MLQ Ch. 33
A client is prescribed 325 mg/day of oral ferrous sulfate. What does the nurse include in client teaching? A. Take 1 hour before breakfast B. Decrease intake of fruits and juices C. Decrease intake of dietary fiber D. Take with dairy products
A
A client with megaloblastic anemia reports mouth and tongue soreness. What instruction will the nurse give the client regarding eating while managing the client's symptoms? A. "Eat small amounts of bland, soft foods frequently." B. "Eat cold, bland foods with a large amount of water." C. "Eat low-fiber blended foods only." D. "Eat larger amounts of bland, soft foods less frequently."
A
A nurse is caring for a client with thrombocytopenia. What is the best way to protect this client? A. Use the smallest needle possible for injections. B. Limit visits by family members. C. Encourage the client to use a wheelchair. D. Maintain accurate fluid intake and output records.
A
A nurse on a hematology/oncology floor is caring for a client with aplastic anemia. Which would not be included in the client's discharge instructions? A. Use a disposable razor when shaving. B. Plan for frequent periods of rest. C. Encourage frequent handwashing. D. Avoid contact with family/friends who are sick.
A
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. Abnormal erythrocyte production B. Destruction of normally formed red blood cells C. Inadequate formed white blood cells D. Blood loss E. Infection
A, B, D
The nurse cares for several clients with hematological conditions. Which assessment needs will the nurse prioritize for the client with aplastic anemia? Select all that apply. A. Infection B. Injury C. Oxygenation D. Bleeding E. Perfusion
A, D
A client diagnosed with systemic lupus erythematosus comes to the emergency department with severe back pain. The client is taking prednisone daily and reported feeling pain after manually opening the garage door. What adverse effect of long-term corticosteroid therapy is most likely responsible for the pain? A. Truncal obesity B. Osteoporosis C. Muscle wasting D. Hypertension
B
A client with sickle cell anemia has a A. normal blood smear. B. low hematocrit. C. normal hematocrit. D. high hematocrit.
B
A clinical nurse specialist (CNS) is orienting a new graduate registered nurse to an oncology unit where blood product transfusions are frequently administered. In discussing ABO compatibility, the CNS presents several hypothetical scenarios. The new graduate knows that the greatest likelihood of an acute hemolytic reaction would occur when giving: A. B-positive blood to an AB-positive client. B. A-positive blood to an A-negative client. C. O-negative blood to an O-positive client. D. O-positive blood to an A-positive client.
B
Which of the following is the most common hematologic condition affecting elderly patients A. Thrombocytopenia B. Anemia C. Bandemia D. Leukopenia
B
A client with anemia has been admitted to the medical-surgical unit. Which assessment findings are characteristic of iron deficiency anemia? A. Itching, rash, and jaundice B. Nausea, vomiting, and anorexia C. Dyspnea, tachycardia, and pallor D. Nights sweats, weight loss, and diarrhea
C
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. Abnormally low hematocrit (HCT) and hemoglobin (Hb) levels D. Low levels of urine constituents normally excreted in the urine
C
A thin client is prescribed iron dextran intramuscularly. What is most important action taken by the nurse when administering this medication? A. Rubs the site vigorously B. Injects into the deltoid muscle C. Employs the Z-track technique D. Uses a 23-gauge needle
C
During the review of morning laboratory values for a client reporting severe fatigue and a red, swollen tongue, the nurse suspects chronic, severe iron deficiency anemia based on which finding? A. Enlarged mean corpuscular volume (MCV) B. Elevated hematocrit concentration C. Low ferritin level concentration D. Elevated red blood cell (RBC) count
C
The client has been diagnosed with myelodysplastic syndrome with an absolute neutrophil count less than 1000/mm³ and is being admitted to the hospital. The nurse A. Places the client in isolation and allows no visitors B. Allows unlicensed assistive personnel who reports having a sore throat to provide care C. Assigns the client to a private room D. Changes the water in the humidifier for oxygen therapy every 48 hours
C
The nurse is assessing a patient who comes to the clinic and reports feeling constantly tired and very weak. The patient also has a very sore tongue, and upon observing the patient's oral cavity, the nurse notices the tongue is beefy red. What type of anemia does the nurse know these symptoms indicate? A. Aplastic anemia B. Sickle cell anemia C. Megaloblastic anemia D. Iron deficiency anemia
C
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 she will feel better after receiving a bath and clean sheets. B. Inform the client that the position must be changed, and then you will give her pain medication and omit the bath. C. Inform the client that the bath and positioning is an important part of client care and will be done right after pain medication administration. D. Obtain the pain medication and delay the bath and position change until the medication reaches its peak.
D
A client with multiple myeloma reports pain along the spinal column. The client is prescribed naproxen (Aleve) and oxycodone. Prior to administering these medications, the nurse A. Teaches the client to bend at the back when lifting objects B. Questions the physician about the use of both medications C. Instructs the client not to lift more than 20 pounds D. Checks the client's BUN and creatinine
D
A pregnant woman is hospitalized as the result of sickle-cell crisis. Which finding indicates the outcome has been achieved for this client? A. Exhibits a temperature more than 100.3°F B. Describes the importance of staying cool C. Takes hydroxyurea during her pregnancy D. Reports joint pain less than 3 on a scale of 0 to 10
D
Hemophilia A is the most common of the three types of hemophilia. What is diminished in the less serious form of hemophilia A, known as von Willebrand's disease? A. quality of factor VIII B. amount and quality of factor IX C. quality of factor XI D. amount and quality of factor VIII
D
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 client for facial droop. B. Observe the gums for bleeding after the client brushes teeth. C. Observe the sputum for signs of blood. D. Observe stools for blood.
D
The nurse is educating a patient with iron deficiency anemia about food sources high in iron and how to enhance the absorption of iron when eating these foods. What can the nurse inform the client would enhance the absorption? A. Eating leafy green vegetables with a glass of water B. Eating a steak with mushrooms C. Eating apple slices with carrots D. Eating calf's liver with a glass of orange juice
D
When a nurse is planning discharge teaching for a client admitted with sickle cell crisis, which information should the nurse include in the teaching? A. Drink only one caffeinated beverage daily B. Take a daily multivitamin with iron C. Limit fluids to 2 quarts a day D. Receive pneumococcal and annual influenza vaccinations
D
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. Assesses the hemoglobin level B. Holds the epoetin alfa if the BUN is elevated C. Questions the administration of both medications D. Ensures the client has completed dialysis treatment
A
A client is hospitalized 3 days prior to a total hip arthroplasty and reports a high level of pain with ambulation. The client has been taking warfarin at home, which is now discontinued. To prevent the formation of blood clots, which action should the nurse take? A. Administer the prescribed enoxaparin (Lovenox). B. Encourage a diet high in vitamin K. C. Have the client limit physical activity. D. Monitor partial thromboplastin (PTT) time.
A
A patient with chronic renal failure is examined by the health care provider for anemia. Which laboratory results will the nurse monitor? A. Decreased level of erythropoietin B. Decreased total iron-binding capacity C. Increased mean corpuscular volume D. Increased reticulocyte count
A
A pregnant woman is hospitalized as the result of sickle-cell crisis. Which finding indicates the outcome has been achieved for this client? A. Reports joint pain less than 3 on a scale of 0 to 10 B. Exhibits a temperature more than 100.3°F C. Takes hydroxyurea during her pregnancy D. Describes the importance of staying cool
A
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 have lower hemoglobin levels B. Women lose iron through menstrual cycles C. Women require grater folic acid supplementation D. Women rarely manifest the gene expression
B
A nurse is caring for a client with thalassemia who is being transfused. What is the nurse's role during a transfusion? A. To assess for enlargement and tenderness over the liver and spleen B. To closely monitor the rate of administration C. To instruct the client to rest immediately if chest pain develops D. To administer vitamin B12 injections
B
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. Anemia B. Thrombocytopenia C. Neutropenia D. Leukopenia
B
The most common cause of iron-deficiency anemia in premenopausal women includes which of the following? A. Iron malabsorption B. Menorrhagia C. Inadequate iron supplementation D. Lack of vitamin B12
B
The nurse is collecting data for a client 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 difficulty breathing when walking 30 feet." C. "I have a difficult time falling asleep at night." D. "I have an increase in my appetite."
B
A nurse cares for a client with aplastic anemia. Which laboratory results will the nurse expect to find with this client? Select all that apply. A. Neutrophil count 17,000/microliter B. Hemoglobin 7 g/dL C. Platelets 35,000 microliters D. White blood cell count 10,000/microliter E. Neutrophil count 1200/microliter
B, C, E
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 caused by abnormal activation of the clotting pathway, causing excessive amounts of tiny clots to form inside organs." D. "DIC is a complication of an autoimmune disease that attacks the body's own cells."
C
A nurse is caring for a client admitted with pernicious anemia. Which set of findings should the nurse expect when assessing the client? A. Pallor, bradycardia, and reduced pulse pressure B. Sore tongue, dyspnea, and weight gain C. Pallor, tachycardia, and a sore tongue D. Angina pectoris, double vision, and anorexia
C
Which patient does the nurse recognize as being most likely to be affected by sickle cell disease? A. A 26-year-old Eastern European Jewish woman B. A 28-year-old Israeli man C. A 14-year-old African American boy D. An 18-year-old Chinese woman
C
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 characteristics. D. There is a strong correlation between iron stores and hemoglobin levels.
D
A client with idiopathic thrombocytopenic purpura (ITP) is admitted to an acute care facility. The nurse monitors the client's platelet count and observes closely for signs and symptoms of bleeding. The client is at greatest risk for cerebral hemorrhage when the platelet count falls below what number? A. 135,000/?l. B. 75,000/?l. C. 20,000/?l. D. 10,000/?l.
D
A nurse cares for a client with anemia requiring nutritional supplementation. Which nursing intervention best promotes client adherence with the prescribed therapy? A. Develop a therapeutic regimen recommendation for the client. B. Assist the client to use a medication reminder system for the therapeutic regimen. C. Develop a therapeutic regimen based on the client's understanding of the medication. D. Assist the client to incorporate the therapeutic regimen into daily activities.
D
The nurse is preparing the patient for a test to determine the cause of vitamin B12 deficiency. The patient will receive a small oral dose of radioactive vitamin B12 followed by a large parenteral dose of nonradioactive vitamin B12. What test is the patient being prepared for? A. Bone marrow aspiration B. Magnetic resonance imaging (MRI) study C. Bone marrow biopsy D. Schilling test
D
A client at the clinic has just been diagnosed with iron deficiency anemia. What would you recommend the client consume to promote the absorption of iron? A. Rich sources of vitamin C B. Meat, egg yolks, oysters, and shellfish C. Sources of vitamin B12 D. Vitamin E
A
A young client is diagnosed with glucose-6-phosphate dehydrogenase deficiency (G-6-PD). After reviewing the client's recent activities, what instruction should the nurse recommend to the client? A. Consult a health care provider about ingesting trimethoprim/sulfamethoxazole for a urinary tract infection. B. Discontinue exposure on a sun tanning bed. C. Quit cigarette smoking. D. Stop drinking excessive caffeinated beverages in less than 24 hours.
A
The nurse is screening donors for blood donation. Which client is an acceptable donor for blood? A. Reports having a cold 1 month ago that resolved quickly B. Had a dental extraction 2 days ago for caries in a tooth C. Has a history of viral hepatitis as a teenager 10 years ago D. Received a blood transfusion within 1 year
A
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. An increased number of erythrocytes C. Clustering of platelets with sickled red blood cells D. Erythrocytes that are macrocytic and hyperchromic
A
Which term refers to an abnormal decrease in white blood cells, red blood cells, and platelets? A. Pancytopenia B. Leukopenia C. Anemia D. Thrombocytopenia
A
The nurse, caring for a client in the emergency room with a severe nosebleed, becomes concerned when the client asks for a bedpan. The nurse documents the stool as loose, tarry, and black looking. The nurse suspects the client may have thrombocytopenia. What should be the nurse's priority action? A. Ask someone to clean the bedpan B. Notify the physician C. Put in an IV line D. Stop the nosebleed
B
When assessing a client with anemia, which assessment is essential? A. Age and gender B. Health history, including menstrual history in women C. Family history D. Lifestyle assessments, such as exercise routines
B
Which of the following describes a red blood cell (RBC) that has pale or lighter cellular contents? A. Microcytic B. Hypochromic C. Hyperchromic D. Normocytic
B
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. Beans, dried fruits, and leafy, green vegetables B. Berries and orange vegetables C. Fruits high in vitamin C, such as oranges and grapefruits D. Dairy products
A
Which iron-rich foods should a nurse encourage an anemic client requiring iron therapy to eat? A. Lamb and peaches B. Shrimp and tomatoes C. Cheese and bananas D. Lobster and squash
A