Chp. 33 PrepU Questions: Management of Nonmalignant Hematologic Disorders (Exam 1)
Which nursing instructions help parents of a child with hemophilia provide a safe home environment for their child?
"Establish a written emergency plan including what to do in specific situations and the names of phone numbers of emergency contacts."
The nurse is collecting data fora pt who has been diagnosed with iron-deficiency anemia. What subjective findings does the nurse recognize as symptoms related to this type of anemia?
"I have difficulty breathing when walking 30 ft."
A client with pernicious anemia is receiving parenteral vitamin B12 therapy. Which client statement indicates effective teaching about this therapy?
"I will receive parenteral vitamin B12 therapy for the rest of my life."
A home care nurse visits a client diagnosed with A fib who is ordered warfarin. The nurse teaches the client about warfarin therapy. Which statement by the client indicates the need for further teaching?
"I'll eat four servings of fresh, dark green veggies every day."
A female client with the beta-thalassemia trait plans to marry a man of Italian ancestry who also has the trait. Which client statement indicates that she understands the teaching provided by the nurse?
"I'll see a genetic counselor before starting a family."
Parents arrive to the clinic with their 5 yr old child inform the nurse the child has just been diagnosed with sickle cell disease. The parents ask the nurse how this could have happened and which one of them is the carrier. What is the best response by the nurse?
"The child must inherit two defective genes, one from each parent."
A client is prescribed 325 mg/day of oral ferrous sulfate. The nurse includes in client teaching, " take your iron pill....
...1 hour before breakfast."
A few minutes after beginning a blood transfusion, a nurse notes a client has chills, dyspnea, and urticaria. The nurse reports this to the physician immediately because the client probably is experiencing what problem?
A hemolytic allergic reaction caused by an antigen reaction
A CBC is commonly performed before a lcientgoes into surgery. What does this test seek to identify?
Abnormally low hematocrit (HCT) and hemoglobin (Hb) levels
Which of the following nursing interventions should be incorporated into the plan of care to manage the delayed clotting process in a pt with leukemia?
Apply prolonged pressure to needle sites or other sources of external bleeding
What nursing intervention should be incorporated into the plan of care to manage the delayed clotting process due to thrombocytopenia in a pt with leukemia?
Applying prolonged pressure to needle sites or other sources of external bleeding
A nurse caring for a client who has hemophilia is fgetting ready to take the client's VS's. What should the nurse do before taking the BP?
Ask if taking a BP has ever produced bleeding under teh skin or in the arm joints
A nurse caring for a client who has hemophilia is getting ready to take the client's vital signs. What should the nurse do before taking a blood pressure?
Ask if taking a BP has ever produced bleeding under the skin or in the arm joints
When teaching a pt with iron deficiency anemia about appropriate food choices, the nurse will encourage the pt to increase the dietary intake of what foods?
Beans, dried fruits, and leafy green veggies
What is a hemochromatosis symptom?
Bronzing of the skin
A client reports feeling tired, cold, and SOB at times. Your assessment reveals tachycardia an d reduced energy. What would you expect the physician to order?
CBC
A pt. with end-stage kidney disease (ESKD) has developed anemia. What lab finding does the nurse understand to be significant in this stage of anemia?
Creatinine level of 6 mg/100 mL
A pt's family member asks the nurse why disseminated IV coagulation (DIC) occurs. Which of the following statements made by the nurse correctly explains the cause of DIC?
DIC is caused by an abnormal activation of clotting pathway causing excessive amounts of tiny clots to form inside organs
A pt with chronic renal fialure is examined by the nurse practitioner for anemia. the nurse knows to review the lab data for a dereasedhemoglobin level, RBC, and what else?
Decreased level of erythropoietin
The nurse is instruction a client about taking a liquid iron preparation for the treatment of iron-deficiency anemia. What should the nurse include in the instructions?
Dilut ethe liquid preparation with another liquid such as juice and drink through a straw
A 89 year old client is preparing to leave the physician's office. The nurse is discussing with the client some strategies for ingesting iron to combat her iron-deficiency anemia. Which of the following are among the nurse's strategies?
Drink liquid iron prepertions with a straw
the nurse observes the blad studies for a client inteh hospital with faituge, felling cold all of the time, and hemoglobin of 8.6 g/dL and a hematocirt of 28%. What finding would be an indicator of iron-deficiency anemia?
Erythrocytes that are microcytic and hypochromic
When assessing a female pt with a disorder of the hematopoietic or lymphatic system, what assessment is most essential?
Health history, such as bleeding, fatigue, or fainting
When assessing a female pt with a disorder of the hematopoietic or the lymphatic system, which of teh following assessments is most essential?
Health hx, such as bleeding, fatigue, or fainting
A pt with ESRD is taking recombinant erythropoietin for the treatment of anemia. What lab study does the nurse understand will have to be assessed at least monthly related to this med?
Hemoglobin level
What describes a RBS that has pale or lighter cellular contents?
Hypochromic
A client receiving a blood transfusion experiences an acute hemolytic reaction. Which nursing intervention is the most important?
Immediately stop the transfusion, infuse normal saline solution, call the physician, and notify the blood bank
A pt with severe anemia is complaining of the following symptoms: tachycardia, palpitations, exertional dyspnea, cool extremities and dizziness with ambulation. Lab results reveal low hemoglobin and hematocrit levels. Based on the assessment data, what nursing diagnosis is most appropriate?
Ineffective tissue perfusion related to inadequate hemoglobin and hematocrit
A pt with severe anemia is complaining of the following symptoms: tachycardia, palpitations, exertional dyspnea, cool extremities, and dizziness with ambulation. Lab results reveal low hemoglobin and hematocrit levels. based on assessment data, which of the following nursing diagnoses is most appropriate for this patient?
Ineffective tissue perfusion related to inadequate hemoglobin and hematocrit
During the review of morning lab values on a pt complaining of severe fatigue and a red, swollen tongue, the nurse suspects chronic, severe iron deficiency anemia based on which of the following findings?
Low ferritin level
What term refers to a WBC involved in immune response?
Lymphocyte
The nurse is assessing apt who comes to the clinic of complaining of feeling constantly tired and very weak. The pt also has a very sore tongue, and upon observing the patient's oral cavity, the nurse notices the tongue is beefy red. What type of anemia does the nurse know these symptoms indicate?
Megaloblastic anemia
Vitamin B and folic acid deficiencies are characterized by production of abnormally large erythrocytes called...
Megaloblasts
What's the most common cause of iron-deficiency anemia in premenopausal women?
Menorrhagia
A nursing instructor is evaluating a student caring for a neutropenic pt. The instructor concludes that the nursing student demonstrates accurate knowldge of neutropenia based on which of the following interventions?
Monitoring the pt's temp and revieing hte pr's CBC with differential
Which cell of haematopoiesis is responsible for the production of RBCs and platelets?
Myeoloid stem cell
A client with a diagnosis of pernicious anemia comes to the clinic complaining of numbness and tingling in his arms and legs. What do these symptoms indicate?
Neuro involvement
A client with a diagnosis of pernicious anemia comes to the clinic complaining of numbness and tingling in their arms and legs. What do these symptoms indicate?
Neurological involvement
A client with multiple myeloma is complaining of severe pain when the nurse comes in to give a bath and change position. What is the priority intervention by the nurse?
Obtain the pain medication and delay the bath and position change until the meds reached its peak
A client diagnosed with systemic lupus erythematosus comes to the ED with severe back pain. She reports that she first felt pain after manually opening her garage door and that she is taking prednisone daily. What AE's of long-term corticosteroid therapy is most likely responsible for the pain?
Osteoporosis
While monitoring a client for the development of DIC, the nurse should take note of what assessment parameter?
Platelet count, prothrombin time, and partial thromboplastin time
A client at the clinic has just been diagnosed with iron deficiency anemia. What would you recommend the client consume to promote the absorption of iron?
Risk sources of vitamin C
Jeremiah, a 10-yr old boy with hemophilia, is a pt on the pediatric unit where you practice nursing. Jeremiah was admitted to your floor via the ED after sustaining an injury whil eplaying outdoors with friends. Initially, he presents with severe bleeding but has since stabilized. What interventions will the nurse include in teh care plan?
Support painful joints on pillows, encourage the client to use a soft toothbrush and rinse the mouth with warm water b/w and after meals, eliminate aspirin and NSAIDS
After receiving chemotherapy for lung cancer, a client's platelt count falls to 98,000/mm3. What term should the nurse use to describe this low platelet count?
Thrombocytopenia
The pediatric Nurse practitioner is doing a physical exam of a client with sickle cell anemia. Why would the nurse practitioner auscultate the lungs and heart?
To detect the abnormal sounds suggestive of acute chest syndrome and heart failure
A nurse on a hematology/oncology floor is caring for a client with aplastic anemia. Which of the following would not be included in the client's discharge instructions?
Use a disposable razor when shaving
A nurse is caring for a client with thrombocytopenia. What is the best way to protect the client?
Use the smallest needle possible for injections
What vitamin enhances teh absorption of iron?
Vitamin C
During preparation for bowel surgery, a client receives an antibiotic to reduce intestinal bacteria. The nurse knows that hypoprothrombinemia may occur as a result of antibiotic therapy interfering with synthesis of which vitamin?
Vitamin K
What's the antidote for coumadin?
Vitamin K
A client is hospitalized 3 days prior to a total hip arthroplasty and reports a high level of pain with ambulation. The client has been taking warfarin at home, which is now discontinued. To prevent the formation of blood clots, it is important for the nurse to...
administer the prescribed enoxaparin (lovenox)
Which of the following is the most common hematologic condition affecting elderly pt's?
anemia
A client has been diagnosed with myelodyplastic sydnrome with an absolute neutrophil count less than 1000/mm3 and being admitted to the hospital. The nurse...
assigns the client a private room
A nurse practitioner provides nutritional information for a pt diagnosed with an iron-deficiency anemia. What's the best advice?
increase the intake of green, leafy greens
A pt with sickle cell anemia has...
low hematocrit
Vitamin B and folic acid deficiencies are characterized by production of abnormally large erythrocytes called...
megaloblasts
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 should be taken?
observe stools for blood (Go is most common cause of blood loss)
A client is being admitted to the hospital with abdominal pain, anemia, and bloody stools. He complains of being dizzy and feeling weak. He has rectal pressure and needs to urinate and move his bowels. the nurse should help him..
onto a bedpan
What's the most obvious sign of anemia?
pallor
A pregnant woman is hospitalized as the result of sickle-cell crisis. A finsing that indicates teh outcome has been achieved for the client, is that the client...
reports joint pain less than 3 on a scale of 0-10
