Adaptive Quiz #3 (EAQ)

Which client statement demonstrates an understanding of cyanocobalamin (vitamin B12) prescribed for pernicious anemia? A) "I should have a vitamin B12 injection every month" B) "I'll take vitamin B12 supplements every morning with my breakfast" C) "I'll eat a diet high in green vegetables" D) "I will increase my intake of processed foods fortified with vitamin B12"

A) "I should have a vitamin B12 injection every month"

Which action will the nurse take for a client with a suspected pulmonary embolus? Select all that apply. A) Administer oxygen at high flow rates B) Notify the Rapid Response Team C) Lower the head of the client's bed D) Place the client on a cardiac monitor E) Anticipate rapid administration of warfarin

A) Administer oxygen at high flow rates B) Notify the Rapid Response Team D) Place the client on a cardiac monitor

Which diagnosis increases the risk for development of a pulmonary embolism? A) Atrial fibrillation B) Forearm laceration C) Migraine headache D) Respiratory infection

A) Atrial fibrillation

Which nursing action would be included in the plan of care when a client is admitted with thrombocytopenia? Select all that apply A) Avoid intramuscular injections B) Institute neutropenic precautions C) Monitor the white blood cell (WBC) count D) Administer prescribed anticoagulants E) Examine the skin for ecchymotic areas

A) Avoid intramuscular injections E) Examine the skin for ecchymotic areas

Which laboratory test result would the nurse expect to be decreased in a client with iron-deficiency anemia? A) Ferritin level B) Platelet count C) White blood cell count D) Total iron-binding capacity

A) Ferritin level

Which laboratory value would the nurse assess to evaluate response to the medication epoetin? A) Hemoglobin B) Platelet count C) Prothrombin time D) Partial thromboplastin time

A) Hemoglobin

Which laboratory finding would the nurse expect in a toddler with iron-deficiency anemia in addition to decreased hemoglobin and hematocrit levels? Select all that apply. A) Microcytic red blood cells B) Hyperchromic red blood cells C) Low total iron-binding capacity D) Slightly reduced reticulocyte count E) Increased erythrocyte sedimentation rate (ESR)

A) Microcytic red blood cells D) Slightly reduced reticulocyte count

Which manifestation would the nurse include when the parents of a child who has just been diagnosed with hemophilia A ask what symptoms of bleeding should they look for in the future? Select all that apply. A) Nosebleeds B) Blood in the urine C) Painful and swollen joints D) Easy bruising E) Frequent fevers F) Fast clotting of injuries G) Dark-colored tarry stools

A) Nosebleeds B) Blood in the urine C) Painful and swollen joints D) Easy bruising G) Dark-colored tarry stools

Which nursing intervention is necessary before a blood transfusion is administered? Select all that apply. A) Obtain the client's vital signs B) Monitor hemoglobin and hematocrit levels C) Allow the blood to reach room temperature D) Determine typing and crossmatching of blood E) Use a Y-type infusion set to initiate 0.9% normal saline

A) Obtain the client's vital signs D) Determine typing and crossmatching of blood E) Use a Y-type infusion set to initiate 0.9% normal saline

Which dietary choices by a client with iron deficiency anemia indicate that the nurse's dietary teaching has been effective? Select all that apply. A) Scrambled eggs B) Baked potato C) Steamed carrots D) Spinach salad E) Dried apricots F) Sliced oranges

A) Scrambled eggs B) Baked potato D) Spinach salad E) Dried apricots

A client sustains a crushing injury to the lower left leg, and a below-the-knee amputation is performed. For which common clinical manifestation of a pulmonary embolus would the nurse assess for in this client? Select all that apply. A) Sharp chest pain B) Acute onset of dyspnea C) Pain in the residual limb D) Absence of the popliteal pulse E) Blanching of the affected extremity

A) Sharp chest pain B) Acute onset of dyspnea

Which action will the nurse take during administration of blood products to ensure the client's safety? A) Stay with client during first 15 minutes of infusion B) Flush packed red blood cells with 5% dextrose and 0.45% normal saline C) Remove the intravenous catheter if a blood transfusion reaction occurs D) Administer the red blood cells through a percutaneously inserted central catheter line with a 20-gauge needle

A) Stay with client during first 15 minutes of infusion

Which response will a nurse give to the parents of a child with sickle cell anemia who ask about their child taking iron supplements to help treat the anemia? A) Taking supplements will not help with this condition B) It is advised that iron be taken with orange juice to aid in absorption C) An OTC multivitamin with iron should meet the needs of the child D) It is advised that liquid iron supplements be given through a straw to prevent staining the teeth

A) Taking supplements will not help with this condition

Which child would the nurse consider at risk for beta thalassemia (Cooley anemia)? A) Two-year-old child of Greek descent with a large abdomen B) Eighteen-month-old child of Irish descent with very pale skin color C) Three-year-old child of Spanish descent with increased hematocrit D) Twenty-month-old child of Asian descent with edematous knee joints

A) Two-year-old child of Greek descent with a large abdomen

A pregnant client with iron-deficiency anemia is prescribed iron supplements daily. To help the client increase iron absorption, the nurse would suggest the client eat foods high in which substance? A) Vitamin C B) Fat content C) Water content D) Vitamin B complex

A) Vitamin C

Information about which vitamin would be included when teaching a client with atrial fibrillation about a new prescription for warfarin? A) Vitamin K B) Vitamin D C) Vitamin B1 D) Vitamin B12

A) Vitamin K

Which statement indicates that the client has a correct understanding of the condition after the nurse has finished teaching a client about sickle cell anemia? A) "I have abnormal platelets" B) "I have abnormal hemoglobin" C) "I have abnormal hematocrit" D) "I have abnormal white blood cells"

B) "I have abnormal hemoglobin"

Which teaching would the nurswe provide to a client with newly diagnosed pancytopenia caused by chemotherapy? A) Begin a program of vigorous mouth care B) Avoid traumatic injury and exposure to infection C) Increase oral fluid intake to at least 3 L/day D) Report unusual tingling sensations in the extremities

B) Avoid traumatic injury and exposure to infection

When performing a focused assessment on a client with a possible diagnosis of iron deficiency anemia, which locations would the nurse examine? A) Sclera B) Nail beds C) Conjunctivae D) Palms of hands E) Bony prominences

B) Nail beds C) Conjunctivae D) Palms of hands

Which cause would a nurse suspect is responsible for warmth, redness, and tenderness identified at a client's intravenous (IV) site? A) Rapid fluid delivery B) Phlebitis C) Allergic response D) Infiltration

B) Phlebitis

Which mechanism would the nurse attempt to increase to prevent postoperative deep vein thrombosis? A) Coagulability of the blood B) Velocity of the venous return C) Effectiveness of internal respiration D) Oxygen-carrying capacity of the blood

B) Velocity of the venous return

A 60-year-old with gastric cancer has a shiny tongue, paresthesias of the limbs, and ataxia. The laboratory results show cobalamin levels of 125 pg/ml. Which medication would the nurse expect to be prescribed for the client? A) Oral hydroxyurea B) Vitamin B12 injections C) Oral iron supplements D) Erythropoietin injections

B) Vitamin B12 injections

When a client with a suspected pulmonary emobolism is scheduled for a spiral computed tomography (CT) scan, which action would the nurse take before the procedure? A) Check the client's blood glucose levels B) Obtain informed consent from the client C) Assess if the client is allergic to shellfish D) Instruct the client to remove dentures

C) Assess if the client is allergic to shellfish

Which prescribed treatment would the nurse question when a client who has sickle cell anemia has been admitted with acute chest syndrome? A) Oxygen administration B) Daily folic acid tablet C) Daily iron supplement D) Morphine sulfate PRN

C) Daily iron supplement

Which action would the nurse take first when caring for a client with a possible pulmonary embolus? A) Auscultate the chest B) Obtain the vital signs C) Elevate the head of the bed D) Notify the rapid response team

C) Elevate the head of the bed

The nurse caring for a child with a low platelet count would monitor the child's urine for the presence of which component? A) Protein B) Glucose C) Erythrocytes D) Lymphocytes

C) Erythrocytes

When caring for a client with a possible pulmonary embolism, the nurse will anticipate preparing the client for which test? A) Chest x-ray B) Thoracic ultrasound C) Helical computed tomography (CT) D) Magnetic resonance imaging (MRI)

C) Helical computed tomography (CT)

After reviewing a client's complete blood cell count, which finding would be most important for the nurse to communicate to the health care provider? A) Hematocrit 41% B) Hemoglobin 12 g/dL (120 g/L) C) Platelet count 75,000 mm^3 (75 x 10^9 /L) D) White blood cell count 5100 mm^3 (5.1 x 10^9 /L)

C) Platelet count 75,000 mm^3 (75 x 10^9 /L)

Which action by the nurse is a priority when a client who is receiving a transfusion of packed red blood cells (PRBCs) after cardiac surgery experiences chest discomfort, chills, and anxiety? A) Administer nitroglycerin B) Monitor the client's vital signs C) Stop the transfusion and administer normal saline D) Ask the client to describe the pain using a 0-10 scale

C) Stop the transfusion and administer normal saline

Which clotting factor would a nurse explain is deficient to the parents of a child newly diagnosed with hemophilia A? A) Factor II B) Factor XII C) Factor IX D) Factor VIII

D) Factor VIII