 0.9% sodium chloride with the blood B. Check the client's identification number with the number on the blood C. witness the informed consent D. prepare the blood with a Y-type infusion set

C. witness the informed consent

A nurse is assisting with the care of a client who is in hypovolemic shock. While waiting for a unit of blood, the nurse should plan to administer which of the following IV solutions? A. 0.45% sodium chloride B. Dextrose 10% in 0.9% NaCl C. Dextrose 10% in water D. 0.9% NaCl

D. 0.9% NaCl

2. A nurse is admitting a client who has multiple myeloma and a WBC count of 2,200/mm^3. Which of the following foods should the nurse prohibit the family members from bringing to the client? A. Fried chicken from a fast food restaurant B. A case of canned nutritional supplements C. A factory-sealed box of chocolates D. A fresh fruit basket

D. A fresh fruit basket

A nurse is contributing to the plan of care for a client during a sickle cell crisis. Which of the following interventions should the nurse recommend? A. Ambulate the client every hour B. Apply cold compresses to painful joints C. Withhold opioids until the crisis is resolved D. Administer oxygen via cannula

D. Administer oxygen via cannula

There was a major catastrophe in the city and healthcare facilities are being overwhelmed with trauma victims. Based on the concept of universal recipient which patient theoretically has the best chance of getting a unit of blood if there is a shortage in the bank? A. Has blood Type O and is Rh negative B. Has blood Type A and and is Rh positive C. Has blood Type B and is Rh negative D. Has blood Type AB and is Rh positive

D. Has blood Type AB and is Rh positive

A nurse in a clinic is caring for a client who has suspected anemia. Which of the following laboratory test results should the nurse expect? A. Iron 90 mcg/dL B. RBC 6.5 million/uL C. WBC 4,800mm3 D. Hgb 10g/dL

D. Hgb 10g/dL

The nurse is caring for a patient experiencing an initial sickle cell crisis. What is the primary sign/symptom that the nurse should expect during the crisis? A. Jaundice B. Fever C. Fatigue D. Pain

D. Pain

A nurse is caring for a client who has pernicious anemia. Which of the following factors is associated with this condition? A. Iron deficiency B. Hemolytic blood loss C. Folic acid deficiency D. Vitamin B12 deficiency

D. Vitamin B12 deficiency

A health care professional is caring for a patient who is about to begin taking folic acid to treat megaloblastic anemia. The health care provider should monitor which of the following laboratory values. A. Amylase level B. Reticulocyte count C. C-reaction Protein D. Creatinine clearance

Reticulocyte count

A nurse is caring for a client who has scurvy. Which of the following vitamin deficiencies should the nurse identify as the cause of this disease? A. Vitamin A: produces manifestations of night blindness and immunodeficiency B. Vitamin B3: manifestations of pellagra, which include a scaly rash on sun exposed skin, confusion, paranoia, and diarrhea. C.Vitamin C: Vitamin C deficiency produces S/S of scurvy, such as delayed wound healing and capillary refill. D. Vitamin D: manifestations of rickets and osteomalacia, which include bowed legs, fractures, and malformed teeth.

Vitamin C

A nurse is Collecting pre-operative data from a client who is about to undergo a cholecystectomy. The nurse should identify a risk for latex allergy when the client reports an allergy to which of the following foods? A: bananas B: cabbage C: milk D: oatmeal

bananas

A nurse is collecting data from a patient who is receiving a unit of whole blood. Which of the following findings should the nurse identify as a manifestation of a hemolytic transfusion reaction? a.) Bradycardia b.) Paresthesia c.) Hypertension d.) Low back pain

d.) Low back pain