chp 10
A client is admitted with a problem of thrombocytopenia. What will the nurse implement to address this problem?
Bleeding precautions Submit
A client is admitted with a suspected diagnosis of aplastic anemia. Which diagnostic test would the nurse expect to be ordered to confirm the diagnosis?
Bone marrow aspiration and biopsy Submit
The nurse is providing dietary teaching for the parent of a child with iron-deficiency anemia. Which foods would the nurse encourage the parent to include in the child's diet?
Liver; dark green, leafy vegetables; and whole grains2
A child is recovering from a sickle cell crisis. To promote health in this child after discharge, what is important for the nurse to discuss with the parents?
Maintain good hydration status.2
What would the nurse expect to find on an assessment with a client who has been diagnosed with anemia?
Malaise and weakness Submit
What would be the best nursing action in the care of a client with an acute exacerbation of polycythemia vera?
Monitor fluid hydration status. Submit
A client has developed aplastic anemia. What health problem in the client's past would be associated with this condition?
Treatment for a pulmonary malignancy4
The nurse understands that the most common symptoms of multiple myeloma are
anemia. Submit
A client begins receiving iron therapy because of iron-deficiency anemia. The nurse would encourage the client to take the iron supplement
between meals. Submit
The nurse understands that the pathophysiology causing a client to develop disseminated intravascular coagulation (DIC) is
caused by an abnormal bleeding and accelerated clotting.3
The nurse is explaining to the family of a client about the characteristics of Hodgkin's disease. Which characteristics are common findings? (Select all that apply.)
Insidious onset of symptoms3 Fever, malaise, and night sweats occur. Painless enlargement of cervical, axillary, inguinal, or mediastinal lymph nodes
The parents of a child diagnosed with hemophilia are taking their child home. Which statement made by the parents indicates a need for further education regarding hemophilia?
"We need to wrap our child's limbs daily to prevent bleeding."3
A client has a diagnosis of acquired aplastic anemia and has the following laboratory results, WBC count of 5000 mm3 and a platelet count of 40,000 mm3. What would be a priority intervention?
Institute bleeding precautions. Submit
A client has been diagnosed with Hodgkin's disease. What best describes Hodgkin's disease?
Is a malignancy of the lymphoid system.3
The nurse would expect to find which symptoms in a client who has hemophilia?
Joint pain and bleeding3
The nurse is caring for an older client with leukemia. He is experiencing bleeding into his knees. What is the best nursing care regarding joint mobility and activity?
Keep the joints immobilized and maintain bed rest. Submit
The nurse is caring for a client with a hemoglobin level of 8.2 gm/dl. What are important nursing measures?
Assess for tachycardia; keep warm.3
Which client would the nurse identify as being at an increased risk for development of iron-deficiency anemia?
A 2-year-old with a high milk intake4
What is the cause of sickle cell anemia?
A genetically induced production of abnormal hemoglobin S3
Which client is most likely to have iron-deficiency anemia?
A toddler whose primary nutritional intake is milk3
The charge nurse is delegating nursing care to the LPN for a newly admitted client with neutropenia. What delegated nursing actions would the LPN question, as it is not within the scope of practical nursing practice? (Select all that apply.)
Administration of pegfilgrastim injection2 Assisting the client with bathing and dressing Submit
An older client is being discharged after diagnosis and treatment for leukemia. What will be important to discuss with this client regarding home care?
Always thoroughly wash, cook, or peel vegetables and fruits.4
Which of the following signs and symptoms are associated with a diagnosis of childhood leukemia?
Anemia, increased incidence of infections, bleeding episodes4
A child with a history of a diagnosis of hemophilia is brought to the clinic after bumping his knee. The knee is rapidly swelling. What is the first nursing action?
Apply ice pack and compression dressings to the knee. Submit
A child has a severe laceration on his finger and it is bleeding profusely. What is the best nursing action?
Apply pressure at the site.3
An adult client is admitted and has the following laboratory results: WBC 4000/mm3, RBC 4.0 million/mm3, platelets 125,000/mm3. They are scheduled for a bone marrow aspiration. What would be the best nursing action in the care of this client after a bone marrow aspiration from the left posterior iliac crest?
Apply pressure to puncture site for 5 to 10 minutes. Submit
A client is experiencing a problem with epistaxis. What is the first nursing action?
Apply pressure to the nose and have the client lean forward.2
A client has been diagnosed with disseminated intravascular coagulation (DIC). Which laboratory test should the nurse anticipate being ordered specifically for the condition?
D-dimer3
After a motor vehicle accident, a client is admitted with a possible lacerated spleen. Which assessment finding would cause the nurse most concern?
Decrease in blood pressure4
A client has been placed on bleeding precautions. What is important to include in the nursing care?
Discourage flossing and encourage use of a soft toothbrush.3
A client has a diagnosis of multiple myeloma. What would be the best nursing action?
Encourage a high fluid intake daily.2
During a well-baby visit, the nurse is teaching the new mother how to prevent iron-deficiency anemia in her healthy, full-term, breastfed infant. Which of the following should be suggested? (Select all that apply.)
Encourage breastfeeding for the first 12 months. Include iron-fortified infant cereal by 4 to 6 months of age.
The nurse has prepared a discharge teaching for a client with aplastic anemia. What will be important to reinforce in the teaching plan? (Select all that apply.)
Establish a balance between rest and activity; avoid excessive fatigue. Rest and supplemental oxygen may be required during periods of dyspnea. Notify your health care provider if you begin to experience frequent bruising.
A young client is being admitted for acute leukemia. The nurse would anticipate what findings on the initial data collection?
Fatigue, fever, and bleeding3
In reinforcing the discharge nutrition instructions, which food sources should the practical nurse encourage the client with vitamin B12 deficiency anemia to eat more in their diet? (Select all that apply.)
Fish Eggs Milk and milk products Submit
What information would the nurse understand as a finding related to the hematologic system?
Frequent bruising2
Which of the following statement is accurate regarding blood components used for transfusions?
Fresh frozen plasma is 250 ml/unit.2
A child with leukemia is being discharged after beginning chemotherapy. What instructions will the nurse include in the teaching plan for the parents of this child?
Fresh vegetables should be cooked or peeled.3
A mother brings her 11-month-old infant to the clinic. He is diagnosed with leukemia. Which symptoms would the practical nurse anticipate finding on her assessment?
He has increased bruising.4
The nurse is performing a well-baby checkup on a 12-month-old infant. What finding would be of most concern?
He has increased bruising.4
A client has been diagnosed with pernicious anemia. What will the nurse discuss with the client regarding the vitamin B12 he will be prescribed when he goes home?
He will need to have monthly injections of vitamin B12.2
The nurse is assessing a client who has been diagnosed with polycythemia vera. What manifestations will the nurse anticipate finding?
Headaches, dyspnea, claudication4
An older adult client has a history of iron-deficiency anemia and has not been consistent with taking iron supplements because of problems with constipation. What would the nurse expect the client's laboratory findings to include?
Hemoglobin (Hb) 9.8 g/dl
The nurse is providing teaching to a family whose child has been recently diagnosed with hemophilia. Which of the following would the nurse include in this discussion?
Hemophilia is most often a sex-linked congenital disorder.4
A child experiences prolonged bleeding from a laceration, and he has multiple bruises without petechiae. The nurse would identify these findings as most often associated with which of the following conditions?
Hemophilia3
The nurse would anticipate which laboratory test to be used in the diagnosis of pernicious anemia?
Homocysteine2
A client arrives at the health stating suffering from a sickle cell crisis. What are the priorities of nursing care?
Hydration, oxygenation, pain management4
A child diagnosed with hemophilia has been hospitalized with hemarthrosis of his left elbow. The child states that his elbow is very painful, and there is an order for bed rest. What would be the best nursing action?
Immobilize and elevate the left elbow in a flexed position.3
Which laboratory report finding would most strongly support a diagnosis of acute myelogenous leukemia (AML)?
Increased leukocytes Submit
The nurse is caring for a client who is receiving a blood transfusion. The transfusion was started 30 minutes ago at a rate of 100 ml/hr. The client begins to complain of low back pain, chills, and a headache; he is becoming increasingly restless. What is the first nursing action?
Notify the RN regarding the status of the transfusion and anticipate the transfusion will be stopped.3
A young woman comes to the clinic complaining of dizziness, weakness, and palpitations. What will be important for the nurse to evaluate initially during the health history?
Nutritional patterns3
The nurse is assessing a client who has been admitted for treatment of his leukemia. What nursing observation should be reported immediately?
Oral temperature of 101°F Submit
A 10-year-old client is admitted in a sickle cell crisis. What would the nurse anticipate to be the priority concern for nursing care?
Pain management2
A young adult has sickle cell disease and is admitted with a vaso-occlusive crisis of the knee after falling down at work. Which intervention should be included in the plan of care?
Pain management2
A client has a diagnosis of thrombocytopenia. Which clinical findings would the nurse monitor for related to the thrombocytopenia? (Select all that apply.)
Petechiae Ecchymoses Epistaxis
A child is diagnosed with hemophilia. The nurse would identify which client findings most often associated with this condition?
Prolonged bleeding from a laceration and multiple bruises without petechiae3
The nurse identifies which problem as most likely to lead to a sickle cell crisis?
Recurrence of upper respiratory tract infection (URI)
The nurse is explaining blood components to a 9-year-old child with anemia. What would be the nurse's best description of what red blood cells do in the body?
Red blood cells carry oxygen from the lungs to nourish the body.4
An adult leukemia client is having a bone marrow aspiration to evaluate his response to chemotherapy. What site for this procedure would the nurse describe to the client?
Right or left iliac crest, or "hipbone"3
A client with iron deficiency anemia is being discharged. To reinforce the importance of the diet teaching the nurse should explain that these are iron rich sources. (Select all that apply.)
Spinach Liver and organ meats Dark chocolate
The nurse would anticipate which common but serious acute complication of polycythemia vera?
Stroke
The nurse is discussing home care with the parents of a child with sickle cell anemia. Included in the discussion are activities that may promote a vaso-occlusive crisis. Which would be an acceptable activity for this child?
Swimming4
The client asks, "If my child has sickle cell disease, does that mean that I am at an increased risk for developing the same problems?" The nurse's response would be based on what principle of sickle cell disease?
The parents are both carriers of the trait, but they do not have the active disease; each child has a 25% chance of having the condition. Submit
The nurse is working with parents who have a child who has been diagnosed with sickle cell anemia and crisis. What will the nurse include in the teaching regarding the pathophysiology of sickle cell crisis?
Tissue hypoxia and vascular occlusion cause the primary problems.3
A client is being treated with epoetin alfa. The nurse would explain to the client that the purpose of the medication is to
increase production of red blood cells. Submit
A mother reports that her 18-month-old toddler has been inactive, tires easily, and plays very little. Based on this information, the nurse suspects
iron deficiency.3
The nurse understands that the following explains that iron-deficiency anemia is common during infancy because
milk does not provide sufficient iron.3
A nurse is preparing to administer an intramuscular injection of iron. The nurse changes the needle after drawing the medication into the syringe to
prevent staining of the skin.2
A client begins to complain of chills and discomfort after about 50 ml of blood has transfused from a unit of packed red blood cells. The best nursing action at this time is to
stop the transfusion, maintain a patent line with normal saline solution, and notify the RN.4
