Hematology/Lymphatics/Immunity TEST questions

A nurse is caring for a child who has nosebleed. Which of the following actions should the nurse take?

​Have the child sit with her head tilted forward and hold pressure on her nose for 10 min.

A nurse is assisting with the care of a client who has lung cancer and is scheduled for a lobectomy. The nurse should instruct the client to expect the use of which of the following equipment postoperatively?

A chest tube

The nurse is caring for a patient with angioedema. Which nursing action should have the highest priority?

Monitor for restlessness. *IF a reaction is severe, maintain the airway?? S/S of respiratory distress

A nurse is reinforcing teaching about the prevention of deep vein thrombosis (DVT) with a group of newly licensed nurses. Which of the following interventions should the nurse include in the teaching?

Place sequential compression devices bilaterally.

A nurse is collecting data from a client who has leukemia. Which of the following findings has the highest priority?

Platelet count 125,000/mm3

A nurse is reinforcing teaching with an assistive personnel (AP) about using personal protective equipment while caring for clients. Which of the following statements should the nurse identify as an indication that the AP understands the instruction?

"I will wear gloves and a gown when bathing a client who has open skin lesions."

A nurse is reinforcing teaching for a client about following a low-purine diet to manage gout. Which of the following statements should the nurse identify as an indication that the client understands the instructions?

"I'll eliminate liver from my diet."

A nurse is caring for a client following major spinal surgery who is reporting pain. The client's partner tells the nurse, "I wish I could do something to make my wife feel better." Which of the following responses should the nurse make?

"It must be very difficult for you to see your wife in pain."

A patient with aplastic anemia is to receive an injection of erythropoietin (Epogen). The patient asks what the injection is intended to do. Which should the nurse respond to the patient?

"It will stimulate your body to produce more of its own red blood cells."

A nurse is reinforcing teaching with a client who is to start taking enteric-coasted naproxen for rheumatoid arthritis. Which of the following client statements by the client indicates a need for further teaching?

"It's okay to crush a tablet as long as I make sure it dissolves completely in water before swallowing it."

A nurse is collecting data from a client who is admitted to undergo a left lobectomy to treat lung cancer. The client tells the nurse that she is scared and wishes she had never smoked. Which of the following responses should the nurse make?

"It's okay to feel afraid. Let's talk about what you are afraid of."

A nurse is caring for a client who asks if home O2 will be provided to her after discharge. Which of the following actions should the nurse take?

Consult with the case manager. *The case manager's role is to plan for the client's discharge needs, including obtaining prescriptions for supplies and equipment, exploring financial resources to cover costs, and locating sources for procuring needed supplies and equipment.

A nurse is reinforcing dietary teaching with a client who has iron deficiency anemia. Which of the following foods should the nurse recommend?

Cooked oatmeal

A patient prescribed corticosteroids for arthritis is surprised to learn of an immune disorder. What should the nurse explain as the reason for the patient not demonstrating typical signs of immune dysfunction?

Corticosteroids are impacting normal immune response functioning.

A nurse is contributing to the plan of care for a client who has a disturbed body image following a motor vehicle crash that resulted in a right arm amputation. Which of the following actions should the nurse take first?

Determine the client's perception of his body image.

A nurse is assisting with the care of a client who is receiving a blood transfusion. Which of the following findings should the nurse report to the provider?

Difficultly breathing - dyspnea *Indicate client going into fluid overload

A nurse is reinforcing teaching with a client who has hemophilia A. Which of the following manifestations should the nurse include in the teaching?

Disabling joint pain

A nurse is reinforcing teaching with a client who has a new diagnosis of gout. The client asks the nurse how she got the disorder. Which of the following information should the nurse include in the teaching?

Intra-articular urate crystal deposits causes inflammation.

A nurse is caring for a child who has juvenile rheumatoid arthritis. Which of the following actions should the nurse take?

Maintain night splints to the affected joint. *assist with pain and reduce flexion deformity.

A nurse is planning client care for the shift. Which of the following tasks should the nurse delegate to an assistive personnel (AP)?

Measuring a client's intake and output for the shift

A nurse is a pediatric clinic is caring for a child who has iron deficiency anemia and is to start taking ferrous sulfate syrup. Which of the following instructions should the nurse give the parent?

Offer the medication through a straw.

A nurse is assisting with the admission of a client who has leukemia. Which of the following transmission-based precautions should the nurse implement?

Protective environment

The nurse is assisting a patient with a bleeding disorder and finds large purplish areas in the skin and oral mucosa. Which term should the nurse use to document this finding?

Purpura *Term for hemorrhage into the skin, mucous membranes, and organs.

A patient is prescribed a transfusion of washed packed red blood cells. What should the nurse realize as being rationale for the using this type of blood?

Reduces the risk of a febrile reaction

A nurse is preparing to administer diphenhydramine to a client who is to receive a blood transfusion. The nurse should explain that the purpose of diphenhydramine is to prevent which of the following manifestation of a transfusion reaction?

Urticaria *like itching, flushing, and hives

A nurse is assisting in the care of a client who is receiving platelets. The client reports feeling chilled and itching. Which of the following priority actions should the nurse take?

Stop the infusion

The nurse is providing care for a patient who has had a splenectomy. Which nursing action has the highest priority?

Teach the patient to cough and deep breathe every hour. *Mobilize secretion and help prevent respiratory infection.

A nurse is caring for a client who comes to the clinic to be tested for tuberculosis (TB) after a close family contact tests positive. Which of the following measures should the nurse anticipate preparing for the client?

Tuberculin skin test

A nurse is caring for a group of clients on an infectious disease unit. The nurse should wear an N95 mask when caring for a client who has which of the following?

Tuberculosis

A nurse is assisting to monitor a client who is receiving a blood transfusion. Which of the following findings should the nurse report to the charge nurse as an indication of an allergic blood transfusion reaction?

​Generalized urticaria *S/S of itching and anaphylaxis

A nurse is assisting with the admission of a child who has pertussis. Which of the following actions should the nurse take?

​Initiate droplet precautions.

A nurse is caring for a client who has pneumonia and is coughing up secretions. Which of the following actions should the nurse take first?

Encourage the client to cough and deep breathe.

A nurse is reinforcing teaching with a client who has a new diagnosis of aplastic anemia. When discussing the pathology of the disease, which of the following instructions should the nurse include in the teaching?

"Aplastic anemia results from decreased bone marrow production of RBCs."

A nurse is assisting with the care of a client who has septic shock and is at risk for disseminated intravascular coagulation (DIC). Which of the following nursing statements indicated an understanding of the condition?

"DIC is caused by abnormal coagulation involving fibrinogen."

A nurse is reinforcing teaching with a client who has rheumatoid arthritis. Which of the following statements by the client indicated understanding of the information?

"I can use heat or cold to help relieve my pain."

A nurse is reinforcing teaching with a client who has rheumatoid arthritis. Which of the understanding of the information?

"I can use heat or cold to help relieve my pain."

A nurse is reinforcing teaching with a client who is about to start taking allopurinol to treat gout. Which of the following statements by the client indicates an understanding of the teaching?

"I need to drink at least 3 quarts of water a day." *want to produce 2,000mL of urine.

A nurse is reinforcing teaching about controlling a bleeding episode with a parent of a child who has hemophilia. Which of the following statements by the parent indicates a need for further teaching?

"I will apply a warm compress over the site."

A nurse is reinforcing teaching about legal issues with a group of newly licensed nurses. Which of the following statements by a newly licensed nurse indicates an understanding of the teaching?

"I will ask permission from the client before observing a procedure the client is having."

A nurse is reinforcing teaching with the parents of a preschooler who had atopic dermatitis. Which of the following information should the nurse include?

"The doctor might recommend an antihistamine to help control your symptoms."

A nurse is caring for a female client who has rheumatoid arthritis and a new prescription for methotrexate. The client tells the nurse she is planning a pregnancy. Which of following should the nurse include in a discussion about the medication?

"The medication should be discounted 3 months prior to a planned pregnancy."

A nurse is caring for a client who asks about the functions of the thymus, spleen, and lymph nodes. Which of the following responses should the nurse make?

"These organs are for immunity." *help fight infections

A nurse is reinforcing teaching with a newly licensed nurse about the purpose of an indirect Coombs test. Which of the following statements should the nurse include in the teaching?

"This test detects Rh-positive antibodies in the mother's blood."

A nurse is reviewing the laboratory data of client who has acute leukemia and received aggressive chemotherapy treatment 10 days ago. Which of the following abnormalities should the nurse expect to see?

-Decrease platelet count -Decrease WBC count -Decreased RBC count

A nurse is collecting data from a client who has an exacerbation of gout. Which of the following findings should the nurse expect?

-Edema -Erythema -Tophi -Tight skin

The nurse has contributed to an educational program for staff members on immunity and classes of antibodies. Which statements indicate that the staff member understandings information about classes of antibodies?

-IgA is found in breast milk. -IgG crosses the placenta. -IgM is found in blood and lymph fluid.

The nurse suspects a patient is experiencing manifestations of Hodgkin's disease. Which are characteristics of this health disorder?

-It is distinguished by the presence of Reed-Sternberg cells. -Hodgkin's disease is the most curable type - Painless swelling of cervical, axillary, or inguinal nodes occurs. -

Which general manifestations should the nurse monitor for when conducting a physical assessment for a pediatric client who is diagnosed with cancer?

-Petechiae -Infection -Pain -Cachexia

A nurse is assisting with the discharge plan of a client who has a permanent tracheostomy and breathes on his own. Which of the following equipment should the nurse ensure is available for home care of the tracheostomy?

-Slit gauze pads -Suction machine

A nurse is assisting in the preparation of a blood transfusion for a client and receives the unit of packed RBCs at 1610. By which of the following times must the transfusion begin?

1640 *The nurse should initiate the blood transfusion within 30 minutes after obtaining the blood from the blood bank.

A nurse is talking with a client who says she knows someone who takes metoprolol for blood pressure and asks if the medication would be appropriate for her as well. Which of the following data from the client's medical record should the nurse identify as a contraindication to metoprolol?

A history of sinus bradycardia. *because metoprolol can cause bradycardia.

The nurse is contributing to a group of patients' care plans. Which patient should the nurse identify as being at risk for developing serum sickness?

A patient who receives intravenous (IV) penicillin for an infection *Serum sickness is seen occasionally after administration of penicillin and sulfonamide.

The nurse is assisting in the development of a care plan for a patient with anemia. Which nursing diagnosis is most common in a patient with anemia?

Activity Intolerance related to tissue hypoxia *Patients with anemia are fatigued related to poor oxygenation

A nurse is assisting with the plan of care for a client who has leukemia and whose platelet count is 50,000 mnm3. Which of the following interventions should the nurse include in the plan of care?

Administer a stool softener. *leukemia client @ risk for bleeding administer a stool softener to prevent constipation which can lead to rectal bleeding.

A nurse is assisting in preparing a presentation at a community center about systemic lupus erythematosus (SLE). The nurse should identify which of the following groups as having the highest risk for developing this disorder?

African American women

A nurse is providing teaching about iron deficiency anemia to the parents of a 14 month old. Which of the following should the nurse recommend as a method of preventing iron deficiency anemia?

Avoid a diet consisting of primarily milk.

A nurse is reinforcing teaching with a client who has rheumatoid arthritis (RA) about self-care techniques. Which of the following strategies should the nurse include in the teaching?

Avoid exercising joints that are swollen.

A nurse is collecting data from a client who has rheumatoid arthritis. Which of the following is an expected finding for this client?

Boutonniere deformity *Rheumatoid arthritis - chronic, inflammatory autoimmune disorder which affects the joints

A nurse is collecting data from a client who has anemia and a hemoglobin level of 7.2 g/dL. Which of the following findings should the nurse expect?

Brittle fingernails *expecting finding of anemia - pruritus and jaundice.

The nurse is caring for a patient with a clotting disorder. Which blood product should the nurse anticipate being prescribed?

Cryoprecipitates *replace specific missing clotting factors.

A nurse is collecting data from a client who has pneumonia and is experiencing acute respiratory acidosis. Which of the following manifestations should the nurse expect to find?

Decreased level of consciousness

A nurse is caring for an 8-year old child who has sickle cell anemia and is recovering from vast-occlusive crisis. Which of the following precautions should the nurse include in the discharge teaching?

Drink 8 glasses of fluid daily. *Hydration decreases the viscosity of the blood which helps lower the risk for sickling as a result of venous status.

A nurse is checking for paradoxical blood pressure on a client who has constrictive pericarditis. Which of the following findings should the nurse expect?

Drop in systolic BP more than 10 mm HG on inspiration

A client who is postoperative is receiving IV fluids and a unit of whole blood. The nurse should observe the client for which of the following as an early sign of circulatory overload?

Dyspnea **Monitor respiratory status! Fluid overload S/S = rales, cough, dyspnea, JVD, tachycardia

A nurse is collecting data from a client who has anemia due to excess blood loos during surgery. The nurse should expect which of the following findings?

Dyspnea on exertion

A nurse is monitoring a client who is receiving chemotherapy and has a platelet count of 22,000 mm3. Which of the following findings should the nurse identify as the priority?

Ecchymosis *greatest risk is bleeding

A nurse is caring for a client who has hemophilia and has developed hemarthrosis of the left knee. Which of the following actions should the nurse take?

Elevate the knee

A nurse is collecting data from a client who has systemic lupus erythematous (SLE). Which of the following findings should the nurse expect?

Facial rash *The rash is often dry, scaly, red, and raised in appearance.

A patient is admitted to the hospital in the final stage of chronic lymphocytic leukemia (CLL). Which manifestations of CLL should the nurse expect to find while collecting admission data?

Fever and abnormal bleeding *from infection and thrombocytopenia

A nurse is assisting with the care of a client who is at risk for disseminated intravascular coagulopathy (DIC). The nurse should plan to report which of the following laboratory values that indicate DIC?

Fibrinogen 85 mg/dL *fibrinogen level is below the expected reference range which can indicate DIC

A nurse is caring for a client who has multiple myeloma and has a WBC count of 2,200/mm3. Which of the following food items brought by the family should the nurse prohibit from being given to the client?

Fresh fruit basket

A nurse is caring for a client who is receiving a unit of packed RBCs. About 15 min following the start of the transfusion, the nurse notes that the client is flushed and febrile, and reports chills. To help confirm that the client is having an acute hemolytic transfusion reaction, the nurse should observe for which of the following manifestations?

Hypotension *S/S = hypotension, tachycardia, tachypnea, low back pain, flushing, chills and fever

The nurse determines that a patient has long-term immunity against a disease. Which part of the immune system should the nurse recognize is responsible for this patient's long-term immunity?

IgG

A nurse is preparing to administer prednisone to a client for treatment of rheumatoid arthritis. Which of the following findings indicates to the nurse the treatment is effective?

Improved range of motion

A nurse is reinforcing teaching with a client who has neutropenia as a result of radiation therapy for the treatment of lung cancer. Which of the following should the nurse plan to include in the teaching?

Increase fluid intake by drinking bottled water.

A nurse is preparing to administer immunizations to a child who has an allergy to eggs. The nurse should know that an allergy to eggs is a contraindication for which of the following immunizations?

Influenza (TIV)

A nurse is assisting in the care of a newborn shortly after birth. Which o the following actions should the nurse take to assist in the prevention of hyperbilirubinemia?

Initiate early feeding. *within the first hour

A nurse is preparing to administer the first dose of etanercept to a client who has rheumatoid arthritis. Which of the following actions should the nurse take?

Inject the medication subcutaneously into the client's upper arm.

A nurse is caring for a child who has idiopathic thrombocytopenic purpura and is experiencing a noseblood. Which of the following actions should the nurse take?

Insert cotton into each of the child's nostrils.

A nurse is assisting with the care of a client who is receiving a blood transfusion. The nurse should monitor for which of the following findings as an indication the client is having an acute hemolytic reaction?

Low back pain *monitor for low back pain, chills, fever, tachycardia, hypotension, and acute jaundice.

A nurse is collecting data from a child and notes the presence of bruises on her arms and legs. Which of the following actions should the nurse take first?

Obtain a detailed history.

A goal for a client who has difficulty with the physical aspects of feeding herself due to rheumatoid arthritis is to use adaptive devices to enhance her capabilities. The nurse caring for a client should initiate a referral to which of the following members of the interprofessional health care team?

Occuptional therapist

A nurse is assisting in the care of a client who is to receive a blood transfusion. Prior to the transfusion, which of the following staff members should the nurse select to assist her in checking the blood?

Oncology nurse *Must be a qualified personnel

A nurse is reinforcing teaching with a client who is pregnant and has a new prescription for ferrous sulfate due to iron-deficiency anemia. The nurse should instruct the client to take this medication with which of the following?

Orange juice

A nurse in a clinic is reviewing the prescriptions for a client who had a delayed hypersensitivity reaction to an unknown trigger. The nurse should expect the provider prescribe which of the following tests?

Patch test *for an unknown allergy and immune response.

A nurse is caring for a client who has an infection. The nurse should use which of the following strategies to interrupt the transmission of the client's infection?

Performing hand hygiene before, during, and after direct contact with the client

When a nurse obtains an unusually low blood pressure measurement for a client whose blood pressure us generally elevated, she considers the possibility of a problem with her technique. Which of the following sources of error should she consider as a possible cause of the low reading?

Positioning the client's arm above heart level *too lose cuff can cause a high blood pressure reading

A nurse is collecting data from a client who has contact dermatitis of the neck and upper chest. Which of the following findings should the nurse expect?

Reports of exposure to a skin irritant

A nurse is reviewing the medical record of a client who just returned to the unit following surgery and notes the client has a history of anaphylaxis in response to penicillin. The client's postoperative prescriptions include a dose of cephalexin. Which of the following actions should the nurse take?

Request that the surgeon prescribe a different antibiotic. *The nurse should inform the surgeon of the client's previous reaction to penicillin because receiving a dose of cephalexin places the client at risk for an anaphylactic reaction due to a cross-sensitivity with penicillin.

When reviewing the admitting prescriptions for a client, the nurse notes that the dose of one medication is three times the usual dose of this medication. The nurse calls the provider but he is unavailable for several days. Which of the following actions should the nurse take?

Request to speak with the provider who is covering for the prescriber.

A nurse is reinforcing teaching with a client who has a new diagnosis of systemic lupus erythematous (SLE). Which of the following information should the nurse include in the teaching?

SLE affects the connective tissue of the body.

A nurse is reinforcing teaching with a client who has gout. Which of the following medication classes should the nurse instruct the client to avoid?

Salicylates *such as aspirin

A nurse is caring for a client whose history reveals the clinical manifestations of pernicious anemia. The nurse should anticipate a prescription for which of the following diagnostic tests?

Schilling test

A nurse is collecting data from a client who has systemic lupus erythematosus (SLE). Which of the following laboratory values should the nurse review to determine theclient's renal function?

Serum creatinine

A nurse is assisting with the care of a client who is receiving packed red blood cells. During the infusion, the client states, "My heart is racing." The nurse notes that the client face has become flushed. Which of the following actions should the nurse take first?

Stop the transfusion.

The nurse is providing care for a patient with Hodgkin's disease has cervical lypmh node enlargement. Which symptom requires priority recognition?

Stridor

A nurse is collecting data on a client who is to receive a blood transfusion. Which of the following data is the nurse's priority before the transfusion begins?

Temperature *which is the greatest risk of a reaction. monitor before, during, and after

Following change-of-shift report, a nurse enters the room of a client who is receiving packed RBCs. Which of the following findings should the nurse identify as appropriate for blood product transfusion?

The blood is connected to a Y-type infusion set with 0.9% sodium chloride.

A nurse is preparing to administer the measles, mumps, and rubella (MMR) vaccine to a 15-month-old child. Which of the following findings should the nurse identify as a contraindication for this immunization?

The child has a congenital immunodeficiency.

A charge nurse is observing a staff nurse caring for a client who has multiple skin sessions from a varicella zoster infection. Which of the following actions should the charge nurse identify as an indication that the nurse understands the precautions to take when caring for a client who has this infection?

The nurse wears a high-efficiency particulate air (HEPA) filter mask.

A nurse is reinforcing teaching with a client who is pregnant and has a prescription for Rho (D) immune globulin. Which of the following information should the nurse include?

This medication prevents the formation of Rh antibodies by a woman who is Rh-negative.

A nurse is reinforcing teaching with a community group about the prevention of viral hepatitis. Which of the following information should the nurse include in the teaching?

Thoroughly cook foods prepared with tap water. *H20 can be contained with Hepatitis A

A nurse is reinforcing teaching about pernicious anemia with a client following a total gastrectomy. Which of the following dietary supplements should the nurse include in the teaching as the treatment for pernicious anemia?

Vitamin B12

A nurse is reviewing the plan of care for a client who has cellulitis of the leg. Which of the following interventions should the nurse recommend?

Wash daily with an antibacterial soap *to promote tissue health and treat the infection.

A nurse is caring for a child who has pertussis. The child's parent asks the nurse what the common name for the disease is. The nurse should respond with which of the following common names?

Whooping cough

The nurse is preparing teaching for a patient with Hodgkin's disease. Which beverage should the nurse instruct this patient to avoid?

Wine *it can induce pain

A nurse in a provider's office is collecting data from a client who has systemic lupus erythematosus (SLE) and takes hydroxychloroquine to reduce skin inflammation. The nurse should identify that which of following is an adverse effect of this medication?

blurred vision

A nurse is assisting in planning care for a client who has advanced multiple myeloma. When planning care the nurse should recognize that the client is at risk for which of the following complications?

fracture

A nurse is reviewing the laboratory results of a client who is taking cyclosporine following a kidney transplant. Which of the following laboratory findings should the nurse identify as the most important to report to the provider?

increase in serum creatinine *Cyclosporine is nephrotoxic

A nurse is assisting with the care of a client who is hypovolemic due to blood loss following a motor-vehicle crash and needs a blood transfusion immediately. The nurse should anticipate a prescription for which of the following IV solutions while awaiting blood from a type and cross-match?

lactated ringer's *contains electrolytes and expands plasma volume.

A nurse is reviewing the laboratory results of a client who has hyperventilating during a panic attack. Which of the following arterial blood gas values should the nurse expect?

pH 7.47 and PaCO2 31 mm Hg *pt in respiratory alkalosis

A nurse is collecting data from a client who sustained blood loss. Which of the following findings should the nurse identify as a manifestation of hypovolemia?

thready pulse *D/T decreased circulation

A nurse is reviewing data for a client who has disseminated intravascular coagulation (DIC). Which of the following findings should the nurse expect?

​Excessive thrombosis and bleeding.