ATI Hematology Questions

The nurse is caring for a client who had an anaphylactic reaction after a blood transfusion. The nurse reviews the literature to further understand anti-body mediated immunity (AMI). Which of the following information should the nurse confirm about AMI? A. AMI is mediated by Antibodies produced by B lymphocytes B. AMI defends only against viral infections C. AMI involves phagocytic natural killer cells D.Humoral immunity response is mediated by T lymphocytes

A. AMI is mediated by Antibodies produced by B lymphocytes AMI is mediated by the anti-bodies produce Bybee lymphocytes in response to an invading Allergan or antigen

A nurse is preparing to administer 2 units of packed RBCs to an older adult client. Which of the following actions should the nurse take? A. Administer each unit over 3 hr. B. Use an 18-gauge needle to obtain venous access. C. Use blood that is less than a month old. D. Obtain the client's vital signs every 30 min throughout the transfusion

A. Administer each unit over 3 hr. The nurse should administer blood to an older adult client at a slower rate. Therefore, each unit should be administered over 2 to 4 hr.

A nurse is preparing to administer blood to a client the unit of blood on hand is type O negative and the client is type A positive blood. Which of the following action should the nurse take? A. Administer the blood as ordered B. Contact the provider for further orders C. Notify the blood bank D. Complete an incident report

A. Administer the blood is ordered The nurse should administer the blood as ordered. Type O blood is compatible with Type A. Type O blood is considered a universal donor as it contains no antigens to react to transfused blood.

A nurse is planning care for a client who has thrombocytopenia. Which of the following interventions should the nurse include in the plan? A. Apply pressure to needlestick sites for 10 min. B. Assess core temperatures using a rectal thermometer. C. Measure abdominal girth twice weekly. D. Monitor for the presence of WBCs in the urine.

A. Apply pressure to needlestick sites for 10 min.

A nurse is monitoring a client who is receiving a blood transfusion. Which of the following findings indicates an allergic transfusion reaction? A. Generalized urticaria. B. Blood pressure 184/92 mm Hg. C. Distended jugular veins. D. Bilateral flank pain

A. Generalized urticaria.

A nurse is caring for a client who has DIC. Which of the following medications should the nurse anticipate administering? A. Heparin B. Vitamin K C. Mefoxin D. Simvastatin

A. Heparin

A nurse is selecting a qualified staff member to double check a blood label with a client ID bracelet prior to infusing a unit of blood. The nurse should identify that which of the following persons is qualified? A. Oncology nurse B. Assistive personnel C. Senior nursing student D. Phlebotomist

A. Oncology nurse The nurse should ask another nurse or a provider to double check the blood label and client ID prior to an infusion.

A nurse is assessing a client who is receiving one unit of packed RBCs to treat intraoperative blood loss. The client reports chills and back pain, and the client's blood pressure is 80/64 mm Hg. Which of the following actions should the nurse take first? A. Inform the provider B. Stop the infusion of blood C. Notify the laboratory D. Obtain a urine specimen

A. Stop the infusion of blood The client is experiencing an acute intravascular hemolytic transfusion reaction. The greatest risk to this client is injury from receiving additional blood; therefore, the first action the nurse should take it to stop the infusion of blood.

A nurse is monitoring a client who reports having chills and back pain during a blood transfusion. Which of the following actions is nurse's priority? A. Stopping the transfusion B. Covering the client with a blanket C. Notifying the provider D. Assessing the client's skin for a rash

A. Stopping the transfusion

A nurse is planning care for a client who has pernicious anemia. Which of the following interventions should the nurse plan to implement? A. Vitamin B12 injections B. Iron supplements C. Blood transfusions D. Vitamin B6 supplements

A. Vitamin B12 injections

A nurse is teaching a client scheduled for an activated partial thromboplastin time (aPTT). Which of the following statements by the client indicates an understanding of the teaching? A. "I will need to skip breakfast until after the test is complete." B. "It measures deficiencies in clotting factors." C. "If my levels are too low, I am at an increased risk for bleeding." D. "This test will help my provider adjust my warfarin dosages."

B. "It measures deficiencies in clotting factors."

A nurse is planning care for a client who is being treated with chemotherapy and radiation for metastatic breast cancer, and who has neutropenia. The nurse should include which of the following restrictions in the client's plan of care? A. All visitors from entering the client's room B. Fresh flowers and potted plants in the room C. Oral fluid intake to between meals only D. Activities that could result in bleeding

B. Fresh flowers and potted plants in the room

A nurse is creating a dietary plan for an adult female client who has a hemoglobin level of 9.8 g/dL. Which of the following foods should the nurse recommend? A. Carrots B. Raisins C. Maple syrup D. Orange juice

B. Raisins

A nurse is caring for an antepartum client who has iron-deficiency anemia. When teaching the client about nutrition, the nurse should emphasize the need for an increased intake of which of the following foods? A. Milk and cheese B. Red meat and organ meat C. Fresh fruits D. Whole grain breads

B. Red meat and organ meat

A nurse is assessing a client who is receiving a blood transfusion. Which of the following findings is a manifestation of hemolytic transfusion reaction? A. Report of metallic taste B. Report of low back pain C. Pallor D. Hypertension

B. Report of low back pain Low back pain fever and chills are manifestations of a hemolytic transfusion reaction. The nurse should discontinue the transfusion and administer a 0.9% sodium chloride through a new IV tube.

A nurse is assessing a client who is receiving a blood transfusion. Which of the following findings is a manifestation of a hemolytic transfusion reaction? A. Hypertension B. Report of low-back pain C. Pallor D. Report of metallic taste

B. Report of low back pain Manifestation of an acute hemolytic reaction include apprehension, tachypnea, hypotension, chest pain, and lower back pain

A nurse is administering platelets to a client who reports having lower back pain and feeling chilled and itchy. Which of the following actions should the nurse take first? A. Notify the provider. B. Stop the infusion. C. Collect a urine sample from the client. D. Return the platelet bag and tubing to the blood bank

B. Stop the infusion.

A nurse is teaching a client who has septic shock about the development of disseminated intravascular coagulation (DIC). Which of the following statements should the nurse make? A. "DIC is controllable with lifelong heparin usage." B. "DIC is characterized by an elevated platelet count." C. "DIC is caused by abnormal coagulation involving fibrinogen." D. "DIC is a genetic disorder involving a vitamin K deficiency."

C. "DIC is caused by abnormal coagulation involving fibrinogen."

A nurse is preparing educational material for a client who has a thrombocytopenic disorder. Which of the following information should the nurse include? A. "Use a rectal suppository if constipated." B. "Swish with a commercial mouthwash after brushing the teeth." C. "Notify the dentist of your condition prior to invasive procedures." D. "Take aspirin for headaches."

C. "Notify the dentist of your condition prior to invasive procedures."

.A nurse is discharging a child who has sickle cell anemia after an acute crisis episode. Which of the following instructions should the nurse include in the teaching? A. "Monitor your child's temperature daily." B. "Restrict outdoor play activity to 1 hour per day." C. "Offer fluids to your child multiple times every day." D. "Apply cold compresses when your child expresses pain."

C. "Offer fluids to your child multiple times every day."

Which collaborative treatment would the nurse anticipate in the client diagnosed with DIC? A. Administer oral anticoagulants B. Prepare for plasmapheresis C. Administer fresh frozen plasma D. Calculate the intake and output

C. Administer fresh frozen plasma

A nurse is caring for a client who has idiopathic thrombocytopenic purpura (ITP). The nurse should notify the provider and report possible small‑vessel clotting when which of the following is assessed? A. Petechiae on the upper chest B. Hypotension C. Cyanotic nail beds D. Severe headache

C. Cyanotic nail beds

A nurse is assessing a client and suspects the client is experiencing DIC. Which of the following physical findings should the nurse anticipate? A. Bradycardia B. Hypertension C. Epistaxis D. Xerostomia

C. Epistaxis

A nurse is caring for a young female adult client who reports weakness, fatigue, and heavy menstrual periods. The client has a hemoglobin level of 8 g/dL and a hematocrit level of 28 g/dL. The nurse suspect which of the following types of anemia? A. Folic acid deficiency anemia B. Pernicious anemia C. Iron-deficiency anemia D. Sickle cell anemia

C. Iron-deficiency anemia

A nurse is assessing a child who is in sickle cell crisis. Which of the following findings should the nurse expect? A. High fever B. Bradycardia C. Pain D. Constipation

C. Pain

A nurse is assessing a child who is in sickle cell crisis. Which of the following findings should the nurse expect? a. High fever b. Bradycardia c. Pain d. Constipation

C. Pain A patient who is in sickle cell crisis has severe pain resulting from tissue hypoxia and necrosis

A nurse is caring for a client who has a prescription for one unit of packed RBCs. The nurse should plan to remain in the room with the client at which of the following times during the infusion to observe for a transfusion reaction? A. The first 2 min B. The final 2 min C. The first 15 min D. The final 15 min

C. The first 15 min

A nurse is planning care for a client who is to receive packed RBCs. The nurse should plan for the total infusion time to not exceed which of the following? A. 2 hr B. 6 hr C. 8 hr D. 4 h

D. 4 h The nurse should infuse the packed RBCs for no longer than 4 hr due to temperature inconsistencies that develop over time and the possibility of bacterial contamination.

A nurse receives a unit of packed RBCs from a blood bank and notes that the time is 1130. The nurse should begin the infusion at which of the following times? A. When the client has finished eating lunch B. When the client states he is ready to start the infusion C. 2 hr after obtaining blood from the blood bank D. As soon as the nurse can prepare the client and the administration set

D. As soon as the nurse can prepare the client and the administration set

A nurse is teaching a client who has a family history of hemophilia A about manifestations of the disorder. The nurse should include which of the following manifestations in the teaching? A. Frequent rapid bleeding B. Tendency to bruise minimally C. Immediate clotting from a minor cut D. Disabling joint pain

D. Disabling joint pain

A nurse is teaching a client who has a family history of hemophilia A about manifestations of the disorder. The nurse should include which of the following manifestations in the teaching? A. Frequent rapid bleeding B. Tendency to bruise minimally C. Immediate clotting from a minor cut D. Disabling joint pain

D. Disabling joint pain

A nurse is reviewing the laboratory values of a client who is at risk for disseminated intravascular coagulopathy. Which of the following values should the nurse report to the provider? A. Platelets 156,000/mm3 B. PT 12 seconds C. PTT 64 seconds D. Fibrinogen 85 mg/dL

D. Fibrinogen 85 mg/dL

A nurse is reviewing the laboratory values of a client who is at risk for disseminated intravascular coagulopathy. Which of the following values should the nurse report to the provider? A. Platelets 156,000/mm3 B. PT 12 seconds C. PTT 64 seconds D. Fibrinogen 85 mg/dL

D. Fibrinogen 85 mg/dL

A nurse is teaching a newly licensed nurse about heparin‑induced thrombocytopenia. Which of the following risk factors for this disorder should the nurse include in the teaching? A. Warfarin therapy for atrial fibrillation B. Placental abruption C. Systemic lupus erythematosus D. Heparin therapy for deep‑vein thrombosis

D. Heparin therapy for deep‑vein thrombosis

A nurse is caring for a client who is experiencing hypovolemic shock. Which of the following blood products should the nurse anticipate administering to the client? A. Cryoprecipitates B. Albumin C. Platelets D. Packed RBCs

D. Packed RBCs Packed red blood cells are given to restore blood volume and a place in Madaket and hemoglobin levels and clients who have hypovolemic shock.

A nurse is reviewing the laboratory findings for a client who has idiopathic thrombocytopenic purpura (ITP). Which of the following findings should the nurse expect to be decreased? A. WBC B. RBC C. Granulocytes D. Platelets

D. Platelets

A nurse is caring for a client who the provider suspects might have pernicious anemia. The nurse should expect the provider to prescribe which of the following diagnostic tests? A. Sweat test B. Haptoglobin C. Antinuclear antibodies D. Schilling test

D. Schilling test

A nurse remains with a client to observe for any adverse reactions after initiating a transfusion of packed RBCs. The client becomes apprehensive and tachycardic, reporting headache and low back pain. The nurse should recognize that these findings indicate which of the following transfusion reactions?

Hemolytic

A nurse is planning nutritional teaching for a client who is experiencing fatigue due to iron deficiency anemia. Which of the following foods should the nurse recommend to the client? a. 1.5 oz raisins b. 8 oz black tea c. 1 cup canned black beans d. 8 oz whole milk

c. 1 cup canned black beans

A nurse is assessing a client who is receiving a platelet transfusion. Which of the following findings is an adverse effect of the transfusion? A. Hypothermia B. Chills C. Nystagmus D. Bradycardia

B. Chills

A nurse is planning care for a client who has thrombocytopenia. Which of the following interventions should the nurse include in the plan? A. Apply pressure to needlestick sites for 10 min. B. Assess core temperatures using a rectal thermometer. C. Measure abdominal girth twice weekly. D. Monitor for the presence of WBCs in the urine.

A. Apply pressure to needlestick sites for 10 min.

A nurse is caring for a client who is receiving a unit of packed red blood cells. Fifteen minutes following the start of the transfusion, the nurse notes that the client is febrile, with chills and red-tinged urine. Which of the following transfusion reactions should the nurse suspect? A. Febrile B. Allergic C. Acute pain D. Hemolytic

D. Hemolytic

A nurse is planning to perform a blood transfusion for a client. Which of the following actions should the nurse plan to take? (Select all that apply.) A. Check vital signs before transfusion. B. Insert an IV with a 19-gauge needle. C. Prime the blood tubing with dextrose 5% in water. D. Transfuse the blood product within 5 hr after removing it from refrigeration. E. Check the expiration date of the blood product with a second nurse

A. Check vital signs before transfusion. B. Insert an IV with a 19-gauge needle. E. Check the expiration date of the blood product with a second nurse.

A nurse is assessing a client who has disseminated intravascular coagulation (DIC). Which of the following findings should the nurse expect? A. Excessive thrombosis and bleeding B. Progressive increase in platelet production C. Immediate sodium and fluid retention D. Increased clotting factors

A. Excessive thrombosis and bleedingThe nurse should expect excessive thrombosis and bleeding of mucous membranes because both DIC impairs both coagulation and anticoagulation pathways.

A nurse is assessing a client who is postoperative and has anemia due to excess blood loss following surgery. Which of the following findings should the nurse expect? A. Fatigue B. Hypertension C. Bradycardia D. Diarrhea

A. Fatigue The nurse should anticipate that the client who has anemia due to blood loss following surgery will experience fatigue. This is due to the body is decreased ability to carry oxygen to vital tissues and organs.

A nurse is creating a teaching plan for a client who has thrombocytopenia. Which of the following instructions should the nurse include? (Select all that apply.) A. Lubricate lips with water-soluble ointment. B. Brush teeth with a soft toothbrush. C. Blow nose gently. D. Limit fruit consumption. E. Use a straight edge razor to shave.

A. Lubricate lips with water-soluble ointment. B. Brush teeth with a soft toothbrush. C. Blow nose gently.

A nurse is creating a teaching plan for a client who has thrombocytopenia. Which of the following instructions should the nurse include? (Select all that apply.) A. Lubricate lips with water-soluble ointment. B. Brush teeth with a soft toothbrush. C. Blow nose gently. D. Limit fruit consumption. E. Use a straight edge razor to shave

A. Lubricate lips with water-soluble ointment. B. Brush teeth with a soft toothbrush. C. Blow nose gently.

A nurse is caring for a client who has disseminated intravascular coagulation (DIC). Which of the following laboratory values indicates the client's clotting factors are depleted? (Select all that apply.) A. Platelets 100,000/mm3 B. Fibrinogen levels 57 mg/dL C. Fibrin degradation products 4.3 mcg/mL D. D-dimer 0.03 mcg/mL E. Sedimentation rate 38 mm/hr

A. Platelets 100,000/mm3 B. Fibrinogen levels 57 mg/dL

A nurse is preparing to administer a unit of packed red blood cells to a client. Which of the following should the nurse plan to take? A. Remain with the client for the first 15 minutes of the transfusion B. Plan to infuse the unit of blood over six hours C. Check the unit of blood with an assistant personnel D. Pre-medicate the client with an antiemetic

A. Remain with the client for the first 15 minutes of transfusion The nurse should remain with the client for the first 15 to 30 minutes of the transfusion to monitor for a transfusion reaction, which occurs often during the first 50 mL of the transfusion.

A nurse is reviewing a client's CBC findings and discovers that the client's platelet count is 9,000/mm3. The nurse should monitor the client for which of the following conditions? A. Spontaneous bleeding B. Oliguria C. Hyperactive deep tendon reflexes D. Infection

A. Spontaneous bleeding

A nurse is assessing a client who is receiving a unit of packed RBCs. The client appears flushed and reports low-back pain. Which of the following actions is the nurse's priority? A. Stopping the transfusion B. Covering the client with a blanket C. Notifying the provider D. Assessing the client's skin for a rash

A. Stop the infusion

A nurse is preparing to administer blood to a client. Which of the following actions should the nurse take to identify the client? (Select all that apply.) A. Verify the provider's prescription with another RN. B. Confirm that the room number matches the medical record. C. Scan the barcode on the client's identification band. D. Ask the client to verbalize if blood type is Rh-negative or positive. E. Compare client identification number to the blood component tag number

A. Verify the provider's prescription with another RN. C. Scan the barcode on the client's identification band. E. Compare client identification number to the blood component tag number

A nurse is caring for a client who is to receive a unit of packed red blood cells. The nurse should prime the blood administration to being using which of the following IV solutions? A. Lactated ringer's solution B. 0.9% sodium chloride C. Dextrose 5% in 0.45% sodium chloride D. Dextrose 5% in water

B. 0.9% sodium chloride The nurse should prime the tubing was 0.9% sodium chloride as this is the only IV solution that does not hemolyze red blood cells.

A nurse at a blood donation center is screening clients for blood donation. The nurse should identify that which of the following clients must reschedule donation? A. Client who is Rh positive B. A client who has an oral temperature of 37.8°C (100°F) C. A client who weighs 50 kg (110lbs) and plans to donate 450 mL of blood D. A client who is 14 years of age

B. A client who has an oral temperature of 37.8°C (100°F) A client who has an oral temperature that exceeds 37.5°C (99.6°F) differs eligibility to donate blood

Which lab result would the nurse expect in the client diagnosed with DIC? A. A decreased prothrombin time (PT) B. A low fibrinogen level C. An increased platelet count D. An increased white blood cell count

B. A low fibrinogen level

.A nurse is reviewing the laboratory results of a client who was admitted with a history of multiple myeloma. The nurse should expect to find an increase in which of the following laboratory values? A. Absolute neutrophil count (ANC) B. Calcium C. Platelets D. WBCs

B. Calcium

A nurse is reviewing a client's laboratory results and finds the hemoglobin is 10 g/dL and the hematocrit is 30%. The nurse recognizes that the client is at risk for which of the following? A. Prolonged bleeding B. Cellular hypoxia C. Impaired immunity D. Fluid retention

B. Cellular hypoxia

A nurse is monitoring a client who is receiving a unit of packed RBCs following surgery. Which of the following assessments is an indication that the client might be experiencing circulatory overload? A. Flushing B. Dyspnea C. Bradycardia D. Vomiting

B. Dyspnea

A nurse is providing teaching for a client who has anemia and a new prescription for ferrous sulfate liquid. Which of the following instructions should the nurse provide? A. Take the medication on an empty stomach to decrease gastrointestinal irritation. B. Take the medication with orange juice to enhance absorption. C. Take the medication with milk. D. Rinse the mouth before taking the iron.

B. Take the medication with orange juice to enhance absorption.

A nurse is reviewing the PT, aPTT, and INR laboratory values for a client who is experiencing an acute episode of disseminated intravascular coagulation (DIC). Which of the following laboratory results should the nurse expect? A. The laboratory values are within the expected reference range. B. The laboratory values are prolonged. C. The laboratory values are decreased. D. The laboratory values are the same as the previous test values

B. The laboratory values are prolonged.

A nurse is monitoring a client who is receiving packed RBCs. The nurse identifies which of the following as an expected finding? A. The drip chamber with filter is filled completely with blood. B. The packed RBCs are connected by Y tubing to normal saline. C. The blood has been infusing steadily for 5 hr with no client symptoms. D. A medication is being administered IV through the injection site closest to the client.

B. The packed RBCs are connected by Y tubing to normal saline.

A nurse is assessing a client before administering a unit of packed RBCs. The nurse should identify which of the following data as most important to obtain prior to the infusion? A. Skin color B. Fluid intake C. Temperature D. Hemoglobin level

C. Temperature

A charge nurse is supervising a newly licensed nurse care for a client who is receiving a transfusion of packed red blood cells. The nurse suspects a possible hemolytic reaction. After stopping the blood transfusion, which of the following actions by the new nurse requires intervention by the charge nurse? A. The nurse sent a blood specimen to the laboratory B. The nurse initiate of infusion of 0.9% sodium chloride C. The nurse collect a urine specimen D. The nurse starts the translation of another unit of blood product

D. The nurse starts the translation of another unit of blood product When suspecting a hemolytic reaction, the nurse should immediately stop the transfusion of all blood products. The transfusion of additional products can increase the clients risk for further complication.

A nurse is preparing to administer a unit of red blood cells. The nurse's responsibility is to compare and verify the information on the blood label with the client's information. The nurse should use which of the following as the priority source of verification? A. chart B. order sheet C. medication administration record D. identification wristband

D. identification wristband

A nurse is planning to perform a blood transfusion for a client. Which of the following actions should the nurse plan to take? Select all that apply. a. Check vital signs before transfusion. b. Insert an IV with a 19-gauge needle. c. Prime the blood tubing with dextrose 5% in water. d. Transfuse the blood product within 5 hours after removing it from refrigeration. e. Check the expiration date of the blood product with a second nurse.

a. Check vital signs before transfusion. b. Insert an IV with a 19-gauge needle. e. Check the expiration date of the blood product with a second nurse.

A nurse is planning care for a client who is to undergo a stem cell transplant. Which of the following actions should the nurse plan to take? a. Place the client in a negative airflow room. b. Keep blood pressure equipment in the client's room. c. Monitor the client's vital signs once every 8 hours. d. Provide the client with 1,000 mL of water to drink every 12 hours.

b. Keep blood pressure equipment in the client's room.

A nurse is caring for a client who has a new prescription for ferrous sulfate tablets twice daily for iron-deficiency anemia. The client asks the nurse why the provider instructed that she take the ferrous sulfate between meals. Which of the following responses should the nurse make? a. "Taking the medication between meals will help you avoid becoming constipated." b. "Taking the medication with food increases the risk of esophagitis." c. "Taking the medication between meals will help you absorb the medication more efficiently." d. "The medication can cause nausea if taken with food."

c. "Taking the medication between meals will help you absorb the medication more efficiently."

A nurse is preparing to initiate a transfusion of packed RBC for a client who has anemia. Which of the following actions should the nurse plan to take? a. Leave the client 5 minutes after beginning the transfusion. b. Infuse the transfusion at a rate of 200 mL/hr. c. Check the client's vital signs every hour during the transfusion. d. Flush the blood tubing with dextrose 5% in water.

c. Check the client's vital signs every hour during the transfusion

A nurse is teaching a client who has a new diagnosis of aplastic anemia. Which of the following information should the nurse include in the teaching? a. Aplastic anemia is associated with a decreased intake of iron. b. Aplastic anemia results in an increased rate of RBC destruction. c. Aplastic anemia results in an inability to absorb vitamin B12. d. Aplastic anemia results from decreased bone marrow production of RBCs.

d. Aplastic anemia results from decreased bone marrow production of RBCs.

A nurse is caring for a client who the provider suspects might have pernicious anemia. The nurse should expect the provider to prescribe which of the following diagnostic tests? a. Sweat test b. Haptoglobin c. Antinuclear antibodies d. Schilling test

d. Schilling test