Hematology

A client admitted to the hospital with abdominal pain, anemia, and bloody stools reports feeling weak and dizzy. The client has rectal pressure and needs to urinate and move their bowels. The nurse should help them: a. to the bathroom. b. onto the bedpan. c. to the bedside commode. d. to a standing position so he can urinate.

b. onto the bedpan. A client who's dizzy and anemic is at risk for injury because of his weakened state. Assisting him with the bedpan would best meet his needs at this time without risking his safety. The client may fall if walking to the bathroom, left alone to urinate, or trying to stand up.

The nurse is caring for a client with type 2 diabetes who take metformin to manage glucose levels. The nurse recognizes the client may be most at risk for which vitamin deficiency? a. vitamin A b. vitamin B12 c. Folate d. vitamin C

b. vitamin B12 The medication metformin (Glucophage) increases the client's risk for developing B12 deficiency because the medication inhibits the absorption of B12.

Your patient is having a blood transfusion and they begin to complain of lower back pain. They start presenting with fever, chills, dyspnea and bronchospasm. You begin to realize they are having an acute hemolytic reaction to the transfusion. Place the order of steps for what the nurse should do in this situation? a. return blood and tubing back to the blood bank for testing b. call the HCP and blood bank c. stop the transfusion d. begin infusion of NS with new tubing

c, d, b, a

A nurse is teaching a client who has SLE about self-care. which of the following statements by the client indicates an understanding of teaching? a. "I should limit my time to 10 minutes in the tanning bed" b. "I will apply powder to any skin rash" c. "I should use mild hair shampoo" d. "I will inspect my skin once a month for rashes"

c. "I should use mild hair shampoo"

The hospitalized client is experiencing gastrointestinal bleeding with a platelets at 9,000/mm³. The client is receiving prednisone and azathioprine. What action will the nurse take? a. Request a prescription of diphenoxylate and atropine for loose stools. b. Teach the client to vigorously floss the teeth to prevent infections. c. Use contact precautions with this client. d. Perform a neurologic assessment with vital signs.

d. Perform a neurologic assessment with vital signs.

What is an autologous blood transfusion?

when a patients own blood is collected 4-6 weeks prior to their procedure. Give iron supplements. Can donate one unit per week but not within 72 hours of procedure.

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 health care provider. What type of anemia is the nurse concerned the co-worker may have? A. Iron deficiency anemia B. Sickle cell anemia C. Megaloblastic anemia D. Aplastic anemia

A. Iron deficiency anemia

A client's family member asks the nurse why disseminated intravascular coagulation (DIC) occurs. Which statement by the nurse correctly explains the cause of DIC? A. "DIC occurs when the immune system attacks platelets and causes massive bleeding." B. "DIC is caused when hemolytic processes destroy erythrocytes." C. "DIC is a complication of an autoimmune disease that attacks the body's own cells." D. "DIC is caused by abnormal activation of the clotting pathway, causing excessive amounts of tiny clots to form inside organs."

D. "DIC is caused by abnormal activation of the clotting pathway, causing excessive amounts of tiny clots to form inside organs."

A client with multiple myeloma is complaining about pain. What instructions will the nurse give the client to help to reduce pain during activity? a. Limit activity to once a day. b. Stay in bed as much as possible. c. Limit fluids to prevent going to the bathroom. d. do not lift more than 10 pounds

d. do not lift more than 10 pounds

A nurse is teaching a newly licensed nurse about heparin-induced thrombocytopenia (HIT). Which of the following risk factors for this disorder should the nurse include in the teaching? a. warfarin therapy b. placental abruption c. systemic lupus erythematosus d. heparin therapy for DVT

d. heparin therapy for DVT

The client is receiving a unit of PRBCS begins to chill and devleop hives. Which action should be the nurses first response? a. notify the laboratory and HCP b. administer diphenhydramine IV c. assist the client for further complications d. stop the transfusion and change the tubing at the hub

d. stop the transfusion and change the tubing at the hub

What is the difference between vitamin b12 deficiency and folic acid deficiency?

neurological complications in vitamin B12 are irreversible vs. in folic acid deficiency neurological complications are reversible

Where in the body is Vitamin B12 absorbed?

the small intestine

The clinic nurse is caring for a client diagnosed with leukopenia. What does the nurse know this client has? a. A general reduction in neutrophils and basophils b. Too many erythrocytes c. A general reduction in all white blood cells d. A decrease in granulocytes

c. A general reduction in all white blood cells

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 28g/dL. The nurse suspects which of the following types of anemia? a. folic acid anemia b. Vitamin B12 anemia c. Iron-deficiency anemia d. Sickle cell anemia

c. Iron-deficiency anemia

A client with sickle cell anemia has a a. normal hematocrit. b. normal blood smear. c. low hematocrit. d. high hematocrit.

c. low hematocrit.

A nurse is reviewing their lab findings of a client who has the measles. The nurse should expect to find an increase of which of the following types of WBCs? a. neutrophils b. basophils c. lymphocytes d. eosinophils

c. lymphocytes

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) Magnesium level of 2.5 mg/dL b) Calcium level of 9.4 mg/dL c) Potassium level of 5.2 mEq/L d) Creatinine level of 6 mg/100 mL

d) Creatinine level of 6 mg/100 mL The degree of anemia in patients with end-stage renal disease varies greatly; however, in general, patients do not become significantly anemic until the serum creatinine level exceeds 3 mg/100 mL.

The nurse is assisting the client with multiple myeloma to ambulate. What is the most important nursing intervention to help prevent fractures in the client? a. Increase mobility. b. Encourage adequate nutrition. c. Provide adequate hydration. d. Promote safety.

d. Promote safety.

A patient is diagnosed with iron deficiency anemia. She asks if there is anything she should do to help correct this. Your best response is: A. sleep 7-8 hours each night. B. Decrease her salt intake and drink more water. C. Increase dietary iron intake with foods such as lean red meat, dark green leafy vegetables, and whole grains. D. Aerobic exercise for at least 30 minutes three times a week.

C. Increase dietary iron intake with foods such as lean red meat, dark green leafy vegetables, and whole grains.

A client is treated for anemia. What is the nurse's best understanding about the correlation between anemia and the client's iron stores? A. There is a weak correlation between iron stores and hemoglobin levels. B. There is an inverse relationship between iron stores and hemoglobin levels. C. There is a strong correlation between iron stores and hemoglobin levels. D. There is a strong correlation between iron stores and hemoglobin characteristics.

C. There is a strong correlation between iron stores and hemoglobin levels.

A client with severe anemia reports symptoms of tachycardia, palpitations, exertional dyspnea, cool extremities, and dizziness with ambulation. Laboratory test results reveal low hemoglobin and hematocrit levels. Based on the assessment data, which nursing diagnoses is most appropriate for this client? A. Fatigue related to decreased hemoglobin and hematocrit B. Imbalanced nutrition, less than body requirements, related to inadequate intake of essential nutrients C. Risk for falls related to complaints of dizziness D. Ineffective tissue perfusion related to inadequate hemoglobin and hematocrit

D. Ineffective tissue perfusion related to inadequate hemoglobin and hematocrit

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 important for the nurse to determine what type of foods the patient will eat. B. It will determine what type of anemia the patient has. C. It is part of the required assessment information. D. It may indicate deficiencies in essential nutrients.

D. It may indicate deficiencies in essential nutrients.

The nurse provides care for an older adult client, diagnosed with anemia, who has a hemoglobin of 9.6 g/dL and a hematocrit of 34%. To determine the cause of the client's blood loss, which is the priority nursing action? a. Monitor the client's body temperature. b. Observe the client's stools for blood. c. Monitor the client's blood pressure. d. Evaluate the client's dietary intake.

b. Observe the client's stools for blood. If an older adult is anemic, blood loss from the gastrointestinal (GI) or genitourinary (GU) tracts is suspected. Observing the stool for blood will determine if the source of the client's bleeding is in the GI tract. Iron-deficiency anemia is unusual in older adults because the body does not eliminate excessive iron, thus increasing total body iron stores and necessitating maintenance of hydration. If evaluation of the GI and GU tracts does not reveal a source of bleeding, evaluating the client's diet may be appropriate; however, this is not the priority nursing action. Monitoring the client's body temperature and BP will assist the nurse in determining the source of the client's blood loss, but these are not priority nursing actions.

The student nurse asks the nurse, "what is sickle cell anemia?" Which statement by the nurse would be the best answer to the student's question? a. "there is some writen material at the desk that displays the disease" b. "it is a congenital disease of the blood in which the blood does not clot" c. "the client has decreased synovial fluid that causes joint pain" d. "the blood becomes thick when the client is deprived of oxygen"

d. "the blood becomes thick when the client is deprived of oxygen"

A nurse cares for a client suspected of having iron deficient anemia. Which diagnostic test will the nurse expect the health care provider to order in order to definitively diagnose the condition? A. Complete blood count B. Bone marrow aspiration C. Serum ferritin D. Blood smear

B. Bone marrow aspiration

A client is prescribed 325 mg/day of oral ferrous sulfate. What does the nurse include in client teaching? a. Decrease intake of dietary fiber b. Decrease intake of fruits and juices c. Take with dairy products d. Take 1 hour before breakfast

d. Take 1 hour before breakfast Instructions the nurse will provide for the client taking oral ferrous sulfate is to administer the medication on an empty stomach. Instructions also include that there is decreased absorption of iron with food, particularly dairy products. The client is to increase vitamin C intake (fruits, juices, tomatoes, broccoli), which will enhance iron absorption. The client is to also increase foods high in fiber to decrease risk of constipation.

T/f: Once neuro Things start to happen in a person with Vitamin B12 Anemia it cannot be reversed

true

The nurse devises a teaching plan for the patient with aplastic anemia. Which of the following is the most important concept to teach for health maintenance? A. Eat animal protein and dark leafy vegetables each day B. Avoid exposure to others with acute infection C. Practice yoga and meditation to decrease stress and anxiety D. Get 8 hours of sleep at night and take naps during the day

B. Avoid exposure to others with acute infection Clients with aplastic anemia are severely immunocompromised and at risk for infection and possible death related to bone marrow suppression and pancytopenia. Strict aseptic technique and reverse isolation are important measures to prevent infection

Which type of malignant lymphoma has a higher survival rate Hodgkins or non-hodgkins?

Hodgkins

Which type of malignant lymphoma has Reed-Sternburg cells, Hodgkins or non-hodgkins?

Hodgkins lymphoma

Explain to me what is happening in Multiple Myeloma.

Plasma cells are transformed into cancerous cells that grow out of control, crowding out all of the normal cells that help fight infection. These malignant plasma cells produce an abnormal antibody = M protein

A patient comes into the hospital with a red flushed face and SOB. they have been complaining that that when they take warm baths they feel super itchy. What does the nurse suspect this person has?

Polycythemia vera

________ "feed" the body

RBCs

What are the 4 classic clinical manifestations of multiple myeloma?

THINK MYA HAS CRABS!! -HyperCalcemia -Renal dysfunction -Anemia -Bone destruction

__________ prevents or limits bacterial infections a. Neutrophil b. Monocytes c. Eosinophils d. Basophil

__________ involved in allergic reactions. a. Neutrophil b. Monocytes •Eosinophils •Basophil

A nurse is teaching her patient about things a patient with sickle cell anemia should avoid doing. Which things put a patient with a sickle cell anemia at risk for complications. (select all that apply) a. high altitudes b. cold temperatures c. wearing loose clothing d. wearing tight clothing e. drinking water f. not drinking water

a, b, d, f

A nurse is providing discharge teaching for a client who had a bone marrow transplant and has thrombocytonpenia. Which of the following statements indicates that the client understands the precautions he must take at home? a. " I'll stick with soft foods for now" b. "My family will be bringing me fresh flowers today" c. "I'll use a new disposable razor each day" d. "I'll blow my nose more often to avoid nosebleeds"

a. " I'll stick with soft foods for now"

A client comes to the walk-in clinic reporting weakness and fatigue. While assessing this client, the nurse finds evidence of petechiae and ecchymoses and notes that the spleen appears enlarged. What would the nurse suspect is wrong with this client? a. Aplastic anemia b. Pernicious anemia c. Iron deficiency anemia d. Agranulocytosis

a. Aplastic anemia

Which of the following is considered an antidote to heparin? a. Protamine sulfate b. Vitamin K c. Narcan d. Ipecac

a. Protamine sulfate

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 bleeding the question is talking about DIC as a whole so in stage 1 there is thrombosis and in stage 2 there is bleeding! if it said just stage 1 it would be thrombosis and it was just stage 2 it would be bleeding!

The client diagnosed with Sickle cell anemia is experiencing an acute vaso-occlusive crisis. Which priority intervention should the nurse implement? a. maintain IV fluids and administer pain medications b. encourage frequent ambulation in the hallways c. administer oxygen via nasal cannula at 10 L per minute d. monitor the clients RBC count every 4 hours

a. maintain IV fluids and administer pain medications

A nurse is reviewing a client's CBC findings and discovers that the client's platelet count is 9000 (low). 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

When a client is diagnosed with aplastic anemia, the nurse monitors for changes in which of the following physiological functions? a.Bleeding tendencies b.Intake and output c.Peripheral sensation d.Bowel function

a.Bleeding tendencies

________ is the insufficient amount of RBCs

anemia

A nurse is caring for a client who has a platelet count of 50,000. After discontinuing the client's peripheral IV site, which of the following actions should the nurse take? a. Apply warm compress b. Apply pressure to the catheter removal site for 5 minutes c. place the affected arm in a dependent position d. clean the insertion site with alcohol

b. Apply pressure to the catheter removal site for 5 minutes

A patient is admitted to the hospital with idiopathic aplastic anemia. Which of these collaborative problems will the nurse include when developing the care plan? a. Potential complication: seizures b. Potential complication: infection c. Potential complication: neurogenic shock d. Potential complication: pulmonary edema

b. Potential complication: infection

A nurse is transfusing a unit of B-positive fresh frozen plasma to a client whose blood type is O-negative. Which of the following actions should the nurse take? a. Continue to monitor for manifestations of a transfusion reaction b. Remove the unit of plasma immediately and start an IV infusion of Normal Saline solution c. continue the transfusion and repeat the type and crossmatch d. Prepare to administer a dose of Diphenhydramine IV

b. Remove the unit of plasma immediately and start an IV infusion of Normal Saline solution

The nurse is caring for an older adult client who has a WBC count of 2,000/mm3 after 3 rounds of chemotherapy. Which of the following actions should the nurse take? a. Humidify the client's room b. Severe cooked fruit with meals c. Clean dentures in a denture cup d. Replace the water in flower vases with fresh water daily

b. Severe cooked fruit with meals bc patient with an infection will be on neutropenic precautions

A nurse is reviewing the PT, aPTT and INR lab values for a client who is experiencing an acute episode of of disseminated intravascular coagulation (DIC) stage-2. Which of the following lab results should the nurse expect? a. The lab values are within expected reference range b. The lab values are prolonged c. The lab values are decreased d. The lab values are the same as the previous test

b. The lab values are prolonged these lab values measure how long it makes (in secs) for clotting. In stage 2 there is loooots of bleeding and no clotting factors present so it will take a LONGER time for the blood to try and clot. The staging is very important!!

A nurse in a provider's office is reviewing the medical records of a group of clients. Which of the following clients is at risk for iron deficiency? (select all that apply) a. A client who is postmenopausal b. a client who is vegetarian c. a middle adult male client d. a client who is pregnant e. a toddler who is overweight

b. a client who is vegetarian d. a client who is pregnant e. a toddler who is overweight A client who is vegetarian might require additional iron because the availability of iron in vegetable sources is limited. During pregnancy, maternal blood volume increases, and the fetus requires additional iron. Toddlers who are overweight may get most of their calories from milk and foods that are not considered healthy which increases their risk for IDA.

A nurse is admitting a child who has leukemia and a critically low platelet count. Which of the following precautions should the nurse initiate? a. neutropenic b. bleeding c. contact d. droplet

b. bleeding

A nurse is planning care for a client who has leukemia and a platelet count of 130,000. Which of the following interventions should the nurse include in the plan of care? a. check the IV site for bleeding every 8 hours b. limit IM injections c. obtain a rectal temperature every 8 hours d. check the client for proteinuria

b. limit IM injections

A nurse is caring for an older adult client who has WBC count of 2,000/mm3 after three rounds of chemotherapy. Which of the following actions should the nurse take? a. Humidify the clients room b. serve cooked fruit with meals c. Clean dentures in a cup d. replace the water in flower vases with fresh water daily

b. serve cooked fruit with meals neutropenic precautions bc they are low on WBC so its harder for them to fight infection

Why is oxygen therapy CRUCIAL AND SO HUGE for patients with sickle cell anemia?

bc they cannot transport oxygen like normal RBCS, they are sickle celled which decreases oxygenation

Thrombocytopenia is when platelet count is _______ normal range

below

A nurse is teaching a client who has polycythemia vera about self-care measures. Which of the following interventions should the nurse include? a. drink at leat 1 L of fluid each day b. continuously wear support hose c. elevate your legs when sitting d. use dental floss dailt

c

Which are the only 2 anticoagulants approved for treatment of Heparin Induced Thrombocytopenia? a. Warfarin b. Platelet transfusions c. Lepirudin d. Argatroban

c, d

The nurse is caring for a female client recovering from a sickle cell crisis. The client tells the nurse about a planned family trip to yellowstone national park. Which response would be the best for the nurse? a. "That sounds like a wonderful trip, have fun" b. "Have you talked to your doctor about taking the trip" c. "You really should not take a trip to areas with high altitudes" d. "Why do you want to go to yellowstone"

c. "You really should not take a trip to areas with high altitudes" you want to avoid high altitudes in these patients bc high altiudes makes it harder to breathe and requires more oxygen

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

c. B12

A newly admitted client has sickle cell crisis. The nurse is planning care based on assessment of the client. The client is complaining of severe pain in his feet and hands. The pulse oximetry is 89. Which of the following interventions would be implemented first? Assume that there are orders for each intervention. a. Adjust the room temperature b. Give a bolus of IV fluids c. Start O2 d. Administer meperidine (Demerol) 75mg IV push

c. Start O2

A nurse is caring for a client who is receiving cisplatin for treatment of ovarian cancer. The client's most recent CBC is shown in the table below. It is important for the nurse to consider which of the following for the client. (WBC= 1,400. RBC=4.3x10^12. Hgb=12.1, Hct= 36.5%. Platelets =170,000) a. the client has increased risk for bleeding b. the client should receive a diet with increased iron c. The client has an increased risk of infection d. The client should receive and erythropoiesis stimulating client

c. The client has an increased risk of infection

What is the hallmark sign for how a patient with sickle cell anemia would present? a. red glossy tongue b. balance and coordination problems c. extreme pain in joints, bones, chest and abd d. blood in stool

c. extreme pain in joints, bones, chest and abd

A nurse is teaching a client who has a new diagnosis of aplastic anemia. Which of the following information should the nurse include in her 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 ALL blood cells

d. Aplastic anemia results from decreased bone marrow production of ALL blood cells

A nurse is teaching a new RN about HIT. Which of the following risk factors for this disorder should the nurse include in the teaching? a. Warfarin therapy for A.fib b. Placental abruption c. SLE d. Heparin therapy for DVT

d. Heparin therapy for DVT

A client is receiving chemotherapy for cancer. The nurse reviews the client's laboratory report and notes that he has thrombocytopenia. To which nursing diagnosis should the nurse give the highest priority? a. Activity intolerance b. Impaired tissue integrity c. Impaired oral mucous membranes d. Ineffective tissue perfusion: Cerebral, cardiopulmonary, GI

d. Ineffective tissue perfusion: Cerebral, cardiopulmonary, GI

You are assessing your patient in clinical and notice that your patient has uneven growth in their fingers and toes. What would you suspect is wrong with your patient? a. iron deficiency anemia b. folic acid deficiency c. vitamin b12 deficiency d. sickle cell anemia

d. sickle cell anemia

What do we not want to do or give to our patients experiencing HIT?

do not administer warfarin or platelet transfusion

People with this disease are known as "free bleeders"

hemophilia

Why is aggressive hydration important in patients with sickle cell anemia?

hydration helps with unsticking and clumping. It also keeps the kidneys flushed

A patient with gout has been ordered allopurinol. What does this medication do?

Allopurinol decreases uric acid levels

What is building up in joints, bone and soft tissue with GOUT

Uric acid

Vitamin _____ is also known as the extrinsic factor that binds to the intrinsic factor

B12

The nurse cares for an older adult client with unprovoked back pain and increased serum protein. Which hematologic neoplasm does the nurse suspect the client has? a. Multiple myeloma b. Chronic myeloid leukemia c. Non-Hodgkin lymphoma d. Hodgkin lymphoma

a. Multiple myeloma

What is the most dangerous type of tranfusion reaction? a. febrile nonhemolytic reaction b. acute hemolytic reaction c. allergic reaction

b. acute hemolytic reaction

During physical assessment of a patient, the nurse suspects a chronic, severe iron-deficiency anemia on finding a.Yellow-tinged sclerae b.Gum bleeding and tenderness c.Shiny, smooth tongue d.Numbness of extremities

c.Shiny, smooth tongue

A nurse is assessing a client who has a new diagnosis of systemic lupus erythematosus (SLE). Which of the following findings should the nurse expect? a. weight gain b. petechiae on thighs c. systolic murmur d. alopecia

d. alopecia

The nurse obtains a unit of blood for the client, Donald D. Smith. The name on the label on the unit of blood reads Donald A. Smith. All the other identifiers are correct. What action should the nurse take? A. Refuse to administer the blood B. Ask the client if he was ever known as Donald A. Smith C. Check with the blood bank first and then administer the blood with their permission D. Administer the unit of blood

A. Refuse to administer the blood

The client is being admitted with Folic acid deficiency anemia. Which would be the most appropriate referral? A.Alcoholics anonymous B.Leukemia society of America C.A hematologist D.A social worker

A.Alcoholics anonymous

When teaching a client with iron deficiency anemia about appropriate food choices, the nurse encourages the client to increase the dietary intake of which foods? A. Fruits high in vitamin C, such as oranges and grapefruits B. Dairy products C. Beans, dried fruits, and leafy, green vegetables D. Berries and orange vegetables

C. Beans, dried fruits, and leafy, green vegetables

In pernicious anemia, intrinsic factor is not being secreted by the _______ cells which are found in the gastric mucosa. A. Visceral B. Langerhan C. Parietal D. Chief

C. Parietal

________ "defend" the body

WBCS

A nurse is caring for a client who is receiving a blood transfusion. Which of the following actions should the nurse plan to take if an allergic transfusion reaction is suspected? a. stop the transfusion b. monitor for hypertension c. maintain IV infusion with 0.9% sodium chloride d. position the client in an upright position with the feet lower than the heart e. administer diphenhydramine

a, c, e

A nurse is reviewing the plan of care for a patient who has systemic lupus erythematosus (SLE). The client reports fatigue, swelling, and difficult urinating. Which of the following laboratory findings should the nurse anticipate? a. Positive ANA titer b. Increased hgb c. 2+ urine protein d. increased serum C3 and C4 e. elevated BUN

a, c, e

A client was admitted to the hospital with a pathologic pelvic fracture. The client informs the nurse that he has been having a strange pain in the pelvic area for a couple of weeks that was getting worse with activity prior to the fracture. What does the nurse suspect may be occurring based on these symptoms? a. Multiple myeloma b. Leukemia c. Polycythemia vera d. Hemolytic anemia

a. Multiple myeloma

A nurse is preparing to administer a scratch test to a client who has a possible food and evironmental allergies. Which of the following actions should the nurse perform prior to the procedure? (select all that apply) a. cleanse the client's skin with iodine b. ask the client about previous reactions c. ask the client about medications taken over the past several days d. Inform the client to expect itching at one site e. obtain emergency resuscitation equipment

b, c, d e

Clients with multiple myeloma have abnormal plasma cells that proliferate in the bone marrow where they release osteoclast-activating factor, resulting in the formation of osteoclasts. What is the most common complication of the pathology resulting from this process? a. Increased mobility b. Pathologic fractures c. Calcified bones d. Osteoporosis

b. Pathologic fractures

A client is awaiting test results to diagnose Hodgkin lymphoma. The nurse knows that which result is the hallmark for the diagnosis of this condition? a. Elevated platelet count b. Reed-Sternberg cells c. Increased basophils d. Misshaped red blood cells

b. Reed-Sternberg cells

A patient with acute myeloid leukemia (AML) has a neutrophil count that persists at less than 100/mm3. What should the nurse cautiously monitor this patient for? a. Hypotension b. Seizure activity c. Infection d. Abdominal cramps

c. Infection

Which term refers to an abnormal decrease in white blood cells, red blood cells, and platelets? a. Anemia b. Thrombocytopenia c. Pancytopenia d. Leukopenia

c. Pancytopenia

What is an intraoperative blood salvage (cell saver) blood donation?

during surgery blood is suctioned into a cell saver machine where it is washed and filtered before transfering it back into patient.

The nurse in the oncology clinic is caring for a 42-year-old female client receiving chemotherapy with fludarabine for acute myeloid leukemia who has developed petechiae, epistaxis, and ecchymosis. Complete the following sentence by choosing from the lists of options. The nurse anticipates that the client has developed _____________ and that the laboratory results will reveal ____________.

hemorrhage and thrombocytopenia

_________ "heal" the body

platelets

Are the neurologic complications for folic acid deficiency reversible or irreversible?

reversible

What is the most common population/types of people to have sickle cell anemia?

African americans

What medication decreases uric acid levels in patients with gout?

Allopurinol

A few minutes after beginning a blood transfusion, a nurse notes that a client has chills, dyspnea, and urticaria. The nurse reports this to the health care provider immediately because the client probably is experiencing which problem? A. A hemolytic reaction to mismatched blood B. A hemolytic reaction to Rh-incompatible blood C. A hemolytic reaction caused by bacterial contamination of donor blood D. A hemolytic allergic reaction caused by an antigen reaction

D. A hemolytic allergic reaction caused by an antigen reaction

The _________ _______ is the site of blood cell formation.

bone marrow

What is the most common rheumatic disease?

rheumatoid arthritis

A client with a diagnosis of pernicious anemia comes to the clinic and reports numbness and tingling in the arms and legs. What do these symptoms indicate? a. Neurologic involvement b. Loss of vibratory and position senses c. Insufficient intake of dietary nutrients d. Severity of the disease

a. Neurologic involvement In clients with pernicious anemia, numbness and tingling in the arms and legs, and ataxia are the most common signs of neurologic involvement. Some affected clients lose vibratory and position senses. Jaundice, irritability, confusion, and depression are present when the disease is severe. Insufficient intake of dietary nutrients is not indicated by these symptoms.

A complete blood count is commonly performed before a client goes into surgery. What does this test seek to identify? a. Electrolyte imbalance that could affect the blood's ability to coagulate properly b. Potential hepatic dysfunction indicated by decreased blood urea nitrogen (BUN) and creatinine levels c. Low levels of urine constituents normally excreted in the urine d. Abnormally low hematocrit (HCT) and hemoglobin (Hb) levels

d. Abnormally low hematocrit (HCT) and hemoglobin (Hb) levels

A client with pernicious anemia is receiving parenteral vitamin B12 therapy. Which client statement indicates effective teaching about this therapy? a. "I will receive parenteral vitamin B12 therapy until my vitamin B12 level returns to normal." b. "I will receive parenteral vitamin B12 therapy for the rest of my life." c. "I will receive parenteral vitamin B12 therapy until my signs and symptoms disappear." d. "I will receive parenteral vitamin B12 therapy monthly for 6 months to a year."

b. "I will receive parenteral vitamin B12 therapy for the rest of my life." Because a client with pernicious anemia lacks intrinsic factor, oral vitamin B12 can't be absorbed. Therefore, parenteral vitamin B12 therapy is recommended and required for life.

In sickle cell anemia we are concerned about __________

clotting

A client with sickle cell crisis is admitted to the hospital in severe pain. While caring for the client during the crisis, which is the priority nursing intervention? a. Limit foods that contain folic acid b. Encouraging the client to ambulate immediately c. Limiting the client's intake of oral and IV fluids d. Administering and evaluating the effectiveness of opioid analgesics

d. Administering and evaluating the effectiveness of opioid analgesics

The strict vegetarian is at highest risk for the development of which anemia? A. Thalassemia B. Iron deficiency anemia C. Folic acid deficiency anemia D. Cobalamin (Vitamin B12) deficiency anemia

B. Iron deficiency anemia

Larry comes into the hospital with balance issues, tinnitus, mood swings, and states that when he lifts his head up he feels like he is being shocked. What does the nurse suspect Larry has? a. Iron Deficiency Anemia b. Vitamin B12 Deficiency c. Folic Acid deficiency d. Sickle cell anemia

b. Vitamin B12 Deficiency

A nurse is completing an integumentary assessment of a client who has anemia. Which of the following finds should you expect? a. absent turgor b. spoon-shaped nails c. shiny, hairless legs d. yellow mucous membranes

b. spoon-shaped nails

The nurse recognizes the clinical assessment of a patient with acute myeloid leukemia (AML) includes observing for signs of infection early. What nursing action will most likely help prevent infection? a. Maintain contact precautions. b. Practice vigilant handwashing. c. Encourage increased fluid consumption. d. Monitor the client's temperature every shift.

b. Practice vigilant handwashing.

A client with anemia may be tired due to a tissue deficiency of which of the following substances? a.Carbon dioxide b.Factor VIII c.Oxygen d.T-cell antibodies

c.Oxygen

A nurse in a clinic is caring for a client who has suspected anemia. Which of the following lab test results should the nurse expect? A. Iron 90 mcg/dL B. RBC 6.5 million/uL C. WBC 4,800 mm3 D. Hgb 10 g/dL

D. Hgb 10 g/dL

A nurse is caring for a client with multiple myeloma. Which laboratory value is the nurse most likely to see? a. Hypernatremia b. Hypercalcemia c. Hypermagnesemia d. Hyperkalemia

b. Hypercalcemia

A nurse preceptor is observing a newly licensed nurse on the unit who is preparing to administer a blood transfusion to an older adult client. Which of the following actions by the newly licensed nurse indicates an understanding of the procedure? a. Inserts an 18-gauge Iv catheter in the client b. verifies blood compatibility and expiration date of the blood with an assistive personnel (AP) c. administers dextrose 5% in 0.9% sodium d. obtains vital signs every 15 min through out the procedure

d. obtains vital signs every 15 min through out the procedure

Which nursing intervention should be incorporated into the plan of care to manage the delayed clotting process due to thrombocytopenia in a client with leukemia? a. Monitoring temperature at least once per shift b. Applying prolonged pressure to needle sites or other sources of external bleeding c. Eliminating direct contact with others who are infectious d. Implementing neutropenic precautions

b. Applying prolonged pressure to needle sites or other sources of external bleeding The interventions for a client with thrombocytopenia are the same as those for a client with cancer who is at risk for bleeding. For a client with leukemia, the nurse should apply prolonged pressure to needle sites or other sources of external bleeding. Reduced platelet production results in a delayed clotting process and increases the potential for hemorrhage. Implementing neutropenic precautions and eliminating direct contact with others are interventions to address the risk for infection.

A nurse is caring for a client who has a WBC count of 20,000/mm3. The nurse should conclude that the client has which of the following? a. Neutropenia b. Leukocytosis c. left shift d. leukopenia

b. Leukocytosis

A nurse is caring for a client with iron deficiency anemia. Which food or beverage will the nurse suggest to the client to eat or drink when taking supplemental iron? a. Leafy green vegetables b. Milk c. Orange juice d. Kidney beans

c. Orange juice you want to increase Vitamin C in these people bc vitamin c helps in the absorption of iron

The nurse is caring for a client with acute myeloid leukemia (AML) with high uric acid levels. What medication does the nurse anticipate administering that will prevent crystallization of uric acid and stone formation? a. Filgrastim b. Hydroxyurea c. Asparaginase d. Allopurinol

d. Allopurinol

A nurse working in an outpatient clinic is assessing a client who has rheumatoid arthritis (RA). The client reports increased joint tenderness and swelling. Which of the following findings should the nurse expect? (select all that apply) a. recent influenza b. decreased ROM c. hypersalivation d. increased BP e. pain at rest

a,b, e

A nurse is teaching a client who has a new diagnosis of rheumatoid arthritis (RA). Which of the following statements should the nurse include in the teaching? a. "you can experience morning stiffness when you get out of bed" b. "you can experience abdominal pain" c. "you can experience weight gain" d. "you can experience low blood sugar"

a. "you can experience morning stiffness when you get out of bed"

A client with acute myeloid leukemia (AML) receiving chemotherapy is treated for an acute renal injury. What is the nurse's best understanding of the pathophysiological reason behind the client's injury? a. Chemotherapy causes an increase in kidney stone formation. b. Chemotherapy causes destruction of the nephrons in the kidney. c. The majority of the disease process occurs in the tissue of the kidneys. d. The majority of the disease process occurs in the vessels of the kidneys.

a. Chemotherapy causes an increase in kidney stone formation.

When assessing a client with anemia, which assessment is essential? a. Family history b. Lifestyle assessments, such as exercise routines c. Health history, including menstrual history in women d. Age and gender

c. Health history, including menstrual history in women When assessing a client with anemia, it is essential to assess the client's health history. Women should be questioned about their menstrual periods (e.g., excessive menstrual flow, other vaginal bleeding) and the use of iron supplements during pregnancy.

After receiving chemotherapy for lung cancer, a client's platelet count falls to 98,000/mm3. What term should the nurse use to describe this low platelet count? a. Neutropenia b. Leukopenia c. Anemia d. Thrombocytopenia

d. Thrombocytopenia A normal platelet count is 140,000 to 400,000/mm3 in adults. Chemotherapeutic agents produce bone marrow depression, resulting in reduced red blood cell counts (anemia), reduced white blood cell counts (leukopenia), and reduced platelet counts (thrombocytopenia). Neutropenia is the presence of an abnormally reduced number of neutrophils in the blood and is caused by bone marrow depression induced by chemotherapeutic agents.

A nurse caring for a client who has hemophilia is getting ready to take the client's vital signs. What should the nurse do before taking a blood pressure? a. Ask if taking a blood pressure has ever produced bleeding under the skin or in the arm joints. b. Ask if taking a blood pressure has ever produced pain in the upper arm. c. Ask if taking a blood pressure has ever caused bruising in the hand and wrist. d. Ask if taking a blood pressure has ever produced the need for medication.

a. Ask if taking a blood pressure has ever produced bleeding under the skin or in the arm joints. Rationale: Due to the client's enhanced risk for bleeding, before taking a blood pressure, the nurse asks the client if the use of a blood-pressure cuff has ever produced bleeding under the skin or in the arm joints.

The nursing instructor is discussing disorders of the hematopoietic system with the pre-nursing pathophysiology class. What disease would the instructor list with a primary characteristic of erythrocytosis? a. Polycythemia vera b. Sickle cell disease c. Aplastic anemia d. Pernicious anemia

a. Polycythemia vera

A nurse cares for clients with hematological disorders and notes that women are diagnosed with hemochromatosis at a much lower rate than men. What is the primary reason for this? a. Women lose iron through menstrual cycles b. Women rarely manifest the gene expression c. Women have lower hemoglobin levels d. Women require grater folic acid supplementation

a. Women lose iron through menstrual cycles Hemochromatosis is a genetic condition where excess iron is absorbed in the GI tract and deposited in various organs, making them dysfunctional. Women are often less affected than men because women lose excess iron through their menstrual cycles. The other answer choices are not correct reasons why women are impacted less than men with hemochromatosis.

A 52-year-old patient has a new diagnosis of pernicious anemia. After teaching the patient about pernicious anemia, the nurse determines that the patient understands the disorder when the patient states, a."I will need to have cobalamin (B12) injections regularly for the rest of my life." b."I will stop having a glass of wine with dinner." c."The numbness in my feet will go away once my hemoglobin level returns to normal." d."My diet should include more red meat or liver."

a."I will need to have cobalamin (B12) injections regularly for the rest of my life."

The nurse is teaching a client about the development of leukemia. What statement should be included in the teaching plan? a. "Acute leukemia develops slowly." b. "Chronic leukemia develops slowly." c. "In acute leukemia there are not many undifferentiated cells." d. "In chronic leukemia, the minority of leukocytes are mature."

b. "Chronic leukemia develops slowly."

A nurse is providing teaching for a client who is scheduled for a bone marrow biopsy of the illiac crest. Which of the following statements made by the client indicates an understanding of the teaching? a. "This test will be preformed while I am lying flat on my back" b. "I will need to stay in bed for about an hour after the test" c. "This test will determine which antibiotic I should take for treatment" d. "I will receive general anesthesia for the test"

b. "I will need to stay in bed for about an hour after the test"

A client in end-stage renal disease is prescribed epoetin alfa and oral iron supplements. Before administering the next dose of epoetin alfa and oral iron supplement, what is the priority action taken by the nurse? a. Holds the epoetin alfa if the BUN is elevated b. Assesses the hemoglobin level c. Ensures the client has completed dialysis treatment d. Questions the administration of both medications

b. Assesses the hemoglobin level

The nurse suspects that a client has multiple myeloma based on the client's major presenting symptom and the analysis of laboratory results. What classic symptom for multiple myeloma does the nurse assess for? a. Debilitating fatigue b. Bone pain in the back of the ribs c. Severe thrombocytopenia d. Gradual muscle paralysis

b. Bone pain in the back of the ribs

Lilly came into the hospital with fissures, a smooth and shinny tongue, and spoon shaped nails. She complains of always being exhausted. What does the nurse suspect Lilly is presenting? a. Vitamin B12 anemia b. Iron deficiency anemia c. Folic acid deficiency d. sickle cell anemia

b. Iron deficiency anemia

Will a person with anemia have higher or lower hemoglobin?

lower

A home care nurse visits a client diagnosed with atrial fibrillation who is ordered warfarin. The nurse teaches the client about warfarin therapy. Which statement by the client indicates the need for further teaching? A. "I'll report unexplained or severe bruising to my doctor right away." B. "I'll eat four servings of fresh, dark green vegetables every day." C. "I'll watch my gums for bleeding when I brush my teeth." D. "I'll use an electric razor to shave."

B. "I'll eat four servings of fresh, dark green vegetables every day." The client requires additional teaching if he states that he'll eat four servings of dark green vegetables every day. Dark, green vegetables contain vitamin K, which reverses the effects of warfarin. The client should limit his intake to one to two servings per day. The client should report bleeding gums and severe or unexplained bruising, which may indicate an excessive dose of warfarin. The client should use an electric razor to prevent cutting himself while shaving.

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 temp daily" b. 'restrict outdoor play activity to one hour a day" c. "offer fluids to your child multiple times everyday" d. "apply cold compresses when your child expresses pain"

c. "offer fluids to your child multiple times everyday"

The nurse is caring for a client with multiple myeloma. Why would it be important to assess this client for fractures? a. Osteosarcomas form producing pathologic fractures. b. Osteolytic activating factor weakens bones producing fractures. c. Osteopathic tumors destroy bone causing fractures. d. Osteoclasts break down bone cells so pathologic fractures occur.

d. Osteoclasts break down bone cells so pathologic fractures occur.

A nurse is doing a physical examination of a child with sickle cell anemia. When the child asks why the nurse auscultates the lungs and heart, what would be best the response by the nurse? A. To detect the evidence of infection such as fever and tachycardia B. To detect the evidence of dehydration that might have triggered a sickle cell crisis C. To detect the motor strength and stroke-related signs and symptoms D. To detect the abnormal sounds suggestive of acute chest syndrome and heart failure

D. To detect the abnormal sounds suggestive of acute chest syndrome and heart failure

A patient with chronic renal failure is examined by the health care provider for anemia. Which laboratory results will the nurse monitor? a. Decreased total iron-binding capacity b. Decreased level of erythropoietin c. Increased reticulocyte count d. Increased mean corpuscular volume

b. Decreased level of erythropoietin

A nurse is providing preoperative teaching for a client who requests autologous donation in preparation for a scheduled orthopedic surgical procedure. Which of the following statements should the nurse include in her teaching? a. "you should make an appointment to donate blood 8 weeks prior to the surgery" b. "if you need an autologous transfusion. the blood your brother donates can be used" c. "you can donate blood each week if your hemoglobin is stable" d. "any unused bloof that is donated can be used for other clients"

c. "you can donate blood each week if your hemoglobin is stable"

A client with acute myeloid leukemia has a fever. What pathophysiological process does the nurse recognize is the cause of the client's fever? a. Pancytopenia b. Thrombocytopenia c. Neutropenia d. Anemia

c. Neutropenia Fever and infection result from a decrease in neutrophils (neutropenia). Decreased red blood cells (anemia) cause weakness, fatigue, dyspnea on exertion, and pallor in AML. Pancytopenia, an overall decrease in all blood components, is not cause of fever in clients with AML. Decreased platelet count (thrombocytopenia) causes petechiae and bruising in AML.

A nurse cares for a client with anemia after having a total gastrectomy a year ago. Which unique assessment findings will the nurse likely find when assessing this client that may not be present in another client with anemia? Select all that apply. a. Fatigue b. Weakness c. Shortness of breath d. Tingling in the fingers e. Poor coordination

d, e The client likely has pernicious anemia, caused by a lack of intrinsic factor, found in the stomach. Paresthesias (tingling in the fingers) and poor coordination are unique to pernicious anemia. Shortness of breath, fatigue, and weakness are common to other anemias and not unique assessment findings.