chapter 21
Which statement about natural killer (NK) cells is the best explanation of their function when reviewing laboratory work for a 10-year-old child?
"The primary job of natural killer (NK) cells is to hunt down and destroy foreign cells in the body."
The globulins that make up part of the plasma of the blood have three distinct purposes. What are the gamma globulins?
Antibodies of the immune system
Which leukocyte is correctly matched with its function within the body?
Eosinophil—allergic reaction
A 6-year-old child is having a stem cell transplant using umbilical cord blood. What benefit does the nurse understand that this type of transplant will have for the child?
This type of transplant creates less risk of graft versus host disease
Which type of white blood cells are related to the connective tissue mast cells and respond in allergic and hypersensitivity reactions?
basophils
Which parts of the body are considered to be parts of the lymphatic system? Select all that apply.
thymus and spleen
A nurse is reviewing the laboratory data for a hospitalized client. The nurse would be most concerned about which finding?
white blood cells (WBC)
The nurse is caring for a pediatric client who will be having bone marrow aspiration from the posterior iliac crest. The parent asks why the sternum is not used to obtain the sample as this is the site used for another relative. How does the nurse respond?
In children, the sternal bone marrow cavity is much more shallow, increasing risk for damage to underlying organs.
A nurse on an oncology floor is treating a client who is anemic following chemotherapy. The drugs being administered are designed to increase the number of red blood cells in circulation. These drugs are likely agonists of:
cytokines
A nurse is caring for a newborn that has developed a low platelet count. What could be the cause?
decreased thrombopoietin (TPO)
Which colony-stimulating factor (CSF) is given to clients with end-stage renal disease to help with chronic anemia?
erythropoietin (EPO)
Which person should the charge nurse assign as a roommate for a client diagnosed with aplastic anemia?
A client in traction with a broken femur
Organ, blood, and bone marrow transplants are lifesaving procedures that come from what sources? Select all that apply.
A histocompatible donor The clients themselves An autologous donor
Which type of lymphocyte is involved with humoral-mediated immunity?
B lymphocytes
A client comes to the clinic following exposure to chicken pox. The client states he had chickenpox as a child but was worried about getting sick again. Which statement best explains humoral-mediated immunity to the client?
B lymphocytes (B cells) in the body produce antibodies to fight infections. Once exposed, the cells retain memory and are able to quickly fight off pathogens during re-exposure and prevent the disease from reoccurring.
Select the option that best describes the production of T lymphocytes.
Bone marrow → thymus → lymph nodes
A client being treated for polymyalgia rheumatica (PMR) comes to the clinic for a follow-up visit. The current erythrocyte sedimentation rate (ESR) rate has decreased from 60 mm/hour to 30 mm/hour and the client is afebrile, denies any headaches, and reports a decrease in joint pain and fatigue. Based on these findings, the nurse anticipates which change to the treatment plan?
Gradually decrease the current dosage of prednisone and repeat ESR in 2 weeks
The results of a client's most recent blood work indicate a precipitous decline in the client's neutrophil level. What intervention should the nurse prioritize?
Moving the client to a positive-pressure isolation room
A nurse sends a blood sample to the lab for analysis. Assuming the sample is normal, the nurse anticipates which white blood cells (WBCs) will account for the highest percentage?
Neutrophils
A client is admitted to the hospital with an elevated temperature and flank pain. When reviewing the complete blood count (CBC), which level is the most important for the nurse to communicate to the health care provider?
Neutrophils 85%
When a white blood cell with differential count reveals an acute infection, which statement is correct regarding the client's neutrophils?
Neutrophils are the first white blood cell to elevate in an acute infection.
The nurse is teaching a client about how a vaccine can help create immunity to a virus. What information does the nurse provide?
The vaccine causes B lymphocytes to create antibodies against the virus.
Stem cell transplantation has been shown to provide potential cures for diseases such as aplastic anemia and the leukemias. What are the sources of stem cells used for transplant?
Umbilical cord blood and bone marrow
The client's primary care physician is reviewing assessment data of a client and suspects a diagnosis of acute leukemia. To confirm the diagnosis, which test would be performed?
bone marrow analysis
The nurse's review of a client's laboratory results indicates that inflammation is absent and platelet levels are low. Which test was performed to provide the platelet count?
complete blood count (CBC)
Although the usual site for a bone marrow test is the posterior iliac crest, other sites include the anterior iliac crest and the sternum. What are the dangers of using the sternum for a bone marrow test in children?
danger of perforating the mediastinum and heart
What are the components of blood? Select all that apply.
electrolytes, enzymes
A nurse is evaluating laboratory results of a client diagnosed with a parasitic infection. The tests reveal a large group of cells that are membrane-bound with granules in their cytoplasm that are aiding in the destruction of the parasite. Which cell is the nurse evaluating?
eosinophil
A client presented to the emergency department with symptoms of fever, abdominal pain and diarrhea following a vacation out of the country. A helminthic parasite infection is suspected. Which lab result should the nurse evaluate?
eosinophils
The nurse is caring for a client who has undergone chemotherapy, which has resulted in anemia and has placed the client at high risk for bacterial infection. Which orders should the nurse anticipate? Select all that apply.
erythropoietin, granulocyte colony-stimulating factor
A client who has received chemotherapy has a steadily decreasing white blood cell count. To increase the neutrophil count, the nurse anticipates administering:
granulocyte colony-stimulating factor
Which type of macrophages are found in the liver?
kupffer cells
A nurse is reviewing a client's complete blood count (CBC) which indicates thrombocytopenia. Based on this result, which action should the nurse include in the plan of care?
place the client on bleeding precautions
The nurse is caring for a client with leukemia who is having difficulty with blood clotting after having several transfusions with packed red blood cells. What does the nurse anticipate infusing for this client to assist with controlling the bleeding?
platelets
A client diagnosed with pancytopenia due to aplastic anemia is scheduled for which treatment that can correct bone marrow deficiencies?
stem cell transplant
A 45-year-old client requires a bone marrow sampling to examine hematopoietically active marrow. The nurse informs the client that the sample may be obtained from what sites? Select all that apply.
the breast bone (sternum), the posterior pelvis (illiac crest)
The nurse is reviewing the complete blood count (CBC) and white blood cell (WBC) differential of a client admitted with lower right abdominal pain. Which laboratory results are the most important for the nurse to communicate to the health care provider?
white blood cells (WBCs) 18,500/uL(18.50 x 10^9/L)
