nursing 6 unit 5 Brunner Med surg (CH 33 - Patients With Nonmalignant Hematologic Disorders)

a. The onset of a bacterial infection

15. 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? a. The onset of a bacterial infection b. Bleeding c. Abdominal pain d. Diarrhea

a. Iron deficiency anemia

2. The nurse observes a co-worker who always seems to be eating a cup of ice. The nurse encourages the co-worker to have an examination and diagnostic workup with the physician. What type of anemia is the nurse concerned the co-worker may have? a. Iron deficiency anemia b. Megaloblastic anemia c. Sickle cell anemia d. Aplastic anemia

c. B12

5. A patient describes numbness in the arms and hands with a tingling sensation. The patient also frequently stumbles when walking. What vitamin deficiency does the nurse determine may cause some of these symptoms? a. Thiamine b. Folate c. B12 d. Iron

d. Creatinine level of 6 mg/100 mL

7. A patient with end-stage kidney disease (ESKD) has developed anemia. What laboratory finding does the nurse understand to be significant in this stage of anemia? a. Potassium level of 5.2 mEq/L b. Magnesium level of 2.5 mg/dL c. Calcium level of 9.4 mg/dL d. Creatinine level of 6 mg/100 mL

c. Hemoglobin level

8. A patient with ESRD is taking recombinant erythropoietin for the treatment of anemia. What laboratory study does the nurse understand will have to be assessed at least monthly related to this medication? a. Potassium level b. Creatinine level c. Hemoglobin level d. Folate levels

a. A 14-year-old African American boy

11. Which patient does the nurse recognize as being most likely to be affected by sickle cell disease? a. A 14-year-old African American boy b. A 26-year-old Eastern European Jewish woman c. An 18-year-old Chinese woman d. A 28-year-old Israeli man

c. Start an intravenous line with dextrose 5% in 0.24 normal saline

14. A patient with sickle cell disease comes to the emergency department complaining of severe pain in the back, right hip, and right arm. What intervention is important for the nurse to provide? a. Administer aspirin b. Administer ibuprofen c. Start an intravenous line with dextrose 5% in 0.24 normal saline d. Begin oxygen at 2 L/M

c. It may indicate deficiencies in essential nutrients.

3. The nurse is performing an assessment for a client with anemia admitted to the hospital to have blood transfusions administered. Why would the nurse need to include a nutritional assessment for this patient? a. It is part of the required assessment information. b. It is important for the nurse to determine what type of foods the patient will eat. c. It may indicate deficiencies in essential nutrients. d. It will determine what type of anemia the patient has.

a. Fewer painful episodes of sickle cell crisis b. Lower incidence of acute chest syndrome c. Decreased need for blood transfusions

13. A patient with sickle cell anemia is to begin treatment for the disease with hydroxyurea (Hydrea). What does the nurse inform the patient will be the benefits of treatment with this medication? (Select all that apply.) a. Fewer painful episodes of sickle cell crisis b. Lower incidence of acute chest syndrome c. Decreased need for blood transfusions d. Decreased need for other analgesic medications e. Ability to reverse the damage done from sickling of cells

c. Megaloblastic anemia

4. The nurse is assessing a patient who is a strict vegetarian. What type of anemia is the nurse aware that this patient is at risk for? a. Iron deficiency anemia b. Aplastic anemia c. Megaloblastic anemia d. Sickle cell anemia

a. Eating calf's liver with a glass of orange juice

6. The nurse is educating a patient with iron deficiency anemia about food sources high in iron and how to enhance the absorption of iron when eating these foods. What can the nurse inform the client would enhance the absorption? a. Eating calf's liver with a glass of orange juice b. Eating leafy green vegetables with a glass of water c. Eating apple slices with carrots d. Eating a steak with mushrooms

d. Pernicious anemia

9. A patient had gastric bypass surgery 3 years ago and now, experiencing fatigue, visits the clinic to determine the cause. The patient takes pantoprazole (Protonix) for the treatment of frequent heartburn. What type of anemia is this patient at risk for? a. Aplastic anemia b. Iron deficiency anemia c. Sickle cell anemia d. Pernicious anemia

b. Megaloblastic anemia

1. The nurse is assessing a patient who comes to the clinic complaining of feeling constantly tired and very weak. The patient 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? a. Iron deficiency anemia b. Megaloblastic anemia c. Sickle cell anemia d. Aplastic anemia

b. Schilling test

10. The nurse is preparing the patient for a test to determine the cause of vitamin B12 deficiency. The patient will receive a small oral dose of radioactive vitamin B12 followed by a large parenteral dose of nonradioactive dose of B12. What test is the patient being prepared for? a. Bone marrow aspiration b. Schilling test c. Bone marrow biopsy d. Magnetic resonance imaging (MRI) study

b. Acute chest syndrome

12. A patient with sickle cell disease is brought to the emergency department by a parent. The patient has a fever of 101.6°F, heart rate of 116, and a respiratory rate of 32. The nurse auscultates bilateral wheezes in both lung fields. What does the nurse suspect this patient is experiencing? a. Pneumocystis pneumonia b. Acute chest syndrome c. An exacerbation of asthma d. Pulmonary edema