Chapter 15 and 16 Test

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Extreme care is use by the nursing staff when repositioning or transporting a pt with advanced multiple myeloma to prevent

Pathologic Factor

. The nurse cautions the 79 year old male who had gastrectomy a month ago that he is at risk for ___ anemia

Pernicious (Megaloblastic)

In completing an assessment of a pt with a bleeding disorder who has dark complexion, the nurse should check the palms of the hands and the soles of the feet for _____

Petechiae

A treatment often used for polycythemia versa is

Phlebotomy

The nurse explains that, in the event of a massive hemorrhagic episode, the ___ contracts and adds blood to the circulator volume

Spleen

The nurse is aware that a person with Hodgkin disease, who has two or more abnormal lymph nodes on the same side of the diaphragm and cancer extending locally from one lymph node area into a nearby organ, would be in:

Stage II

The nurse is conscientious in the care of the feet and legs of a pt with sickle cell anemia because

Stasis ulcers are a constant threat

The Home health nurse recommends to the mother of a 12-year-old child with leukemia that the child should have:

. An Annual influenza vaccine

Neutrophils release ____an enzyme that destroys certain bacteria

. lysozyme

A 23-year-old male pt with hemophilia A says, "how can I keep from having hemophilia A?" which of following is the most informative response?

"Your daughter may be a carrier and her children may have hemophilia A. Your son is not at risk"

The nurse reminds the pt with a bleeding disorder that the life span of the platelet is the shortest of all the blood cells, approximately ____ days.

10

What is the average lifespan of an erythrocyte

120 day

A nurse is monitoring the lab values of a child with leukemia who is receiving chemotherapy. The nurse prepares to implement bleeding precautions if the child becomes thrombocytopenic and the platelet count is less than

20,000

Blood infusions must be started within how many minutes of its arrival on the unit?

30 mins

A nurse provides instruction to the parents of a child with leukemia regarding measures related to monitoring for infection. Which statement by the parents indicates the need for further instruction?

I need to take my child's rectal temperature daily

The nurse evaluates the lab reports for the pt on the unit and recognizes the report the most immediate attention is for the pt with RBC_, WBC_, and Hg_.

4.2, 4500, 9.1

The nurse explains to a person that has undergone bone marrow transplant that engraftment takes up to ___ weeks

5 weeks.

Approximately how much blood is in the spleen that can be released in a hypovolemic emergency?

500ml

When the nurse observes melena, she is aware that the minimum of _ to _ ml of blood has been deposited into the GI tract

50;75

The pt who has purpura and blood in the urine and stool is being examined by the nurse. The nurse reviews the ordered blood work and suspects that the pt might be experiencing:

A decrease in thrombocytes

Activity intolerance and fatigue occur with some hematologic disorders because

A deficiency of hemoglobin decreases the oxygen-carrying capacity of the blood.

A nurse reinforces home-care instructions to the parents of a 3 year old child who has been hospitalized for hemophilia. Which statement by a parent indicates the need for further instruction

I will avoid immunization and dental hygiene treatments for my child.

When reviewing the hematologic system, the student nurse is correct when making which statement

African American have the highest incidence of sickle cell disease

The nurse notes a rise in the eosinophil count and suspects the pt has an...

Allergy

What would a nurse include in a teaching plan for a home health pt with a hemoglobin of 8.4 mg?

Alternating Activity with rest periods

The nurse reading a CBC note there is an abnormal number of "bands", or immature granulocytes. From this assessment, the nurse suspects...

An ongoing bacterial infection

The nurse assessing a differential sees and increase in immature neutrophils (bands) and is aware that this indicates:

An overwhelming bacterial infection

Aplastic anemia has its etiology in a variety of drugs, such as:

Antimetabolite cancer drugs, sulfonamides, phenylbutazone (Butazolidin), chloramphenicol (Chloromycetin)

Which nursing intervention is most appropriate following a bone marrow aspiration on the left posterior iliac crest from a pt with pernicious anemia

Apply pressure to the site for 5 min with an ice pack

. The pt with acute myelogenous leukemia (AML) asks why he is making more WBCs when he already has so many. The nurse clarified that the large number of leukemic white cells he already has:

Are not as effective as normal white cells would be

The nurse is aware that person of the Jehovah Witness faith accepts which types of blood transfusion?

Autologous Blood Transfusions

The information that the nurse recognizes as pertinent pt self-care with a sickle cell anemia is

Avoid dehydration and high altitudes.

The foods that the nurse would include in a nutrition teaching plan for an iron-deficiency anemia pt are:

Beans and Dried Fruits

The nurse explains why they are jaundice

Bilirubin

When assessing a complete blood count of a pt with all, the blood cells are called

Blasts

The elderly pt daughter ask why her dad seems to be catching so many colds. Which response by the nurse is the best.

Bone marrow activity decreases by 50% with aging which lowers the immune response

The mother of a 4 year old child with leukemia says to the nurse, "I don't understand why he is crying about his leg hurting." The nurse's most informative response would be based on the information that bone pain is related to:

Bone marrow congested with white cells

When the 14-year-old African American boy comes into the emergency room in sickle cell crisis, what should be the primary focus of care.

Pain control

The nurse is caring for a patient with anemia who has a past medical history of diabetes, hypertension, chronic kidney disease, and acid reflux. The nurse is aware the pt's anemia is likely related to which condition?

Chronic Kidney Disease

. The nurse is reviewing a pt assessment data upon admission to the acute care facility and observes signs of Iron deficiency anemia that include

Pale Conjunctivae

The nurse cautions that often confused and irritable older adults are thought to have dementia when the real underlying problem is a blood-related

Deficiency in RBC causes hypoxia

The nurse explains that a positron emission tomography (PET) has been ordered to:

Determine the extent of possible metastasis

The nurse explains that because it is a reliable and predictable indicator of the body's level of infection or recovery the _____ is a common diagnostic tool.

Differential

The pt with AML has a platelet count of 95,000. What interventions should the nurse include int eh pts care plan?

Electric razor, observe for melena and hematuria, apply ice and pressure to puncture sites, abd girth measures.

The nurse is reviewing a pt's intake data and observe signs of anemia that include

Pallor and fatigue

. The nurse is caring for a pt with sickle cell anemia. Based on the underlying pathophysiology of this disorder, the nurse should carefully perform which detailed assessment?

Examination for skin breakdown

A sign of spleen enlargement

Feeling of fullness in upper left abdomen

The nurse is monitoring a pt who is receiving a blood transfusion. Which findings would lead the nurse to stop the infusion?

Fever, Back pain, Headache, report of rash

To assess cyanosis in a pt with dark complexion, the nurse should inspect the:

Gums, Roof of mouth

A pt is being evaluated for anemia. The LPN expects to find the pt

Had decreased RBC

The nurse formulates the following expected outcomes for a pt admitted with hemarthrosis: "The pt will have no new hematomas or other evidence of bleeding." The most appropriate nursing intervention would be to:

Handle the patient very gently, protecting joints

The nurse makes a visual aid differentiating between mild, moderate, and severe anemia. Which signs and symptoms are manifestations of mild anemia?

Headache, Dyspnea on exertion

The pt who is taking radiation treatment has a platelet count of 100,000. The nurse should be alert for

Hematuria

Because of a deficiency of iron, the pt with iron deficiency anemia is unable to make sufficient...

Hemoglobin

. The nurse is assessing a pt with polycythemia vera. Which finding is correct with this disorder?

Hemoglobin of 17 mg/dL

Sam is a 16-year-old pt with an inherited bleeding disorder in which there is a lack in clotting factors. The LPN known that his likely diagnosis is

Hemophilia

The nurse explains that induction therapy for acute lymphatic leukemia is an...

Intensive protocol for chemotherapy to achieve remission

The home health nurse assesses the pt taking ferrous sulfate. Which pt statement alerts the nurse that reaching is necessary regarding this medication?

It taste better when I take my meds with milk

The nurse is assessing an 82 yr old AFM with sickle cell anemia and notes the sclera of his eyes to be yellow what does he have.

Jaundice

The nurse caring for a patient with pernicious anemia should make provisions for:

Lightweight blanket

The nurse is caring for a pt with iron deficiency anemia. The nurse should encourage intake of which foods?

Lima Beans, Prune Juice, Dried apricots, Liver

The nurse stresses to the pt with sickle cell anemia that one of the simplest interventions to help prevent sickle cell crisis is to ...

Maintain adequate fluid intake

The home health nurse caring for the pt with polycythemia vera will focus care on:

Maintenance of High fluid intake

The nurse is caring for a pt who is diagnosed with thrombocytopenia. The nurse expects the pt might be treated with:

Platelet transfusion

The most common cause of anemia in the elderly is due to

Poor nutrition

From which location would the bone marrow sample come in the aspiration of a 25-year-old pt?

Posterior Iliac Crest

Nursing Interventions for the pt with idiopathic thrombocytopenia purpura must include measures to:

Prevent spontaneous bleeding

Mr. Jones, age 52, is admitted with thrombocytopenia. The most important nursing intervention is to:

Prevent trauma and falling

The Pt who is taking radiation treatments has a platelet count of 60,000. The nurse should be alert for:

Prolonged bleeding after venipuncture

A pt with a nutritional anemia may lack with nutrients?

Proteins, Folic Acid, Iron

The nurse is caring for a pt with aplastic anemia. Which actions are most important for the nurse to take?

Provide a soft toothbrush and decrease clutter in the room.

In caring for a patient with multiple myeloma, what should the nurse include in the daily care?

Provisions for close supervision and assistance when ambulating

Which factors may be causative for leukemia?

Radiation exposure, Benzene exposure, Pesticide's exposure

The nurse assesses the abnormal blood value for a young woman as:

Red blood cells 2,000,000

In an adult, where are erythrocytes continuously produced?

Red bone marrow

The presence of excess bands in the peripheral blood that indicate severe infection is called

Shift to the left

When the pt with pernicious anemia says idk why I'm tired the nurse says

The lack of o2 being sent to the extremities

A pt with multiple myeloma has been stated on filgrastim (Neupogen) for treatment of neutropenia. The nurse identifies the drug is being effective when.

The pt white blood cell count increase.

The student nurse is preparing to administer an iron preparation via IM route. Which action by the student indicated to need for further instruction

The students choose a 1 ½ inch needle

The nurse instructs a 20-year-old female pt with sickle cell trait that

The trait can be passes on to all of her children

The pt with disseminated intravascular coagulation (DIC) is being treated with fresh frozen plasma and heparin therapy. The nurse explains to the family that the priority for this pt is:

To monitor for bleeding

What must a pt undergo before a bone marrow transplant

Total body irradiation to kill all the marrow cells

The 9-year-old child with leukemia who is on palliative care has drawn a picture of a boy under a huge black cloud that has lightning coming out of it. Which of the following would be an appropriate intervention for the nurse?

What is the picture about?

. The nurse takes into consideration that the patient with polycythemia vera will have a phlebotomy to thin the blood

every 2-3 months

The nurse frequently assesses a pt with aplastic anemia for signs of infection, bc the pt will not be able to produce and inflammatory response related to the low level of

leukocytes

A child with sickle cell anemia is places on the drug hydroxyurea. The nurse explains that this drug will:

produce a hemoglobin that resists sickling

At the end of a shift, a nurse documents the effectiveness of parent teaching concerning the transmission of hemophilia. Which of the following statements by mom shows she understands the teaching?

Hemophilia is a genetic disorder that my children will be carriers of.

The nurse assessing a patient with polycythemia vera would anticipate what

High hemoglobin

The nurse explains that in the event of an invasion of an allergen, the basophils release a strong vasodilator, which is:

Histamine

A pt with anemia is in the er. What is an appropriate question for the nurse to ask during her assessment?

How much meat do you eat in a week?

The nurse anticipates that the pt with iron deficiency anemia will have red cells that are...

Hypochromic and microcytic

The nurse evaluates a need for further instruction for the pt with sickle cell anemia when he say...

I am looking forward to my annual ski trip to Colorado

A pt with acute leukemia reports having nose bleeds throughout the night. Which of the following Nursing actions has the highest priority?

Report the nose bleeds to the physician

All the following are appropriate nursing interventions for the diagnosis of altered tissue perfusion related to a decreased number of RBC's and decrease oxygenation except:

Restrict fluid intake to avoid fluid overload

When the nurse administers a form of iron to an anemic pt, she keeps in mind that iron:

Should be given through a straw if in liquid oral form


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