Hematology/Immunology Review

The client asks the nurse how long injections of Vitamin B12 will be needed. Which response by the nurse is best?

"For the rest of your life."

The nurse completes the client's admission history and physical examination. Which question does the nurse ask to obtain information related to symptoms of pernicious anemia?

"How much alcohol have you been consuming over the past year?"

The nurse educates the client diagnosed with iron deficiency anemia. Which client statement indicates the client needs further teaching?

"I don't have to worry about diet because I take iron preparations."

The client diagnosed with iron deficiency anemia receives ferrous gluconate daily. The client asks the nurse, "Why do I have to dilute this iron and drink more fluids?" Which response by the nurse is best?

"Undiluted iron stains the teeth and causes constipation."

The nurse plans discharge for an elderly client diagnosed with anemia. The nurse learns the client lives in a two-story house, and the bedrooms are on the second floor. It is most important for the nurse to ask which question?

"Where do you plan to sleep?" Rationale: Fatigue is a complication of anemia; the client may be too fatigued to climb stairs; if necessary, nurse arranged for client to have a bed on the first floor, encourage client to balance rest and activity

The nurse provides care for a client diagnosed with contact dermatitis from dish washing that resulted in ulcerations on both hands. Which precaution does the nurse include in discharge instructions for the client?

"You should wear rubber gloves while washing dishes until patch testing is completed to determine the causative factor."

The spouse of a client diagnosed with pernicious anemia asks why Vitamin B12 can't be given in pill form. Which response by the nurse is best?

"Your spouse's stomach doesn't secrete the necessary substance for B12 to be absorbed orally."

Following the transfusion of one unit of packed RBCs, the nurse prepares to administer another unit. Which action is most appropriate for the nurse to take initially?

Check the type and cross-match with another nurse

The nurse understands that which food is MOST likely to cause an allergy in a 6 month old infant?

Eggs

The nurse makes a home care visit to an elderly client diagnosed with iron deficiency anemia. The client states that even though an "iron pill" is taken daily, the client is feeling more and more fatigued. Which action does the nurse take first?

Obtain a stool specimen to test for occult blood

The nurse cares for the client diagnosed with pernicious anemia. Which treatment does the nurse expect the health care provider to prescribe?

Parental administration of Vitamin B12 once a month.

The nurse cares for a client with an abdominal wound. The nurse notes there is purulent drainage from the wound. Which action should the nurse take first?

Place the client on contact precautions

The client diagnosed with iron deficiency anemia says to the nurse, "I have always been a picky eater." The client's menstrual flow is normal and no sources of occult bleeding were identified in the client's diagnostic workup. The nurse understands that which is the most likely cause of anemia?

Poor nutrition

The nurse assesses the dietary education provided to the client diagnosed with pernicious anemia. The client's selection of which food indicates the teaching is effective?

Red Meat

The nurse cares for the client who has urticaria and swelling of the lips and eyes immediately after a contrast-enhanced computerized tomography procedure. Which statement best explains the reason for these observations?

Release of histamine

Which should the nurse expect to be an appropriate outcome for daily baths with colloidal oatmeal treatment?

Relief of itching

The nurse counsels a client diagnosed with iron deficiency anemia. The nurse determines teaching is effective if the client selects which menu?

Flank steak, green leafy veggies, and prunes

If a client has an anaphylactic reaction to an antibiotic, it is most important for the nurse to take which action after notifying the HCP?

Give epinephrine subcutaneously

The nurse cares for a client receiving a blood transfusion. The nurse is most concerned if which observation is made?

Hematuria

The nurse prepares the client for a Schilling test. Which information is most important to for the client to know before starting the test?

How to collect a 24-hour urine

The nurse understands which is the most common type of anemia?

Iron-deficiency

The nurse identifies which group of symptoms is indicative of a hemolytic transfusion reaction?

Kidney pain, hematuria, cyanosis

The nurse performs diet teaching for a client with iron deficiency anemia. The nurse determines teaching is successful if the client selects which menu?

Liver and onions, spinach, and rice pudding with raisins

The home health nurse visits a client diagnosed with pernicious anemia 18 months after having a total gastrectomy. The client asks, "Why do I have this anemia?" Which reason does the nurse give the client?

Loss of mucosal surface that secretes intrinsic factor.

The emergency room nurse cares for the client having an anaphylactic reaction as a result of a bee sting. The client exhibits signs of bronchial edema, hypotension, rapid pulse, and pruritus at the sting site. Which is the priority action for the nurse to perform?

Maintain a patent airway

The client was stung by a bee less than 15 minutes ago and now presents with a Type I hypersensitivity reaction. Which should the nurse do when caring for this client?

Maintain the client airway and monitor vital signs

The nurse understands which common foods are the most likely the cause of eczema and need to be eliminated from the diet?

Milk, wheat, egg whites

Which client is at highest risk to develop iron deficiency anemia?

A 60-year-old client with a bleeding gastric ulcer

The nurse identifies which client is most likely to have latex hypersensitivity?

A client diagnosed with spina bifida

A nurse observes a staff member enter the client's room wearing a fit-tested respiratory device. The nurse determines care is appropriate if the staff member is caring for which client?

A client diagnosed with varicella

After reviewing the medical histories of the nurses on the unit, the nurse manager determines which nurse can safely use latex products?

A nurse with a history of GI upset

The nurse cares for clients in the prenatal clinic. The nurse identifies which pregnant woman as MOST likely to have a problem with Rh incompatibility with the fetus?

An Rh-negative client who conceived with a Rh-positive partner and who has Rh antibodies

The nurse cares for the client scheduled for a bone marrow biopsy. Which nursing action is MOST important to prevent complications following the biopsy?

Applying pressure to the biopsy site.

Which diagnostic study does the nurse expect to confirm the diagnosis of pernicious anemia?

Schilling test

The nurse cares for the client diagnosed with severe anemia and notes the client has pallor of the skin, conjunctivae, and mucous membranes. Which statement best explains the reason for the pallor?

Shunting of blood to heart and brain

The nurse cares for the client recently diagnosed with agranulocytosis. Which sign(s) would the nurse expect to observe within 2 to 3 days of the dianosis?

Sore throat, fever, and weak rapid pulse

The nurse teaches the client diagnosed with iron deficiency anemia about dietary management of the anemia. At the end of the session, the client's selection of which foods indicates the client understands the teaching?

Spinach and eggs

The client has a transfusion reaction. Which is the nurse's first action?

Stop the transfusion

The nurse monitors a client receiving a blood transfusion. The nurse should intervene if which is observed?

The blood infuses at 10 mL/min at first for the first 15 minutes

Several days following bone marrow aspiration, the nurse notes the client has a temp of 103, and there is yellow drainage from the aspiration site. Which interpretation by the nurse is most accurate?

The client has developed osteomyelitis

The nurse cares for a client diagnosed with pernicious anemia. The client asks the nurse "What is the purpose of this 24-hour urine test?" Which explanation by the nurse is the best?

The purpose of the 24-hour urine test is to assess absorption and subsequent excretion of vitamin B-12 in the urine.