exam 2
A client with multiple myeloma presents to the emergency department and reports excessive thirst and constipation. Family members report that the client has been confused for the last day. Which laboratory value is most likely responsible for this client's symptoms?
Serum calcium level 13.8 mg/dl
A client's family member asks the nurse why disseminated intravascular coagulation (DIC) occurs. Which statement by the nurse correctly explains the cause of DIC?
"DIC is caused by abnormal activation of the clotting pathway, causing excessive amounts of tiny clots to form inside organs.
The clinic nurse is caring for a client diagnosed with leukopenia. What does the nurse know this client has?
A general reduction in all white blood cells
A few minutes after beginning a blood transfusion, a nurse notes that a client has chills, dyspnea, and urticaria. The nurse reports this to the health care provider immediately because the client probably is experiencing which problem?
A hemolytic allergic reaction caused by an antigen reaction
The nurse is caring for a client with acute myeloid leukemia (AML) with high uric acid levels. What medication does the nurse anticipate administering that will prevent crystallization of uric acid and stone formation?
Allopurinol
Which is a symptom of hemochromatosis
Bronzing of the skin
The nurse cares for a client with iron deficiency anemia. What findings will the nurse expect to find when reviewing the client's CBC results? Select all that apply.
Decreased MCV Decreased reticulocytes
A nurse prepares a client for a bone marrow biopsy who is suspected of having acute myeloid leukemia. What results from the bone marrow biopsy does the nurse expect?
Excess of immature leukocytes
Which of the following are assessment findings associated with thrombocytopenia? Select all that apply.
Hematemesis Epistaxis Bleeding gums
A nurse plans care for a client with multiple myeloma. Using the CRAB acronym for symptoms associated with this disease, which clinical features does the nurse expect to find upon assessment of the client? Select all that apply.
Hypercalcemia Renal insufficiency Anemia Bone lesion
During a routine assessment of a patient diagnosed with anemia, the nurse observes the patient's beefy red tongue. The nurse is aware that this is a sign of what kind of anemia?
Megaloblastic
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?
Neurologic involvement
A nurse is caring for a client admitted with pernicious anemia. Which set of findings should the nurse expect when assessing the client?
Pallor, tachycardia, and a sore tongue
Which term refers to an abnormal decrease in white blood cells, red blood cells, and platelets?
Pancytopenia
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?
Rich sources of vitamin C
Which term refers to an injury to ligaments and other soft tissues surrounding a joint?
Sprain
A patient is taking prednisone 60 mg per day for the treatment of an acute exacerbation of Crohn's disease. The patient has developed lymphopenia with a lymphocyte count of less than 1,500 mm3. What should the nurse monitor the client for?
The onset of a bacterial infection
After receiving chemotherapy for lung cancer, a client's platelet count falls to 98,000/mm3. What term should the nurse use to describe this low platelet count?
Thrombocytopenia
The most common cause of iron deficiency anemia in men and postmenopausal women is
bleeding.
A fracture is considered pathologic when it
occurs through an area of diseased bone.
The nurse is discussing disorders of the hematopoietic system when a client asked about erythrocytosis. What disease will the nurse mention with a primary characteristic of erythrocytosis?
polycythemia vera
The nurse is performing an assessment on a patient with acute myeloid leukemia (AML) and observes multiple areas of ecchymosis and petechiae. What laboratory study should the nurse be concerned about?
Platelet count of 9,000/mm3
A client with polycythemia vera reports gouty arthritis symptoms in the toes and fingers. What is the nurse's best understanding of the pathophysiological reason for this symptom?
The dead red blood cells release excess uric acid.
The nurse is assessing a client admitted with a deep vein thrombosis with an elevated red blood cell count. The admitting diagnosis is polycythemia vera. What is the hallmark clinical sign of PV
splenomegaly
A client has been diagnosed with a muscle strain. What does the physician mean with the term "strain"?
stretched or pulled beyond its capacity
The nurse is caring for a client with type 2 diabetes who take metformin to manage glucose levels. The nurse recognizes the client may be most at risk for which vitamin deficiency?
B12
A nurse cares for a client with early Hodgkin lymphoma. While assessing the client, the nurse will most likely find painless enlargement of which lymph node
Cervical
A client with multiple myeloma reports pain along the spinal column. The client is prescribed naproxen (Aleve) and oxycodone. Prior to administering these medications, the nurse
Checks the client's BUN and creatinine
The nurse is teaching a client about the development of leukemia. What statement should be included in the teaching plan?
Chronic leukemia develops slowly."
A client sustains a fractured right humerus in an automobile accident. The arm is edematous, the client states that he cannot feel or move his fingers, and the nurse does not feel a pulse. What condition should the nurse be concerned about that requires emergency measures?
Compartment syndrome
A client with arterial insufficiency undergoes below-knee amputation of the right leg. Which action should the nurse include in the postoperative care plan?
Elevating the stump for the first 24 hours
A nurse is assigned to support a patient while a cast is being applied to treat a greenstick fracture. The nurse documents that this fracture is classified as what type of fracture?
Incomplete
A patient with AML is having aggressive chemotherapy to attempt to achieve remission. The patient is aware that hospitalization will be necessary for several weeks. What type of therapy will the nurse explain that the patient will receive?
Induction therapy
A nurse cares for a client with aplastic anemia. Which laboratory results will the nurse expect to find with this client? Select all that apply.
Neutrophil count 12,000/microliter Hemoglobin 7 g/dL Platelets 35,000 microliters
A client diagnosed with systemic lupus erythematosus comes to the emergency department with severe back pain. The client is taking prednisone daily and reported feeling pain after manually opening the garage door. What adverse effect of long-term corticosteroid therapy is most likely responsible for the pain?
Osteoporosis
Clients with multiple myeloma have abnormal plasma cells that proliferate in the bone marrow where they release osteoclast-activating factor, resulting in the formation of osteoclasts. What is the most common complication of the pathology resulting from this process
Pathologic fracture
The hospitalized client is experiencing gastrointestinal bleeding with a platelets at 9,000/mm³. The client is receiving prednisone and azathioprine. What action will the nurse take?
Perform a neurologic assessment with vital signs.
The nurse is assessing a patent with polycythemia vera. What skin assessment data would the nurse determine is a normal finding for this patient?
Ruddy complexion
A client with suspected multiple myeloma is reporting back pain. What is the priority nursing action?
Send the client for a spinal x-ray study.
A client is prescribed 325 mg/day of oral ferrous sulfate. What does the nurse include in client teaching?
Take 1 hour before breakfast
Parents arrive to the clinic with their young child and 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 nurse is caring for a client with thalassemia who is being transfused. What is the nurse's role during a transfusion?
To closely monitor the rate of administration
Which of the following are associated with compartment syndrome? Select all that apply.
Trauma from accidents Surgery Casts Tight bandages Crushing injuries
A nurse is caring for a client with thrombocytopenia. What is the best way to protect this client?
Use the smallest needle possible for injections.
You are caring for a 13-year-old diagnosed with sickle cell anemia. The client asks you what they can do to help prevent sickle cell crisis. What would be an appropriate answer to this client?
Drink at least 8 glasses of water every day.
