Ch. 19 PrepU: Hematologic Function (Pellico, 1st Ed)
Which of the following reports from the client during the health history would lead the nurse to suspect that the client has a disorder of the hematopoietic or lymphatic system? Select all that apply. -Experiences prolonged bleeding from an obvious injury. -Has unexplained blood loss, as in rectal bleeding, nosebleeds, bleeding gums, or vomiting blood. -Feels fatigued with normal activities. -Rarely bruises. -Feels discomfort in the stomach.
-Experiences prolonged bleeding from an obvious injury. -Has unexplained blood loss, as in rectal bleeding, nosebleeds, bleeding gums, or vomiting blood. -Feels fatigued with normal activities.
An instructor asks students approximately how long platelets last? What would the students correctly identify? Fill in the blank with a number.
7.5 days (p. 516)
Plasma proteins play an essential role in maintaining water balance and blood pressure. Select the laboratory analysis that a nurse should review to check the levels of the most abundant plasma protein. -Fibrinogen -Prothrombin -Gamma globulin -Albumin
Albumin (p. 521)
The instructor in the anatomy and physiology class is discussing the components of the blood. What would the instructor cite as the most abundant protein in plasma? -Platelets -Fibrinogen -Albumin -Globulins
Albumin (p. 521)
A nurse is assigned to care for a patient with ascites, secondary to cirrhosis. The nurse understands that the fluid accumulation in the peritoneal cavity results from a combination of factors including an alteration in oncotic pressure gradients and increased capillary permeability. Therefore, the nurse monitors the serum level of the plasma protein responsible for maintaining oncotic pressure, which is: -Albumin. -Globulin. -Fibrinogen. -Prothrombin.
Albumin. (p. 521)
Which of the following cell types are produced from pluripotential stem cells? -All options are correct. -Erythrocytes -Platelets -Lymphocytes
All options are correct. (p. 517)
A nurse caring for a patient with severe neutropenia would be primarily concerned about the patient's susceptibility to which of the following? -Anemia -Renal failure -Bacterial infections -Heart failure
Bacterial infections (p. 524)
You are caring for three clients who have the following blood count values: Client A has 24,500 white blood cells (WBCs), client B has 13.4 g/dL hemoglobin, and client C has a 250,000/mm3 platelet count. Which statement correctly describes the condition of each client? -Client A has a normal WBC count, client B has a higher hemoglobin count than normal, and client C has a normal platelet count. -Client A has a higher WBC count than normal, client B has a normal hemoglobin count, and client C has a normal platelet count. -Client A has a higher WBC count than normal, client B has a normal hemoglobin count, and client C has a higher platelet count than normal. -Client A has a normal WBC count than normal, client B has a normal hemoglobin count, and client C has a normal platelet count.
Client A has a higher WBC count than normal, client B has a normal hemoglobin count, and client C has a normal platelet count. (p. 523)
A 75-year-old woman visited her health care provider for an annual check-up. She told the doctor that she feels exhausted all the time and barely has the energy to go out of her home, run errands, and visit friends. The nurse expects that the health care provider will order which of the following lab studies based on the most common hematologic condition affecting the elderly? -White blood count -Complete blood count -Thrombocyte count -Level of B lymphocytes
Complete blood count (p. 519, 523)
A patient with chronic kidney disease is being examined by the nurse practitioner for anemia. The nurse has reviewed the laboratory data for hemoglobin and RBC count. What other test results would the nurse anticipate observing? -Decreased level of erythropoietin -Decreased total iron-binding capacity -Increased mean corpuscular volume -Increased reticulocyte count
Decreased level of erythropoietin. (p. 519)
The nurse expects which assessment finding when caring for a client with a decreased hemoglobin level? -Bright red venous blood. -Elevated temperature. -Decreased oxygen level. -Increased bruising.
Decreased oxygen level.
The nurse is reviewing a client's laboratory results and notes that her hemoglobin level is 15 g/dL. What action should the nurse take next? -Document the finding as normal. -Notify the physician because the client requires further testing. -Record the result and recommend a retest in 6 weeks -Ask the client if she has had excessive menstruation or is lacking iron in her diet.
Document the finding as normal. (p. 523)
A client undergoing a complete blood cell (CBC) count for the detection of anemia wants to know more about hemoglobin. Which of the following should the nurse explain to the client as being the main function of hemoglobin? -Gives its oxygen to cells of the body and picks up carbon dioxide -Defends the body against disease organisms, toxins, and irritants -Essential for blood clotting, plug formation and further hemostasis -Releases chemicals to assist the body in detoxifying foreign proteins
Gives its oxygen to cells of the body and picks up carbon dioxide. (p. 518)
Albumin is a protein in the plasma portion of the blood. Under normal conditions albumin cannot pass through the wall of a capillary. What significance is this for the vascular compartment? -Helps push oxygen into the tissues of the body. -Retains leukocytes in the vascular compartment. -Helps retain fluid in the vascular compartment. -Absorbs carbon dioxide from the tissues for transport to the lungs.
Helps retain fluid in the vascular compartment. (p. 521)
The nurse is preparing a patient for a bone marrow aspiration and biopsy from the site of the posterior superior iliac crest. What position will the nurse place the patient in? -Lateral position with one leg flexed -Lithotomy position -Supine with head of the bed elevated 30 degrees -Jackknife position
Lateral position with one leg flexed
A client has a leukocyte count of 3,000/mm3. How would the nurse document the client's condition? -Leukocytosis -Leukopenia -Leukotoxic -Hemolysis
Leukopenia (p. 523)
Albumin is important for the maintenance of fluid balance within the vascular system. Albumin is produced by which of the following? -Liver -Pancreas -Kidney -Large intestine
Liver (p. 560)
Which term refers to a form of white blood cell involved in immune response? -Granulocyte -Lymphocyte -Spherocyte -Thrombocyte
Lymphocyte
The nurse reviewing laboratory results of a client recovering from abdominal surgery notices an elevated number of reticulocytes. What is the nurse's first action? -Perform an abdominal assessment. -Notify the healthcare provider. -Document the findings as expected results. -Hold the prescribed blood transfusion.
Perform an abdominal assessment.
The nurse is aware that a patient has been diagnosed with thrombocytopenia. Which of the following is the most typical first indicator of the diagnosis that a patient will exhibit? -Fatigue -Petechiae -Hypotension -Tachycardia
Petechiae (p. 525)
Which finding should a nurse identify as requiring further investigation? -Red blood cell (RBC) count of 4.9 million/mm3 -Platelet count of 115,000/mm3 -White blood cell (WBC) count of 7,000/mm3 -Hematocrit of 45%
Platelet count of 115,000/mm3. (p. 525)
Which cells have the lifespan of approximately 7.5 days and one-third of their population remains in the spleen (unless needed to fight significant bleeding)? -Platelets -Leukocytes -Erythrocytes -Lymphocytes
Platelets (p. 516)
An older adult patient presents to the physician's office with a complaint of exhaustion. The nurse, aware of the most common hematologic condition affecting the elderly, knows that which laboratory values should be assessed? -WBC count -RBC count -Thrombocyte count -Levels of plasma proteins
RBC count (p. 519)
Your client is taking medications that depress the hematopoietic system. What signs should you closely monitor in this client? -Signs of leukocytosis -Signs of painful joints and discomfort -Signs of leukopenia and thrombocytopenia -Signs of hemolysis
Signs of leukopenia and thrombocytopenia. (p. 520)
The physician believes that the patient has a deficiency in the leukocyte responsible for cell-mediated immunity. What should the nurse check the WBC count for? -Basophils -Monocytes -Plasma cells -T lymphocytes
T lymphocytes (p. 517)
Both the liver and the spleen have a role in erythrocyte metabolism. How would this role best be described? -The spleen helps in creating mature erythrocytes. -The liver generates erythropoietin which regulates the rate of erythrocyte production. -The spleen stores the iron component of hemoglobin from erythrocytes and returns it to the red marrow. -The spleen removes erythrocytes after 120 days, and the liver removes severely damaged erythrocytes.
The spleen removes erythrocytes after 120 days, and the liver removes severely damaged erythrocytes. (p. 519)
The client is to receive a unit of packed red blood cells. The first intervention of the nurse is to -Check the label on the unit of blood with another registered nurse. -Ensure that the intravenous site has a 20-gauge or larger needle. -Observe for gas bubbles in the unit of packed red blood cells. -Verify that the client has signed a written consent form.
Verify that the client has signed a written consent form. (p. 567)
Which client is not a candidate for blood donation according to the American Heart Association? -86 year old male with blood pressure 110/70 mmHg -50 year old female with pulse 95 beats/minute -26 year old female with hemoglobin 11.0 g/dL -18 year old male weighing 52 kg.
26 year old female with hemoglobin 11.0 g/dL
A client has an increased number of eosinophils. Which of the following disorders would the nurse expect the client to have? -Allergy -Liver failure -Hemophilia -Pediculosis pubis
Allergy (p. 520)
The nurse is caring for a client who had undergone hemodilution during surgery. Immediately after surgery, the nurse expects to see which lab result? -Elevated erythrocyte concentration -Elevated creatinine -Critically low arterial oxygen saturation -Decreased hematocrit
Decreased hematocrit.
What factor in plasma can be transformed from a liquid to a solid? -Globulins -Albumin -Leukocytes -Fibrinogen
Fibrinogen (p. 522)
A nurse is caring for a patient who has had a bone marrow aspiration with biopsy. What complication should the nurse be aware of and monitor the patient for? -Hemorrhage -Blood transfusion reaction -Shock -Splintering of bone fragments
Hemorrhage (p. 526)
The client's CBC with differential reveals small-shaped hemoglobin molecules. The nurse expects to administer which medication to this client? -Iron -Vitamin B12 -Folate -Fresh frozen plasma
Iron
Which cell of hematopoiesis is responsible for the production of red blood cells (RBCs) and platelets? -Myeloid stem cell -Lymphoid stem cell -Monocyte -Neutrophil
Myeloid stem cell (p. 535)
Which cells are converted to red blood cells, white blood cells, and platelets? -Myeloid stem cells -Lymphoid stem cells -Pluripotential stem cells -None of the options are correct
Myeloid stem cells (p. 517)
Which type of white blood cell (WBC) is the most numerous? -Neutrophil -Lymphocyte -Eosinophil -Basophil
Neutrophil (p. 519)
The body responds to infection by increasing the production of white blood cells (WBCs). The nurse knows to evaluate the differential count for the level of __________, the first WBCs to respond to an inflammatory event. -Basophils -Neutrophils -Eosinophils -Monocytes
Neutrophils (p. 517, 520)
You are presenting an educational workshop for a local community group. You have been asked to speak about older adults and their health. What is the most important piece of information to include in this presentation? -Older adults are more fragile than younger adults. -Older adults get sicker than other people. -Older adults take longer to heal than other people. -Older adults are more susceptible to infections and malignancies.
Older adults are more susceptible to infections and malignancies. (p. 523)
You are caring for a client who is undergoing bone marrow aspiration to determine their blood cell formation status. What nursing intervention should you provide to your client after the test? -Administer oral radioactive vitamin B12 to the client. -Administer a nonradioactive B12 injection. -Collect urine for 24 to 48 hours after the client receives the nonradioactive B12. -Support the client during a bone marrow aspiration and monitor the status.
Support the client during a bone marrow aspiration and monitor the status. (p. 526)
A female patient has been diagnosed with an unusual delayed response to allergic agents, as well as a compromised immune system. Which of the following does the nurse identify as the WBC value that is consistent with this diagnosis? -Basophils: 80/cmm -Monocytes: 600/cmm -T lymphocytes: 850/cmm -Neutrophils: 5,500/cmm
T lymphocytes: 850/cmm (p. 520)
What is hematopoiesis? -The manufacture and development of blood cells -The production of lymphatic fluid in the body -The making of red blood cells and lymph -The development of lymph in the bone marrow
The manufacture and development of blood cells. (p. 516)