Hematology/Immunity ATI Quiz Bank

What's the therapeutic use for Factor VIII?

Hemophilia A

A nurse is caring for a client who has acute lymphocytic leukemia and reports fever, chills, fatigue, and pallor over the past week. When checking the clients lab results, which of the following values should the nurse identify as contributing to the clients fatigue and pallor?

Hgb 6.5g/dL

A nurse is assessing a client who has DVT in her left calf. Which manifestation should the nurse expect to find? SATA

Hardening along the blood vessels Tenderness in the calf Increase leg circumference

A nurse is monitoring a newly licensed nurse who is caring for a client. The client has active pulmonary TB, was placed on airborne precautions, and is scheduled for a chest X-ray. The nurse should instruct the newly licensed nurse to take which following actions?

Have the client wear a surgical mask

A nurse is providing teaching to a client who has a diagnosis of Hep A. Which statement by the client indicates an understanding of the teaching?

I should stop eating raw clams

A nurse is caring for a male client who reports a thick urethral discharge. Which actions should the nurse take?

Obtain a urethral specimen for culture

A nurse is teaching a client who has AIDS about the transmission of Pneumocystis jirveci pneumonia (PCP). Which of the following pieces of info should the nurse include in the teaching?

PCP results from an impaired immune system

A client is about to start Warfarin to prevent venous thrombosis. You should explain to the client that taking this drug initially requires daily blood samples to monitor what lab?

PT/INR

A nurse is transfusing a unit of B-positive fresh frozen plasma to a client who is type o- . Which of the following actions should the nurse take?

Remove the unit of plasma immediately an start IV infusion of normal saline solution

A nurse is reviewing the laboratory results for a client who reports bilateral pain and swelling in her fingers and joints, with stiffness in the morning. The nurse should recognize that an increase in which of the following laboratory values can indicate arthritis?

Rheumatoid factor

A nurse is teaching a client who has polycythemia Vera about self-care measures. Which of the following should the nurse include?

"Elevate your legs while sitting"

A nurse is teaching a client who has anemia and a new prescription for epoetin alfa . Which of the following pieces of info should the nurse include in the teaching?

"Hypertension is a common adverse effect of this medication"

A nurse in a providers office is teaching a client with a recent diagnosis of RA who has a new prescription for naproxen. Which of the following statements by the client indicates that further teaching is needed?

"I can take aspirin with my medication "

A nurse providing discharge teachings to a client who has aplastic anemia. Which of the following statements indicates that the client understands the instructions?

"I should eliminate uncooked food from my diet for now"

A nurse is providing discharge teaching to a client who has a new diagnosis of systemic lupus (SLE) Which of the following statements by the client indicates an understanding of the teaching?

"I will need to take Methotrexate, even is I'm in remission "

A nurse is providing teaching to a client who had a bone marrow transplant an has thrombocytopenia. Which statement indicates that the client understands the precautions he must take at home?

"I'll stick with soft foods for now"

A nurse is providing discharge teachings to a client who has acquired immune deficiency syndrome (AIDS) Which of the following statements by the clients partner indicates a need for further teaching?

"Ill clean up blood spills immediately with hot water"

A nurse is caring for a client who is HIV positive. The client ask the nurse, " Should I tell my partner that I'm positive?" What statement should the nurse provide?

"It sounds like you are unsure what to say to your partner"

A nurse is planning discharge teachings to a client who has systemic lupus. Which of the following instructions should the nurse include?

"Monitor your body temperature and report any elevations promptly

A nurse is providing discharge teaching to a client who has sickle cell crisis. Which of the following statements indicates that the client understands the instructions?

"Physical activity is good for me, but i need to avoid overexertion" Rationale: Clients should avoid high altitudes and be encouraged to drink 3 to 4 liters of fluids per day

A nurse is preparing a client for a bone-marrow biopsy. Which of the following pieces of information should the nurse include in PREOPERATIVE teaching?

"You will feel a tugging, pulling sensation when the doctor withdraws the marrow"

A nurse is caring for a client who is undergoing conservative treatment for DVT. The client asks the nurse what will to the clot. Which response should the nurse make?

"Your body has a process called fibronolysis that will eventually dissolve the clot"

A client is about to start taking clopidogrel to prevent transient ischemic attacks. You should instruct the client to watch for and report which of the following adverse effects of this drug? SATA A: petechiae B: tinnitus C: diaphoresis D: weakness E: vision changes

A, D, E which would indicate bleeding

You should monitor a client throughout continuous heparin therapy for which of the following adverse reactions? SATA A: thrombocytopenia B: hypotension C: hypokalemia D: DVT E: fever

A,B,D,E

You are caring for a client who is receiving alteplase to dissolve a thrombus. Which of the following should you include in your care plan for this client? SATA A:Monitor temperature B:Reposition frequently C:Limit veinipunctures D:Assess neurologic status E:Apply pressure to oozing sites

A,C,D,E

A nurse is caring for a patient who has thrombocytopenia and developed epitaxis. What action should the nurse take?

Apply lateral pressure to the clients nose for 10 mins

A nurse is caring for a client who has systemic lupus erythematosus (SLE) and is concerned about skin lesions on her face an neck. The client ask the nurse, "what should I do about these spots?" Which of the following responses should the nurse give?

Apply moisturizer after bathing the lesions with warm water

You are reviewing the history of a client who is about to start therapy with factor VIII to treat hemophilia A. Which of the following drugs the client takes should alert you to take further action?

Aspirin

A nurse in a clinic assessing a client who was diagnosed with mononucleosis 2 weeks ago. Which of the following should the nurse report to the provider immediately?

Abdominal pain in the left upper quadrant

A nurse is assessing the hematologist system of an older adult client. The nurse should report which of the following findings to the provider as a possible indication of a hematologist disorder?

Absence of hair on the legs

A nurse is caring for a client who has an upper GI bleed and a hematocrit of 24%. Prior to initiating a transfusion of packed RBCs, which of the following actions should the nurse take? SATA

Assess and document the clients vital signs Verify blood type and Rh factor with another nurse Change IV tubing to a set that has a filter

A nurse is planning care for a client who has acute myelogenous leukemia and a platelet count of 48,000/mm^3. Which of the following intervention should the nurse include?

Avoid IM injections

A nurse in a providers office is reviewing the medical records of a group of clients. Which of the following clients are at risk for iron deficiency? SATA A: A client who is post menopausal B: A client who is a vegetarian C: A middle adult male client D: A client who is pregnant E: A toddler who is overweight

B, D, E

A nurse is performing a preoperative assessment of a client about to undergo a cholecystectomy. The nurse should identify a risk of latex allergy when a client reports an allergy to which of the following foods?

Bananas Rationale: other cross reactive foods include pineapple, avocado, mangoes, kiwi, passion fruit and chestnuts. The healthcare team should wear only non latex gloves when caring for this client

A nurse is caring for a client who is suspected to have TB. Which findings should the nurse expect to find?

Blood-streaked sputum

A home health nurse is planning care for a client who is receiving chemotherapy and has neutropenia. Which of the following food should the nurse include in the clients plan of care?

Baked chicken

A client is about to start taking oprelvekin for thrombocytopenia. To assess for adverse effects of this drug, you should monitor which of the following carefully during therapy? A: liver function B: hearing C: ECG D: Level of consciousness

C Rationale: Oprelvekin, a thrombopoietic growth factor can cause cardiac dysrhythmias, such as a-fib, tachycardia, palpitations, dizziness, an rapid pulse

A nurse is planning care for a client who has thrombocytopenia. Which of the following interventions should the nurse include?

Measure the clients abdominal girth daily

What's the therapeutic use for Folic Acid?

Megaloblastic anemia

A nurse is preparing to administer packed RBCs to a client who is anemic. Which of the following actions should the nurse take? SATA

Check to determine the packed RBCs are a week or less old Ask another nurse to verify Prime the transfusion tubing with 0.9% sodium chloride

What's the therapeutic use for Filgrastim"?

Chronic neutropenia

A nurse is planning care for a client who has acute systemic lupus erythematosus (SLE) and is scheduled to begin treatment for systemic manifestations. Which of the following medications should the nurse plan to administer?

Corticosteroids

A nurse is caring for a client who has peripheral vascular disease (PVD) and ulcers on the toes. Which of the following findings of pvd is a risk factor for ulceration of the extremities? A: insufficiency of skin care B: dehydratration C: immobility D: impaired circulation

D impaired circulation

A nurse is reviewing the lab results for a client with end stage renal disease and reports fatigue. The clients hemoglobin is 8g/dL. The nurse should expect a prescription for what medication?

Erythropoietin

What's the therapeutic use for Heparin?

DVT

A nurse is reviewing the laboratory findings of a client who has protein-calorie malnutrition. Which of the following findings should the nurse expect?

Decreased albumin

Alteplase pharmacological action?

Dissolves blood clots

A nurse in a clinic is assessing the lower extremities and ankles of a client who has a history of peripheral artery disease. Which finding would the nurse expect?

Dry, pale skin, with minimal body hair

A nurse is teaching a client who has pernicious anemia. The nurse should encourage the client to increase consumption of what food?

Eggs

A nurse is caring for a client who has femoral thrombophlebitis and a prescription for enoxaparin. Which action does the nurse take?

Elevate the effected leg

A nurse is planning care for a client during a sickle cell crisis. Which intervention should the nurse include in the clients plan of care?

Encourage increased fluid intake

A nurse is caring for a client who is 2 days post operative. Which of the following findings indicate that the client is developing an infection?

Erythema at the incision site

A nurse is reviewing the lab results of a client who reports manifestations suggesting systemic lupus erythematosus. The nurse should expect an increase in which of the following parameters for a client who has SLE?

Erythrocyte sedimentation rate (ESR)

A nurse is teaching a client who was recently diagnosed with Raynaud's disease about preventing the onset of manifestations. Which statement by client indicates an understanding?

I will not smoke

A nurse is caring for a client who underwent radioallergosorbent (RAST) testing due to seasonal allergies. The nurse should anticipate an elevation in which of the following immunoglobulin lab values?

IgE Rationale: RAST testing involves measuring the quantity of IgE present in serum after exposure to specific antigens selected on a basis of the clients symptom history. An elevated IgE indicates a positive response an is common among clients who have a history of allergic manifestations, anaphylaxis an asthma. An elevated IgM is associated with bacterial or viral infections An elevated IgA is associated with autoimmune disease and chronic infections An elevated IgG indicates the production of antibodies to all types of infections, especially blood-borne and tissue infections

A nurse is teaching a client about the manifestation of an allergic reaction. The release of histamine causes which of the following reaction?

Increase mucous secretion

Patients taking prednisone should be monitored for what adverse effect?

Infection and hyperglycemia

Clopidogrel pharmacological action?

Inhibits platelet aggregation

A nurse is planning care for a client who has pernicious anemia. Which of the following intervention should the nurse include in the patients plan?

Initiate weekly b12 injections

A nurse is teaching a client who has iron-deficiency anemia. The nurse should encourage the client to increase consumption of what food?

Lentils

A nurse is assessing a client 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?

Low back pain Rationale: other findings include tachycardia, headache,chest pain, tachypnea, and dark urine

A nurse is assessing a client who has pernicious anemia. Which of the following findings should the nurse expect?

Paresthesias of the hands and feet

A nurse is assessing a client for manifestations of aplastic anemia . Which of the following findings should the nurse expect?

Petechiae and ecchymosis Rationale: a client with aplastic anemia will also have manifestations of dyspnea on exertion. All 3 blood major components (RBC, WBC, and platelets) are reduced or absent. Which is known as pancytopenia

A nurse is caring for a client who is postoperative following a vein ligation and stripping for varicose veins. Which of the following actions should the nurse take?

Position the client in supine position with legs elevated

A client is about to start taking cyanocobalamin, a Vit B12 preparation. You understand that this drug treats what type of anemia?

Prenicious

A nurse is caring for a client who has hemophilia. The client reports pain an swelling in the joint following an injury. Which of the following actions should the nurse take?

Prepare for replacement of the missing clotting factor

Which drug should you have available in case of a heparin overdose?

Protamine

A nurse is teaching a patient that has Raynauds disease. What piece of information should the nurse include in the teaching?

Protect against the cold by wearing layers of clothing. Rational: Raynauds makes the body prone to attacks during cold weather. Extreme cold can lead to tissue damage.

A nurse is reviewing a client's laboratory results 4 hours after administering fresh frozen plasma (FFP) which of the following laboratory results should the nurse Review?

Prothrombin time

Before administering IV folic acid, you should explain to the client that this drug can cause which of the following adverse effects.

Rash Rationale: can cause rash and irratation at injection site

A nurse is assessing a client who has Karposi sarcoma. Which of the following findings should the nurse expect?

Reddish-purple skin leisons

A nurse is caring for a client who has HIV. Which of the following types of isolation should the nurse implement?

Standard precautions

Epoetin alfa pharmacological action?

Stimulates RBC production

Filgrastim pharmacological action?

Stimulates leukocyte production

A nurse is caring for a client who is receiving IV ampicillin and develops urticaria and dyspnea. Which of the following actions should the nurse take first?

Stop the medication infusion

A nurse is assessing a client who is receiving transfusion of packed RBCs. Which of the following findings should the nurse identify as an indication of an acute intravascular hemolytic reaction?

Sudden oliguria Rationale: This type of transfusion reaction causes acute kidney injury resulting in sudden oliguria and hemoglobinuria

A nurse is preparing to administer a Mantoux skin test to a client. What is the purpose of a Mantoux skin test using purified protein derivative (PPD)

To find out if the client has been infected with Myobacterium TB

A nurse is assessing a client who has an exacerbation of herpes zoster. Which of the following manifestations of the clients skin should the nurse expect?

Unilateral, localized, modular, skin leisons

A nurse is conducting dietary teachings to a client with AIDS. Which instructions should the nurse include in the teaching?

Use a separate cutting board for poultry

A nurse is caring for a client with CDiff who has contact isolation precautions in place. Which action should the nurse take?

Use dedicated equip for the client

A nurse is caring for a client with pernicious anemia. Which of the following findings should identify with this condition?

Vit B12 deficiency

While a client is still receiving continuous IV heparin (enoxaparin), the provider prescribes oral warfarin. This is because?

Warfarin takes 3-5 days to achieve therapeutic effects. Once it provides effective coagulation, with INR of 2 to 3, the provider should discontinue heparin therapy

A nurse is preparing to transfuse a unit of packed red blood cells for a client who has anemia. Which of the following actions should the nurse take first?

Witness the informed consent document

A provider prescribes IV heparin for this client. Which parameters should you monitor for in regard to determining if a therapeutic dose is being administered?

aPTT, 1.5 to 2 times the clients baseline