med surge 31

A 79-year-old client has been diagnosed with pernicious anemia. In your client education, as his nurse, you emphasize the importance of lifelong intramuscular administration of which of the following? a) Folic acid b) Vitamin B c) Vitamin C d) Vitamin A

vitamin b

A 36-year-old African-American client has a history of sickle-cell anemia with several sickle cell crises over the past 10 years. What blood component results in sickle cell anemia? a) Hemoglobin S b) Hemoglobin F c) Hemoglobin A d) Hemoglobin M

a

A patient is admitted to the hospital with pernicious anemia. What possible complications would the nurse caring for this patient know to monitor for? a) Confusion b) Ascites c) Peripheral edema d) Pulmonary edema

a

A patient with sickle cell anemia has a a) low hematocrit. b) normal blood smear. c) high hematocrit. d) normal hematocrit.

a

An 82-year-old client has pernicious anemia and has been receiving treatment for several years. What is she lacking that results in pernicious anemia? a) Intrinsic factor b) Hemoglobin c) Extrinsic factor d) Vitamin B

a

A client with anemia has been admitted to the medical-surgical unit. Which assessment findings are characteristic of iron deficiency anemia? a) Itching, rash, and jaundice b) Dyspnea, tachycardia, and pallor c) Nausea, vomiting, and anorexia d) Nights sweats, weight loss, and diarrhea

b

An 82-year-old client has pernicious anemia and has been receiving treatment for several years. Which symptom may be confused with another condition in older adults? a) Ataxia b) Dementia c) Glossitis d) Stomatitis

b

You are triaging patients in the walk-in clinic. A 77-year-old man comes in complaining of fatigue and back pain. What should be closely evaluated in this patient? a) Non-Hodgkin's lymphoma b) Multiple myeloma c) Hodgkin's disease d) Acute thrombocythemia

b

A pregnant woman is hospitalized as the result of sickle-cell crisis. A finding that indicates the outcome has been achieved for this client is that the client a) Exhibits a temperature less than 100.3°F b) Describes the importance of staying cool c) Reports joint pain less than 3 on a scale of 0 to 10 d) Takes hydroxyurea (Hydrea) during her pregnancy

c

Which of the following nursing interventions should be incorporated into the plan of care to manage the delayed clotting process in a patient with leukemia? a) Eliminate direct contact with others who are infectious. b) Monitor temperature at least once per shift. c) Implement neutropenic precautions. d) Apply prolonged pressure to needle sites or other sources of external bleeding.

d

A patient with advanced leukemia is responding poorly to treatment. You find the patient tearful and trying to express his feelings, but he is having difficulty. What would be your first nursing action? a) Tell him that you'll leave for now but you'll be back. b) Offer to call pastoral care. c) Ask if he would like you to sit with him while he collects his thoughts. d) Tell him that you can understand how he's feeling.

c

A client is prescribed 325 mg/day of oral ferrous sulfate. The nurse includes in client teaching, "Take your iron pill a) and decrease fruits and juices in your diet" b) with dairy products" c) 1 hour before breakfast" d) along with a decreased amount of dietary fiber"

c

A nurse is caring for a client with the following laboratory values: white blood cell count (WBC) 4,500/mm3, neutrophils 15%, and bands 1%. Based on the client's absolute neutrophil count (ANC), what is the client's risk of infection? a) High risk b) No increased risk c) Risk d) Almost certain risk

c

A patient has come to the OB/GYN clinic with complaints of a heavy menstrual flow. The nurse knows that red blood cell production will be increased in the patient's body. Because of this, the nurse is aware that the patient may need to increase her daily intake of what? a) Magnesium b) Vitamin C c) Iron d) Vitamin D

c

The nurse is providing education to a patient with iron deficiency anemia who has been prescribed iron supplements. What will the nurse include in her teaching? a) Take the iron with dairy products to enhance absorption. b) Limit foods high in fiber due to the risk for diarrhea. c) Increase the intake of vitamin E to enhance absorption. d) Iron will cause the stools to darken in color.

d

A 67-year-old client at the free clinic where you practice nursing has a history of seizures and presents with severe fatigue, frequent headaches, and a sore, beefy-red tongue. Which of the following could be causing her current condition? Choose all correct options. a) Lack of vitamin B b) Lack of meat consumption c) Alcoholism d) Intestinal disorders

c d

A client is receiving chemotherapy for cancer. The nurse reviews the client's laboratory report and notes that he has thrombocytopenia. To which nursing diagnosis should the nurse give the highest priority? a) Impaired oral mucous membranes b) Activity intolerance c) Impaired tissue integrity d) Ineffective tissue perfusion: Cerebral, cardiopulmonary, GI

d

A client reports feeling tired, cold, and short of breath at times. Your assessment reveals tachycardia and reduced energy. What would you expect the physician to order? a) Antibiotic b) Chest radiograph c) ECG d) CBC

d

A hematocrit greater than which percentage is associated with spontaneous clotting? a) 40% b) 30% c) 50% d) 60%

d

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? a) Leukopenia b) Neutropenia c) Anemia d) Thrombocytopenia

d

The nurse on the pediatric unit is caring for a 10-year-old boy with a diagnosis of hemophilia. The nurse knows that a priority nursing diagnosis for a patient with hemophilia is what? a) Self-image b) Coping c) Nutrition d) Infection

self image

A critical care nurse is caring for a patient with autoimmune hemolytic anemia. The patient is not responding to conservative treatments, and his condition is now becoming life threatening. The nurse is aware that a treatment option in this case may include what? a) Hepatectomy b) Splenectomy c) Platelet transfusion d) Vitamin K administration

splenectomy

Which of the following are assessment findings associated with thrombocytopenia? Select all that apply. a) Bradypnea b) Hypertension c) Bleeding gums d) Hematemesis e) Epistaxi

• Bleeding gums • Epistaxis • Hematemesis

A client being treated for iron deficiency anemia with ferrous sulfate (Ferasol) continues to be anemic despite treatment. The nurse should assess the client for use of which medication? a) Aluminum hydroxide (Maalox) b) Prednisone (Deltasone) c) Tegretol (Carbamazepine) d) Amoxicillin (Amoxil)

a

A young male client is diagnosed with a mild form of hemophilia. He is experiencing bleeding in the joints with pain. In preparing the client for discharge, the nurse educates the client to a) Wear a medical identification bracelet. b) Take ibuprofen (Motrin) for joint pain. c) Take warm baths to lessen pain. d) Undergo genetic testing and counseling.

a

Of the following types of haemolytic anaemia, which is categorised as inherited disorder? a) Sickle cell anaemia b) Autoimmune haemolytic anaemia c) Cold agglutinin disease d) Hypersplenism

a

Which is the following is the most obvious sign of anaemia? a) Pallor b) Tachycardia c) Flow murmurs d) Jaundice

a

Which of the following describes a red blood cell (RBC) that has pale or lighter cellular contents? a) Hypochromic b) Normocytic c) Microcytic d) Hyperchromic

a

Which of the following terms refers to a form of white blood cell involved in immune response? a) Lymphocyte b) Spherocyte c) Thrombocyte d) Granulocyte

a

A nursing student is caring for a patient with acute myeloid leukemia who is preparing to undergo induction therapy. In preparing a plan of care for this patient, the student should assign the highest priority to which nursing diagnoses? a) Activity intolerance b) Risk for infection c) Disturbed processes d) Risk for spiritual distress

b

A patient comes to the clinic complaining of fatigue and pica. Laboratory findings reveal a low serum iron level and a low ferritin level. What would the nurse suspect that the patient will be diagnosed with? a) Hemolytic anemia b) Iron deficiency anemia c) Pernicious anemia d) Sickle cell anemia

b

The nursing instructor is talking with the students about the care of a patient with multiple myeloma who is experiencing bone destruction. What would the instructor tell the students the patient should be assessed for signs of? a) Hyperproteinemia b) Hypercalcemia c) Elevated RBC count d) Elevated serum viscosity

b

The term that is used to refer to a primitive cell, capable of self-replication and differentiation, is a a) spherocyte. b) stem cell. c) band cell. d) reticulocyte.

b

A student nurse is caring for a patient who is receiving chemotherapy for cancer. The student nurse reviews the laboratory data with his preceptor and notes that the patient has thrombocytopenia. Which nursing diagnosis should the nurse give the highest priority? a) Impaired oral mucous membranes b) Activity intolerance c) Ineffective tissue perfusion (cerebral, cardiopulmonary, GI) d) Impaired tissue integrity

c

Ralph Meander, an 80-year-old retired chemist, has been diagnosed with Cooley's anemia, a severe form of beta-thalassemia. Which of the following is a symptom of Cooley's anemia? a) Inflammation of the mouth b) Dyspnea c) Bronzing of the skin d) Inflammation of the tongue

c

Which nursing diagnosis should a nurse expect to see in a care plan for a client in sickle cell crisis? a) Impaired skin integrity related to pruritus b) Imbalanced nutrition: Less than body requirements related to poor intake c) Acute pain related to sickle cell crisis d) Disturbed sleep pattern related to external stimuli

c

You are the nurse assessing a patient with multiple myeloma. What should you keep in mind that patients with multiple myeloma are at risk for? a) Chronic liver failure. b) Hypoxemia. c) Pathologic bone fractures. d) Acute heart failure.

c

Your cousin from Denver, who has been visiting for several months, seeks treatment due to her increased fatigue, pruritis, and dizziness. Most disturbingly, her face and lips have taken on a reddish-purple tone. What could have contributed to her condition? a) What she drinks b) Medicines she consumes c) Where she lives d) What she eats

c

A young female client has pale nailbeds. Her hemoglobin count is 10.2 gm/dL and her hematocrit count is 30%. She reports fatigue and states, "I'm tired all the time." The client also reports excessive menstrual flow. The nurse assesses further and determines the client's diet is balanced and provides adequate calories. The client is prescribed supplemental iron therapy. The highest nursing diagnosis is a) Fatigue related to diminished oxygen-carrying capacity of the blood b) Deficient knowledge related to new information with no previous experience c) Altered nutrition: less than body requirements, related to inadequate intake of nutrients d) Altered tissue perfusion related to diminished oxygen-carrying capacity of the blood

d

The nurse is talking with the parents of a toddler who was diagnosed with hemophilia A. The nurse teaches the parents a) The importance of administering over-the-counter preparations for a cold b) To allow the toddler to participate in playground activities with other toddlers c) That nasal packing will be necessary for any nose bleeds d) How to administer factor VIII intravenously at the first sign of bleeding

d

Which cell of haematopoiesis is responsible for the production of red blood cells (RBCs) and platelets? a) Lymphoid stem cell b) Monocyte c) Neutrophil d) Myeloid stem cell

d

You are the nurse caring for a patient with acute leukemia. What would you do to assess the risk for infection? a) Monitor creatinine levels b) Monitor hepatic function tests c) Monitor electrolyte levels d) Monitor WBC count

d

A young mother with a 2 year old and a 6 month old is experiencing fatigue related to anaemia. The client states that she is having difficulty performing the activities needed for her job, family, and home. The nurse assists the client to a) Prioritise and balance activities and rest. b) Find a babysitter to take care of her children. c) Request a leave of absence from her job. d) Obtain assistance from someone to help with cleaning in the home.

a

Richard Brooks, a 36-year-old male who is African-American is a client at the primary care group where you practice nursing. Mr. Brooks has a history of sickle cell anemia with several sickle cell crises over the past ten years. While it is a genetic disorder, it is found primarily in African Americans. How many African Americans does it affect in the United States? a) 1 in 600 b) 1 in 750 c) 1 in 1,000 d) 1 in 900

a

Vitamin B and folic acid deficiencies are characterised by production of abnormally large erythrocytes called a) megaloblasts. b) monocytes. c) blast cells. d) mast cells.

a

When assessing a female patient with a disorder of the hematopoietic or the lymphatic system, which of the following assessments is most essential? a) Lifestyle assessments, such as exercise routines b) Health history, such as bleeding, fatigue, or fainting c) Menstrual history d) Age and gender

b

Which of the following is the most common haematologic condition affecting elderly patients a) Thrombocytopenia b) Anaemia c) Leukopenia d) Bandaemia

b

The couple with the lowest risk of having a child with sickle cell anemia disease is the one in which the: a) father is HbS and the mother is HbAS. b) father is HbA and the mother is HbS. c) father is HbAS and the mother is HbAS. d) father is HbS and the mother is HbS.

c

A patient newly diagnosed with thrombocytopenia is admitted to your unit. After the admission assessment, the patient asks you to explain the disease to her. What would you explain to the patient about this condition? a) There could be elevated platelet production. b) There could be decreased white blood cell production. c) There could be an attack on the platelets by the antibodies. d) There could be decreased production of platelets.

d

he home health nurse is caring for a patient with multiple myeloma. What does the nurse know is a priority issue to be managed in a patient with multiple myeloma? a) Nutrition b) Coping c) Stress d) Pain

d