Chapter 31

A client with hemophilia was admitted after sustaining an injury while playing outdoors with friends. Initially, the client presented with severe bleeding but has since stabilized. Which interventions will the nurse include in the care of plan for this client? Select all that apply. A. eliminate aspirin and NSAIDs B. obtain an oral temperature to ensure accuracy C. support painful joints on pillows D. encourage the client to use a soft toothbrush and rinse the mouth with warm water between and after meals

A, C, D

Which nursing interventions should be incorporated into the plan of care to manage the delayed clotting process in a patient with leukemia? A. eliminate direct contact with others who are infectious B. apply prolonged pressure to needle sites or other sources of external bleeding C. monitor temperature at least once per shift D. implement neutropenic precautions

B

A client has been diagnosed with Cooley's anemia, a severe form of beta-thalassemia. Which is a symptom of Cooley's anemia? A. bronzing of the skin B. dyspnea C. inflammation of the tongue D. inflammation of the mouth

A

A client has a history of seizures and presents with severe fatigue, frequent headaches, and a sore, beefy-red tongue. What could be causing the client's current condition? Select all that apply. A. alcoholism B. intestinal disorders C. lack of vitamin B12 D. lack of meat consumption

A, B

A client has a history of sickle cells anemia with several sickle cell crises over the past 10 years. What blood component results in sickle cell anemia? A. hemoglobin F B. hemoglobin S C. hemoglbin M D. hemoglobin A

B

A client has been diagnosed with pernicious anemia. During client education, the nurse emphasizes the importance of lifelong intramuscular administration of: A. vitamin A B. vitamin B12 C. folic acid D. vitamin C

B

A client has pernicious anemia and has been receiving treatment for several years. Which symptom may be confused with another condition in older adults? A. dementia B. stomatitis C. ataxia D. glossitis

A

A nurse is caring for a client in the emergency department following an accident that caused severe blood loss. Which are compensatory mechanisms for lost RBC function? Select all that apply. A. tachycardia B. constipation C. dyspnea D. alkalosis E. flushed skin

A, B, C

A client is hospitalized with sickle cell anemia and the nurse is preparing a teaching plan to review with the client and the client's family. Which interventions should be included? Select all that apply. A. whilte participating in physical exercise, wear constrictive clothing to support circulation. B. during a sickle cell crisis, fluids are to be restricted C. dress warmly in cold temperatures D. never exceed the recommended dosages of analgesics

A, C, D

A client has pernicious anemia and has been receiving treatment for several years. What is the client lacking results in pernicious anemia? A. extrinisic factor B. intrinsic factor C. vitamin B D. hemoglobin

B

A nurse is caring for a client who developed toxicity after long-term treatment with sulfasalazine for Crohn's disease. The client is experiencing fatigue, fever, chills, and headache and is at risk to develop opportunistic infections. Which condition has the client most likely developed? A. pernicious anemia B. agranulocytosis C. leukopenia D. hemolytic anemia

B

A client reports feeling tired, cold, and short of breath at times. Assessment reveals tachycardia and reduced energy. What would the nurse expect the physician to order? A. ECG B. chest radiograph C. CBC D. antibiotic

C

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. amount and quality of factor VIII D. quality of factor XI

C

A client has a history of sickle cells anemia with several sickcle crises over the past 10 years. Although it is a genetic disorder, sickle cells is found primarily in African Americans. How many African Americans does it affectr in the United States? A. 1 in 900 B. 1 in 750 C. 1 in 1000 D. 1 in 625

D

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. encourage frequent handwashing B. avoid contact with family/friends who are sick C. plan for frequent periods of rest D. use of a disposable razor when shaving

D

The nurse and the client are discussing some strategies for ingesting iron to combat the client's iron-deficiency anemia. Which is among the nurse's strategies? A. avoid vitamin C as it prevents absorption B. drink liquid iron prepartions with a straw C. taking iron pills with milk aids in absorption D. take iron with an antacid to avoid stomach upset

B

The nurse is assessing a client who lives in a community that is at a very high altitude. When reviewing the client's most recent lab values, the nurse notes that the client has elevated red blood cell levels. The client denies having any unwanted symptoms. What is the nurse's best response? A. document the assessment finding B. monitor vital signs every 4 hours C. promptly inform the primary care provider D. perform a focuses cardiovascular assessment

A