med surg 1- chapters 30, 31, 32

The nurse is inspecting the tonsils for a client with a fever and sore throat. The nurse observes purulent exudate on the surface of the tonsils. What does this finding indicate to the nurse? A) Filariasis B) Thrush C) An abscess D) Tonsillitis

Tonsillitis

The nurse is caring for a client with Hodgkin's disease who has developed anemia. What would you expect would be ordered for this client? A) Lower doses of radiation B) Transfusions C) A break in chemotherapy D) Increased rest and fluid

Transfusions

The nursing instructor is teaching her clinical group about laboratory blood tests. What is the major function of erythrocytes? A) Act as mediators for the immune system B) Destroy invading organisms C) Transportation of O2 to the tissues and removal of CO2 from the tissues D) Oxygenation of the brain

Transportation of O2 to the tissues and removal of CO2 from the tissues

The nurse caring for an older adult with a diagnosis of leukemia would encourage the client to use an electric razor. Why? A) Trauma and microabrasions may contribute to anemia. B) Fragile tissues and altered clotting mechanisms may result in hemorrhage. C) The client is at risk for spontaneous and uncontrolled bleeding. D) The client is at risk for infection from microorganisms.

Trauma and microabrasions may contribute to anemia.

The nurse is caring for a client with hypovolemic anemia who is now in hypovolemic shock. What indication does the nurse have that the client is having inadequate renal perfusion? A) Hematuria B) Blood pressure of 90/60 mm Hg C) Jaundice of the sclera D) Urine output of 15 mL/hour

Urine output of 15 mL/hour

The nurse is caring for the client with infectious mononucleosis that has inflammation of the pharyngeal mucosa. What foods or liquids would be best to offer to this client? A) A hot cup of milk B) Vanilla pudding and iced tea C) Tomato soup and hot herbal tea D) Beef and broccoli stir fry and a soft drink

Vanilla pudding and iced tea

A client is seen in the emergency department with severe pain related to a sickle cell crisis. What does the nurse understand is occurring with this client? A) The client has a decreased tolerance of pain related to the chronic nature of the illness. B) Bone marrow decreases the erythrocyte production causing decrease in hypoxia. C) Overhydration enlarges the red blood cells. D) Vascular occlusion in small vessels decreasing blood and oxygen to the tissues.

Vascular occlusion in small vessels decreasing blood and oxygen to the tissues.

The nurse is discussing vitamin replacement with a client in the clinic. Which vitamin should the nurse discuss with the client in order to increase the absorption of folic acid and iron? A) Vitamin B12 B) Vitamin C C) Vitamin B6 D) Vitamin E

Vitamin C

A client with Hodgkin's disease has a weight loss of 10% of body weight 6 months prior to the diagnosis, fever of 101° F, and drenching night sweats. What subclassification of Hodgkin's disease does this client fit into? A) A B) B C) C D) E

b

A client is being treated for anemia and has a hemoglobin level of 9.6 g/dL. What does the nurse understand is the basic nutritional component of heme in hemoglobin that the client may be deficient in? A) Folic acid B) Copper C) Protein D) Iron

iron

A client is in the hospital with a bleeding gastric ulcer and requires a blood transfusion. He has been typed and crossmatched for 2 units of packed red blood cells and found to have type O blood. What type of blood will the nurse administer to this client? A) Type A B) Type B C) Type AB D) Type O

type O

The nurse is collecting data for a patient who has been diagnosed with iron-deficiency anemia. What subjective findings does the nurse recognize as symptoms related to this type of anemia? A) "I feel hot all of the time." B) "I have a difficult time falling asleep at night." C) "I have an increase in my appetite." D) "I have difficulty breathing when walking 30 feet."

"I have difficulty breathing when walking 30 feet."

The nurse is assigned to care for a client with polycythemia vera. When the nurse encourages the client to drink 3 L of fluid per day, the client states, "Why do I have to drink so much?" What is the best response by the nurse? A) "We don't want you to get dehydrated." B) "It helps adequately hydrate you and ensures a sufficient urine production." C) "It will help your heart beat regularly and effectively." D) "It will help restrict blood circulation."

"It helps adequately hydrate you and ensures a sufficient urine production."

An adolescent client diagnosed with infectious mononucleosis asks the nurse if he will keep getting the disease. What is the best response by the nurse? A) "After having the disease, the virus dissipates and is gone forever." B) "Once you get the virus, it will infect you when your immune system is compromised." C) "One episode produces immunity, but the virus remains for a lifetime." D) "Once you have the symptoms of the virus, it will go away within a week and there will be no further episodes."

"One episode produces immunity, but the virus remains for a lifetime."

Parents arrive to the clinic with their 5-year-old child and inform the nurse the child has just been diagnosed with sickle cell disease. The parents ask the nurse how this could have happened and which one of them is the carrier. What is the best response by the nurse? A) "Most likely, the father is the carrier of the gene." B) "The trait is passed down through the mother." C) "The child must inherit two defective genes, one from each parent." D) "It is an acquired, not a hereditary disorder."

"The child must inherit two defective genes, one from each parent."

The registered nurse (RN) and licensed practical nurse (LPN) are preparing an educational program for clients who may be at risk for the development of iron-deficiency anemia. Which clients would receive the greatest benefit from this program? Select all that apply. A) A young female client with bulimia nervosa B) An older adult client on a fixed income C) A client with Crohn's disease D) A client who lives in a nursing home E) A client who is a vegetarian

-A young female client with bulimia nervosa -An older adult client on a fixed income -A client with Crohn's disease

A client is found to have a low hemoglobin and hematocrit when laboratory work was performed. What does the nurse understand the anemia may have resulted from? Select all that apply. A) Infection B) Blood loss C) Abnormal erythrocyte production D) Destruction of normally formed red blood cells E) Inadequate formed white blood cells

-Blood loss -Abnormal erythrocyte production -Destruction of normally formed red blood cells

A client is suspected of having leukemia and is having a series of laboratory and diagnostic studies performed. What does the nurse recognize as the hallmark signs of leukemia? Select all that apply. A) Diarrhea B) Nausea and vomiting C) Frequent infections D) Fatigue from anemia E) Easy bruising

-Frequent infections -Fatigue from anemia -Easy bruising

The nurse is sending a client to be fitted for a compression garment for the treatment of lymphedema after having a mastectomy and node dissection. What does the nurse inform the client that will do to decrease the edema? Select all that apply. A) Increases local tissue pressure B) If worn for 30 days continuously, will permanently reduce the edema C) Decreases the stretching of the skin D) Helps muscles to propel lymphatic drainage E) Prevents tissue refilling with an excess volume of lymph

-Increases local tissue pressure -Decreases the stretching of the skin -Helps muscles to propel lymphatic drainage -Prevents tissue refilling with an excess volume of lymph

You are caring for a client newly admitted to the unit with a diagnosis of lymphangitis. What interventions would you institute to help promote the resolution of the lymphangitis? Select all that apply. A) Apply ice to the area. B) Note the response to antibiotic therapy. C) Encourage independent activities of daily living. D) Elevate the area. E) Apply warm soaks/compresses to the area.

-Note the response to antibiotic therapy. -Encourage independent activities of daily living. -Elevate the area. -Apply warm soaks/compresses to the area.

A client is scheduled for a Schilling test in the morning. What diagnostic results would be indicated if the test is positive? Select all that apply. A) Iron-deficiency anemia B) Pernicious anemia C) Macrocytic anemia D) Malabsorption syndromes E) A gastric ulcer

-Pernicious anemia -Macrocytic anemia -Malabsorption syndromes

The nurse is providing instruction on the use of compression garments for the client with lymphedema. What should be included in the instructions? Select all that apply. A) Purchase two compression garments. B) Change the garment in the morning and in the evening. C) Limit the time the garment is not worn to 30 to 60 minutes. D) Replace a compression garment every month. E) Place the garment in the dryer after washing.

-Purchase two compression garments. -Change the garment in the morning and in the evening. -Limit the time the garment is not worn to 30 to 60 minutes.

The nurse is inspecting the tonsils of a client that complaints of a sore throat for size and appearance. What is the appropriate documentation for an observation of tonsils that touch the uvula? A) 1 B) 2 C) 3 D) 4

3

The nurse is caring for a group of clients. Which client does the nurse suspect is most likely to have mononucleosis? A) A 46-year-old male who is complaining of chest pain and weakness B) A 19-year-old college student with cervical node enlargement and fever C) A 28-year-old female with lower abdominal discomfort and vaginal discharge D) A 30-year-old male client with a cough, chest discomfort, and fever

A 19-year-old college student with cervical node enlargement and fever

A client had a left radical mastectomy with an axillary node dissection 6 months ago and is having a large amount of edema in the left arm down to the fingers. What should the nurse inform the client is the reason for the edema? A) An accumulation of lymphatic fluid that results from impaired lymph circulation. B) It is congenitally acquired and is not related to the mastectomy. C) They are most likely ingesting too much sodium and should be advised to decrease the amount. D) There is inadequate blood flow from circulatory impairment.

An accumulation of lymphatic fluid that results from impaired lymph circulation.

A client comes to the walk-in clinic complaining of weakness and fatigue. While assessing this client, you find evidence of petechiae and ecchymoses. You note that the spleen appears enlarged. What would you suspect is wrong with this client? A) Aplastic anemia B) Pernicious anemia C) Iron-deficiency anemia D) Agranulocytosis

Aplastic anemia

A client is scheduled for a bone marrow aspiration and is extremely apprehensive about having the procedure done. The nurse explains that there may be a feeling of pressure or discomfort when puncturing the bone. What intervention can the nurse provide to assist with this concern? A) Inform the client that he will not be able to move and will have to tolerate the discomfort for 20 minutes. B) Inform the client that if he is concerned that he will move when the bone is punctured, soft wrist restraints can be used if the client approves. C) Assist the client with focused imagery to avoid focusing on the procedure and any discomfort associated with it. D) Suggest chewing gum or eating candy in order to focus on something other than the discomfort.

Assist the client with focused imagery to avoid focusing on the procedure and any discomfort associated with it.

The nurse is admitting a client with Cooley's anemia to the hospital with a hemoglobin of 6.2 g/dL and hematocrit of 26%. What does the nurse document about the client's skin? A) Bronzing of the skin B) Jaundice of the skin and mucous membranes C) Ruddy complexion D) Pale skin and mucous membranes

Bronzing of the skin

A 55-year-old female client has developed lymphedema postmastectomy. What is the common method used to promote lymphatic drainage and prevent edema in all clients with lymphedema? A) Reduce the intake of fluids. B) Avoid exercising the affected part. C) Decrease the intake of sodium and calcium. D) Elevate the affected part of the body.

Elevate the affected part of the body.

The nurse is collecting objective data from the client with lymphedema of the left leg. The nurse observes that the affected leg is 10 cm greater in measurement than the unaffected leg. The affected leg is hot to the touch and red. What classification of lymphedema does the nurse recognize this client has? A) Grade I (Mild) B) Grade II (Moderate) C) Grade III (Severe) D) Grade IV (Extreme)

Grade III (Severe)

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? A) Helps push oxygen into the tissues of the body B) Retains leukocytes in the vascular compartment C) Helps retain fluid in the vascular compartment D) Absorbs carbon dioxide from the tissues for transport to the lungs

Helps retain fluid in the vascular compartment

A client has been diagnosed with non-Hodgkin's lymphoma but has no symptoms at this time. The client has received radiation and chemotherapy with responsiveness to this treatment. How would this disease be classified according to the lack of symptoms and responsiveness to treatment? A) Indolent B) Aggressive C) Cured D) Immunosuppressed

Indolent

A client has laboratory studies that determine he is deficient in copper. What does the nurse understand is the importance of copper in the body? A) Essential for the maturation of red blood cells B) Basic nutritional component of heme in hemoglobin C) Involved in the transfer of iron from storage to plasma D) Serves as a coenzyme in hemoglobin formation

Involved in the transfer of iron from storage to plasma

A client with lymphedema in the left arm has weeping from the skin and has a small 2-cm ulcer on the upper arm. What test does the nurse anticipate the client will be prepared for? A) X-ray of the left arm B) Ultrasound of the left arm C) CT scan D) Lymphangiography

Lymphangiography

The nurse is caring for a client who is having a sickle cell crisis. Which order for analgesia should the nurse consult with the physician? A) Meperedine (Demerol) B) Morphine sulfate C) Sublimaze (Fentanyl) D) Buprenorphine (Buprenex)

Meperedine (Demerol)

A client with a diagnosis of pernicious anemia comes to the clinic complaining of numbness and tingling in his arms and legs. What do these symptoms indicate? A) Loss of vibratory and position senses B) Neurologic involvement C) Severity of the disease D) Insufficient intake of dietary nutrients

Neurologic involvement

A client with multiple myeloma is complaining of severe pain when the nurse comes in to give a bath and change position. What is the priority intervention by the nurse? A) Inform the client that the position must be changed, and then you will give her pain medication and omit the bath. B) Inform the client that she will feel better after receiving a bath and clean sheets. C) Obtain the pain medication and delay the bath and position change until the medication reaches its peak. D) Inform the client that the bath and positioning is an important part of client care and will be done right after pain medication administration.

Obtain the pain medication and delay the bath and position change until the medication reaches its peak.

You are caring for a client with multiple myeloma. Why would it be important to assess this client for fractures? A) Osteopathic tumors destroy bone causing fractures. B) Osteoclasts break down bone cells so pathologic fractures occur. C) Osteolytic activating factor weakens bones producing fractures. D) Osteosarcomas form producing pathologic fractures.

Osteoclasts break down bone cells so pathologic fractures occur.

The nurse will be assisting the physician with a bone marrow aspiration. Where should the nurse cleanse, clip hair, and drape the skin prior to the procedure? A) Over the posterior superior iliac crest B) Over the anterior tibia C) Over the radius D) Over the metatarsal area

Over the posterior superior iliac crest

The nurse is caring for a client who is developing hypovolemic shock from a duodenal ulcer bleed. What is the first intervention the nurse can provide to facilitate blood flow to the brain? A) Prepare the client for an endoscopy. B) Administer a crystalloid solution. C) Place the client in a modified Trendelenburg position. D) Test the client for blood in the stool.

Place the client in a modified Trendelenburg position.

The nurse observes that a client who had an arterial blood gas performed 30 minutes ago is still oozing blood from the puncture site. Pressure was held to the site for 5 minutes after the puncture and another 5 minutes when the site was still oozing. What factor does the nurse know will participate in the ability for the blood to clot? A) Platelets B) Leukocytes C) Erythrocytes D) Albumin

Platelets

Your client was admitted to the emergency department after an accident with a chain saw. The client is exhibiting signs and symptoms of acute hypovolemic anemia from severe blood loss. What signs and symptoms would you assess for? A) Malabsorption disorders B) Postural hypotension C) Fatigue D) Reduced urine output

Reduced urine output

A client is having a lymph node biopsy for suspicion of Hodgkin's disease. What type of cells would be identifiable in the lymph node biopsy that may indicate this disease process? A) Reed-Sternberg cells B) Sickled cells C) Epstein-Barr virus D) Red blood cells

Reed-Sternberg cells

You are assisting your client with multiple myeloma to ambulate. What is the most important nursing diagnosis to help prevent fractures in this client? A) Increased mobility B) Adequate hydration C) Safety D) Adequate nutrition

Safety

A 16-year-old male client is in the burn unit following a motor vehicle accident. The nurse notes nonpitting edema in the client's left calf. What would the nurse document about this finding? A) 3+ edema of the left calf B) Secondary edema of the left calf C) Nonpitting primary edema of the left calf D) Primary edema of the left calf

Secondary edema of the left calf

A client with lymphedema of the left leg has a nursing diagnosis of Disturbed Body Image related to lymphedema of the left leg as evidenced by the statement, "I look terrible and am embarrassed to go out." What intervention can the nurse provide to help this client? A) Inform the client it is acceptable to stay away from social activities. B) Encourage the client to go out and socialize even if he doesn't want to. C) Suggest certain styles of clothing that conceal the enlargement of the leg. D) Refer the client to a psychiatrist.

Suggest certain styles of clothing that conceal the enlargement of the leg.

You are caring for a client who is undergoing bone marrow aspiration to determine the blood cell formation status. What nursing intervention should you provide to your client during the test? A) Administer oral radioactive vitamin B12 to the client. B) Administer a nonradioactive B12 injection. C) Collect urine for 24 to 48 hours after the client receives the nonradioactive B12 . D) Support the client and monitor the status.

Support the client and monitor the status.

Undifferentiated cells that migrate to the thymus gland develop into which of the following? A) A lymphocytes B) D lymphocytes C) T lymphocytes D) S lymphocytes

T lymphocytes

A patient's family member asks what hematopoiesis is. What should the nurse tell the family member? A) The manufacture and development of blood cells B) The production of lymphatic fluid in the body C) The making of red blood cells and lymph D) The development of lymph in the bone marrow

The manufacture and development of blood cells

A client has been involved in an automobile accident and is assessed to have an enlarged spleen. What does the nurse understand is the significance of attempting to prevent unnecessary removal of the spleen for this client? A) The spleen is a large lymph node and takes waste debris away. B) The spleen is a lymphatic structure and assists with phagocytosis. C) The spleen is lymphoid tissue in the upper chest that contains stem cells. D) The spleen assists with blood clotting.

The spleen is a lymphatic structure and assists with phagocytosis.

A client is volunteering to donate blood for the second time and was mailed a letter telling him that he has type AB blood. If the client requires a blood transfusion in the future, what type of blood must he receive? A) They can receive blood from persons with any type of blood if the RH factor is compatible. B) They can only receive blood from persons with type A blood. C) They can only receive blood from persons with type B blood. D) They can only receive blood from persons with type O blood if the RH factor is positive.

They can receive blood from persons with any type of blood if the RH factor is compatible

A client is brought to the emergency department with suspected bleeding esophageal varices. Which hemoglobin level should the nurse immediately report to the physician? A) 13.0 g/dL B) 10.2 g/dL C) 5.0 g/dL D) 11.4 g/dL

5.0 g/dL

The nurse is caring for four clients on the medical-surgical unit of the hospital. What client is mostly likely to be receiving treatment for sickle cell crisis? A) A 29-year-old Caucasian female B) A 19-year-old African American male C) A 24-year-old Native American female D) A 36-year-old Eastern European female

A 19-year-old African American male

Which client does the nurse recognize as most likely to be diagnosed with non-Hodgkin's lymphoma rather than Hodgkin's lymphoma? A) A 55-year-old client with AIDS B) A 35-year-old client with type 2 diabetes mellitus C) A 20-year-old client with infectious mononucleosis D) A 40-year-old client with Reed-Sternberg cells in an axillary lymph node

A 55-year-old client with AIDS

The nurse is assisting the physician with obtaining a sample to determine the status of blood cell formation. What type of procedure will the nurse have prepared the client for? A) A bone marrow aspiration B) A Schilling test C) A thoracentesis D) A urine sample

A bone marrow aspiration

The nurse is assisting the physician to control the bleeding for a client who has had an insertion of a vascular access. What can the nurse obtain for the physician to use to control the bleeding? A) A fibrin sponge B) Injection of alpha globulins C) Albumin D) Injection of beta globulins

A fibrin sponge

The nurse is on a mission trip to a third world country to provide nursing care to a large group of clients. A client asks the nurse to look at his leg that is grossly edematous compared to the other extremity. What does the nurse understand is the most common cause of this disorder known as elephantiasis? A) Reaction to an antibiotic B) Smallpox vaccination C) Lack of healthcare D) A parasitic worm

A parasitic worm

A client has developed an infection that resulted in lymphangitis. What does the nurse suspect the causative organism is that caused the infection? A) A streptococcal microorganism B) A Staphylococcus microorganism C) Escherichia coli D) Candida albicans

A streptococcal microorganism

A client with sickle cell disease informs the nurse that he is having chest pain. The nurse hears the client coughing, wheezing, and breathing rapidly. What does the nurse suspect is occurring with this client? A) Vaso-occlusive crisis B) Pneumocystis pneumonia C) Acute chest syndrome D) Acute muscular strain

Acute chest syndrome

A client has just been admitted to your unit with a diagnosis of Hodgkin's disease. When doing the initial assessment, what pertinent questions should the nurse ask the client to help determine the correct nursing diagnosis? A) Are you experiencing fever, chills, or night sweats? B) Do you use artificial respirators? C) Have you ever had a blood transfusion? D) Have you ever experienced fractures?

Are you experiencing fever, chills, or night sweats?

You are caring for an 87-year-old female who has been admitted to your unit with anemia. What would you suspect? A) Excessive consumption of coffee or tea B) Elimination of iron by the body C) Decrease in the total body iron stores with age D) Blood loss from the gastrointestinal or genitourinary tract

Blood loss from the gastrointestinal or genitourinary tract

The nurse is caring for a client in the hospital who is being treated for Hodgkin's disease and is taking a chemotherapeutic regimen in the hospital's oncology unit. When reviewing the client's medication history, what regimen does the nurse recognize as the drugs in the treatment of Hodgkin's disease? A) Rocephin, Lasix, rifampin B) Cisplatin, cytarabine, prednisone C) Infliximab (Remicade) D) Enalapril (Lisinopril), Lopressor (Atenolol)

Cisplatin, cytarabine, prednisone

You are caring for three clients who have the following blood count values: Client A has 24,500/mm3 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? A) Client A has a normal WBC count, client B has a higher hemoglobin count than normal, and client C has a normal platelet count. B) Client A has a higher WBC count than normal, client B has a normal hemoglobin count, and client C has a normal platelet count. C) 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. D) 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

The nursing instructor is talking with her clinical group about coagulopathies. How should the instructor define coagulopathies? A) Coagulopathies are bleeding disorders that are characterized by abnormalities in the numbers and types of red blood cells in the body. B) Coagulopathies are bleeding disorders that involve platelets or clotting factors. C) Coagulopathies are bleeding disorders that are characterized by a deficiency of globulins in the plasma. D) Coagulopathies are bleeding disorders that involve the destruction of stem cells in the bone marrow.

Coagulopathies are bleeding disorders that involve platelets or clotting factors.

The nurse is caring for a client with a diagnosis of Hodgkin's disease and is aware that there is enlargement of the retroperitoneal nodes when reviewing the review of systems on the physician's history and physical. What symptoms are the nurse aware may be indicative of enlargement of the retroperitoneal nodes? A) Complaints of a sense of fullness in the stomach and epigastric pain B) Sore throat, white discharge on the tonsils C) Nausea and vomiting D) Respiratory rate of 14 and shallow

Complaints of a sense of fullness in the stomach and epigastric pain

Why would it be important for the nurse to obtain information regarding dietary history of a client with a possible abnormality of the hematopoietic or lymphatic system? A) It could determine if the illness is self-induced by nutritional starvation. B) If the client has impaired protein intake, it will cause diseases of the hematopoietic system. C) Altered nutrition is the cause of abnormalities of the hematopoietic and lymphatic system. D) Compromised nutrition interferes with production of blood cells and hemoglobin.

Compromised nutrition interferes with production of blood cells and hemoglobin.

A client diagnosed with polycythemia vera has come into the clinic because he has developed a nighttime cough, fatigue, and shortness of breath. What complication would you suspect in this client? A) Stroke B) Tissue infarction C) Congestive heart failure D) Pulmonary embolus

Congestive heart failure

The nurse is instructing the client with polycythemia vera how to perform isometric exercises such as contracting and relaxing the quadriceps and gluteal muscle during periods of inactivity. What does the nurse understand is the rationale for this type of exercise? A) Isometric exercise programs are inclusive of all muscle groups and have an aerobic effect to increase the heart rate. B) Isometric exercise decreases the workload of the heart and restores oxygenated blood flow. C) This type of exercise increases arterial circulation as it returns to the heart. D) Contraction of skeletal muscle compresses the walls of veins and increases the circulation of venous blood as it returns to the heart.

Contraction of skeletal muscle compresses the walls of veins and increases the circulation of venous blood as it returns to the heart.

The nurse is instructing a client about taking a liquid iron preparation for the treatment of iron- deficiency anemia. What should the nurse include in the instructions? A) Do not take medication with orange juice because it will delay absorption of the iron. B) Iron may cause indigestion and should be taken with an antacid such as Mylanta. C) Dilute the liquid preparation with another liquid such as juice and drink with a straw. D) Discontinue the use of iron if your stool turns black.

Dilute the liquid preparation with another liquid such as juice and drink with a straw.

The nurse is caring for a client diagnosed with infectious mononucleosis who is having trouble eating. What would the nurse advise this client to improve his oral intake? A) Eat warm food and drink warm liquids. B) Eat soft, bland foods and drink cool liquids. C) Avoid spicy foods and drink warm liquids. D) Eat soft, bland foods and drink warm liquids.

Eat soft, bland foods and drink cool liquids.

A client informs the nurse that he is having a difficult time coping with seasonal allergies and have taken some over-the-counter medications to assist with control of symptoms. What results would indicate to the nurse that the client does have allergies? A) Elevated eosinophils B) Elevated basophils C) Elevated monocytes D) Elevated neutrophils

Elevated eosinophils

The family nurse practitioner is performing a physical assessment on a client with a suspected lymphatic disorder. What would be the nurse practitioner's primary assessment for all clients with lymphatic disorders? A) Fever and sore throat B) Painful joints C) Signs of leukopenia and thrombocytopenia D) Enlargement of the lymph glands

Enlargement of the lymph glands

A client with end-stage renal disease has a decreased red blood cell production. What medication can the nurse administer with physician's order that will increase the production of erythrocytes? A) Filgrastim (Neupogen) B) Pegfilgrastim (Neulasta) C) Epoetin alfa (Epogen) D) Interleukin 2

Epoetin alfa (Epogen)

A client is seeing the physician at the clinic and tells the nurse he is fatigued and short of breath with minimal exertion. What lab study may reflect a decrease in transport of oxygen? A) Erythrocyte count B) Leukocyte count C) Platelet count D) Albumin level

Erythrocyte count

The nurse observes the laboratory studies for a client in the hospital with fatigue, feeling cold all of the time, and hemoglobin of 8.6 g/dL and a hematocrit of 28%. What finding would be an indicator of iron-deficiency anemia? A) Erythrocytes that are microcytic and hypochromic B) Erythrocytes that are macrocytic and hyperchromic C) Clustering of platelets with sickled red blood cells D) An increased number of erythrocytes

Erythrocytes that are microcytic and hypochromic

A client is taking a medication that has the side effect of depressing the hematopoietic system. What signs of leukopenia should the nurse monitor for while the client is taking this drug? A) Fever, sore throat, and chills B) Nausea and vomiting C) Diarrhea, diaphoresis, and fever D) Intolerance to heat and rash

Fever, sore throat, and chills

A 15-year-old client with hemophilia sustains a leg laceration after falling off of his skateboard and is brought to the emergency department. The laceration is bleeding profusely even with direct pressure to the site. What does the nurse anticipate will be ordered for administration to control bleeding? A) Fresh frozen plasma B) A colloid solution such as hetastarch (Hespan) C) A crystalloid solution such as lactated Ringer's D) Albumin

Fresh frozen plasma

A nurse is providing care to a cancer patient. Which protein in plasma functions primarily as immunologic agents? A) Gamma globulins B) Albumin C) Fibrinogen D) Beta globulins

Gamma globulins

The LPN is following a plan of care for a client who is being treated for hypovolemic anemia and is at risk for hypovolemic shock. The nurse assesses vital signs and O2 saturation and observes the saturation at 89% for 3 minutes. What should the first action by the nurse be? A) Notify the charge nurse. B) Prepare to assist with intubation. C) Give oxygen per nasal cannula D) Place the client in the supine position.

Give oxygen per nasal cannula

The nurse is caring for a client with lymphedema of the left arm in the clinic. The nurse measures a circumference of the affected extremity 4 cm larger in circumference than the opposite limb, and the client complains of feeling a heaviness and pain. There is limited movement of the left arm. What would the nurse grade and document this lymphedema as? A) Grade I (Mild) B) Grade II (Moderate) C) Grade III (Severe) D) Grade IV (Grossly edematous)

Grade II (Moderate)

When obtaining vital signs from a client who has reduced erythrocyte production and a hemoglobin level of 8.2 g/dL, what results would be indicative of these lab studies? A) Heart rate of 120 beats/minute B) Respiratory rate of 16 breaths/minute C) Blood pressure of 140/90 mm Hg D) Oxygen saturation of 95%

Heart rate of 120 beats/minute

A client with lymphadenitis has developed persistent swelling of the affected area. What would be important information for you to teach this client? A) How to apply an elastic sleeve or stocking B) How to apply ice to the affected area C) How to do exercises to increase blood flow in the area D) How to dependently do activities of daily living

How to apply an elastic sleeve or stocking

A client with Hodgkin's disease has bilateral lymph nodes that are affected with extension through the spleen as well as affecting the bone marrow. What stage of the disease does the nurse recognize the client is in? A) I B) II C) III D) IV

IV

A student nurse is having difficulty understanding the function of globulins. What information can you provide to the student? A) Immunologic agents B) Destruction of invading organisms C) Precursors to clot formation D) Transport of oxygen to the tissues

Immunologic agents

Macrophages attack and destroy foreign substances to the body. Where does this action occur? A) At the site of trauma B) In the lymph node C) In the vascular system D) In the thymus

In the lymph node

A client, age 22 years, comes to the clinic and informs the nurse that he began having swelling in his right arm. There has been no injury or precipitating occurrence that caused the swelling. The nurse observes nonpitting edema from the upper arm to the fingertips. What action should the nurse initially perform? A) Instruct the client to elevate the extremity. B) Inspect and measure the arm. C) Apply a compression stocking. D) Administer a diuretic.

Inspect and measure the arm.

A young client has just been diagnosed with lymphoma. The client asks you what a lymphoma is. What would be your best answer? A) It is a group of cancers that affect the body. B) It is a group of cancers connected to the hematopoietic system. C) It is a group of cancers that affect the lymphatic system. D) It is a group of cancers connected to the cardiovascular system.

It is a group of cancers that affect the lymphatic system.

A 15-year-old client arrives at the clinic and informs the nurse that he attended 2 weeks of summer camp last month and now is not feeling well with complaints of sore throat, fever, and very tired. The nurse observes white exudate on the tonsils. What test does the nurse anticipate the physician will order for this client? A) Monospot test B) AST and ALT C) Glucose level D) T3 , T4 , and TSH

Monospot test

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) Hemolytic anemia B) Polycythemia vera C) Leukemia D) Multiple myeloma

Multiple myeloma

The nurse is instructing the client with sickle cell disease about the use of an inhaled vasodilator that may reduce sickling. What medication is the nurse instructing the client about? A) Nitrous oxide B) Nitric oxide C) Betamethasone D) Terbutaline (Brethine)

Nitric oxide

A client is being treated in the hospital for hypovolemia related to a bleeding peptic ulcer. The nurse obtains a blood pressure reading of 88/62 mm Hg, heart rate of 112 beats/minute, and a respiratory rate of 24 breaths/minute. What is the first action by the nurse? A) Administer blood. B) Notify the physician. C) Insert two large-bore intravenous catheters. D) Administer a colloid solution.

Notify the physician.

The nurse is caring for a client with lymphangitis of the right leg who is receiving treatment with a broad-spectrum antibiotic. The nurse is giving a bath and observes the right leg is larger than it was 2 hours ago and the client feels hot. What is the first action by the nurse? A) Place the leg below the level of the heart. B) Notify the physician. C) Place cool compresses on the extremity. D) Begin performing passive range of motion exercises.

Notify the physician.

A client is admitted to the emergency department with significant blood loss. The physician orders 2 units of packed red blood cells to be transfused immediately. Which blood groups would be compatible with his O Rh-positive blood group? A) O Rh-positive or O Rh-negative B) Only O Rh-positive C) Only O Rh-negative D) AB Rh-positive or Rh-negative

O Rh-positive or O Rh-negative

The nurse is caring for an older adult client who has a hemoglobin of 9.6 g/dL and a hematocrit of 34%. To determine where the blood loss is coming from, what intervention can the nurse provide? A) Observe stools for blood. B) Observe the gums for bleeding after the client brushes teeth. C) Observe the sputum for signs of blood. D) Observe client for facial droop.

Observe stools for blood.

Your client is receiving chemotherapy for a diagnosis of lymphosarcoma. The client experiences nausea. What measures should the nurse suggest to help the client reduce the feeling of nausea? A) Administer immunosuppressive drugs. B) Apply ice to the skin for brief periods. C) Offer clear liquids such as carbonated beverages, water, and ice pops. D) Advise bed rest as much as possible.

Offer clear liquids such as carbonated beverages, water, and ice pops.

The nurse is caring for an older adult client with hemolytic anemia. What does the nurse understand about the reason this client is most susceptible to this disorder? A) The client is older and is probably noncompliant with medications. B) Older adult clients often take more medications than younger people. C) Older adult clients have more incidences of coagulation disorders. D) The older adult client does not follow up with physician appointments.

Older adult clients often take more medications than younger people.

The nurse is preparing the client for a bone marrow aspiration at the posterior iliac crest. What would be the best position for the nurse to place the client in for the test? A) Head of the bed in a 90° semi-Fowler's position B) Prone position C) On the side opposite the aspiration site D) Lithotomy position

On the side opposite the aspiration site

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

Polycythemia vera

A client with non-Hodgkin's lymphoma is receiving chemotherapy for treatment. The client is complaining of nausea during treatment. To maintain fluid intake, what type of food or fluid could the nurse offer the client? A) Milk B) Pudding C) Popsicle D) Chicken

Popsicle

A client is experiencing chronic hypovolemic anemia as evidenced by laboratory results. What symptoms does the nurse expect to find for this client when collecting objective data? A) Postural hypotension B) Urinary output of 10 mL/hr C) Altered consciousness D) Extreme pallor

Postural hypotension

The nurse is obtaining objective data from a client with lymphangitis of the left arm. What does the nurse expect to find when collecting this data from the client? A) Pulsatile mass in the axilla B) Weeping and oozing of fluid from the arm C) Cold, clammy arm D) Red streaks following the course of the lymph channels

Red streaks following the course of the lymph channels

A client will be having a bone marrow aspiration to determine the status of blood cell formation. What role does the nurse have during the test? A) Inject the anesthetic so the client will have no sensation of pain. B) The nurse explains the procedure to the patient and obtains the informed consent. C) The nurse sets up the equipment for the physician and then must leave the room to allow for privacy. D) The nurse assists the physician and supports the client during the procedure.

The nurse assists the physician and supports the client during the procedure.

The nurse is observing the skin of a client who is taking medications that depress the hematopoietic system and notices multiple areas of ecchymosis on the arms; bleeding for a prolonged period after an IV was started; and reports of black, tarry stool. What does the nurse understand may be a side effect of this medication that the client displays? A) Leukocytosis B) Leukopenia C) Thrombocytopenia D) Neutropenia

Thrombocytopenia

A client calls the clinic and informs the nurse that her boyfriend was diagnosed with infectious mononucleosis and wonders how long it would be before she got it. What does the nurse inform the client that the incubation period is for infectious mononucleosis? A) 3 days B) 7 to 10 days C) 30 to 50 days D) 50 to 70 days

30 to 50 days