Med Surg Chapter 20

Which of the following are assessment findings associated with thrombocytopenia? Select all that apply. A .Bleeding gums B. Bradypnea C. Epistasis D. Hematemesis E. Hypertension

A .Bleeding gums C. Epistasis D. Hematemesi

The nurse is 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.

B. Osteoclasts break down bone cells so pathologic fractures occur.

Which of the following is the only curative treatment for chronic myeloid leukemia (CML)? A. Cytarabine B. Idarubicin C. Allogeneic stem cell transplant D. Imatinib

C. Allogeneic stem cell transplant

The nurse is working at a blood donation clinic. What teaching should the nurse provide to the donor immediately after blood donation? A.Hold the involved arm below the heart. B. Sit up promptly after the needle is removed C. Remove the band-aid after 5 minutes. D. Remain for observation after eating and drinking.

D. Remain for observation after eating and drinking.

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) Severity of the disease b) Insufficient intake of dietary nutrients c) Neurologic involvement d) Loss of vibratory and position senses

c) Neurologic involvement

A patient presents with peripheral neuropathy and hypothesia of the feet. What is the best nursing intervention? a) Keep the feet cool. b) Encourage ambulation. c) Have the client elevate his legs. d) Assess for signs of injury.

d) Assess for signs of injury.

When assessing a female patient with a disorder of the hematopoietic or the lymphatic system, which of the following assessments is most essential? a) Lifestyle assessments, such as exercise routines b) Age and gender c) Menstrual history d) Health history, such as bleeding, fatigue, or fainting

d) Health history, such as bleeding, fatigue, or fainting

A nurse is transfusing whole blood to a client with impaired renal function. During the transfusion, the client tells the nurse, "I feel very short of breath all of a sudden." What is the nurse's primary action? A. Assess the client's vital signs. B. Call the health care provider. C. Slow the infusion. D. Stop the infusion.

D. Stop the infusion.

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. Neutropenia C. Leukopenia D. Thrombocytopenia

D. Thrombocytopenia

A patient with acute myeloid leukemia (AML) is having hematopoietic stem cell transplantation (HSCT) with radiation therapy. In which complication do the donor's lymphocytes recognize the patient's body as foreign and set up reactions to attack the foreign host? a) Graft-versus-host disease b) Bone marrow depression c) Remission d) Acute respiratory distress syndrome

a) Graft-versus-host disease

Which of the following 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) Implement neutropenic precautions. c) Apply prolonged pressure to needle sites or other sources of external bleeding. d) Apply prolonged pressure to needle sites or other sources of external bleeding.

c) Apply prolonged pressure to needle sites or other sources of external bleeding.

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) Leukopenia b) Neutropenia c) Anemia d) Thrombocytopenia

d) Thrombocytopenia

The nurse is performing an assessment on a patient with acute myeloid leukemia (AML) and observes multiple areas of ecchymosis and petechiae. What laboratory study should the nurse be concerned about? A. Platelet count of 9,000/mm3 B. WBC count of 4,200 cells/mcL C. Hematocrit of 38% D. Creatinine level of 1.0 mg/dL

A. Platelet count of 9,000/mm3

A client is prescribed 325 mg/day of oral ferrous sulfate. The nurse includes in client teaching, "Take your iron pill A. Take 1 hour before breakfast B. Take with dairy products C. Decrease intake of dietary fiber D. Decrease intake of fruits and juices

A. Take 1 hour before breakfast

A patient with sickle cell crisis is admitted to the hospital in severe pain. While caring for the patient during the crisis, which of the following is the priority nursing intervention? A. Limiting the client's intake of oral and IV fluids B. Administering and evaluating the effectiveness of opioid analgesics C. Encouraging the client to ambulate immediately D. Limit foods that contain folic acid

B. Administering and evaluating the effectiveness of opioid analgesics

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. Berries and orange vegetables B. Fruits high in vitamin C, such as oranges and grapefruits C. Dairy products B. Beans, dried fruits, and leafy, green vegetables

B. Beans, dried fruits, and leafy, green vegetables

A home care nurse visits a client diagnosed with atrial fibrillation who is ordered warfarin. The nurse teaches the client about warfarin therapy. Which statement by the client indicates the need for further teaching? A. "I'll report unexplained or severe bruising to my doctor right away." B. "I'll watch my gums for bleeding when I brush my teeth." C. "I'll eat four servings of fresh, dark green vegetables every day." D. "I'll use an electric razor to shave."

C. "I'll eat four servings of fresh, dark green vegetables every day."

A client with anemia has been admitted to the medical-surgical unit. Which assessment findings are characteristic of iron deficiency anemia? A. Nausea, vomiting, and anorexia B. Nights sweats, weight loss, and diarrhea C. Dyspnea, tachycardia, and pallor D. Itching, rash, and jaundice

C. Dyspnea, tachycardia, and pallor

A client with sepsis is experiencing disseminated intravascular coagulation (DIC). The client is bleeding from mucous membranes, venipuncture sites, and the rectum. Blood is present in the urine. The nurse establishes the nursing diagnosis of Risk for deficient fluid volume related to bleeding. The most appropriate and measurable outcome for this client is that the client exhibits? A. Decreased bleeding B. Systolic blood pressure greater than 70 mm Hg C. Stable level of consciousness D. Urine output greater than or equal to 30 mL/hour

D. Urine output greater than or equal to 30 mL/hour

A nurse cares for clients with hematological disorders and notes that women are diagnosed with hemochromacytosis at a much lower rate than men. What is the primary reason for this? A. Women require grater folic acid supplementation B. Women have lower hemoglobin levels C. Women rarely manifest the gene expression D. Women lose iron through menstrual cycles

D. Women lose iron through menstrual cycles

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 larger amounts of bland, soft foods less frequently." B."Eat small amounts of bland, soft foods frequently." C."Eat low-fiber blended foods only." D."Eat cold, bland foods with a large amount of water."

D."Eat cold, bland foods with a large amount of water."

Which is the following is the most obvious sign of anaemia? a) Pallor b) Tachycardia c) Flow murmurs d) Jaundice

a) Pallor

Which of the following is the most common haematologic condition affecting elderly patients a) Thrombocytopenia b) Anaemia c) Leukopenia d) Bandaemia

b) Anaemia

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 stools for blood. c) Observe the sputum for signs of blood. d) Observe the gums for bleeding after the client brushes teeth.

b) Observe stools for blood.

A patient with severe anemia is complaining of the following symptoms: tachycardia, palpitations, exertional dyspnea, cool extremities, and dizziness with ambulation. Lab results reveal low hemoglobin and hematocrit levels. Based on the assessment data, which of the following nursing diagnoses is most appropriate for this patient? a) Fatigue related to decreased hemoglobin and hematocrit b) Imbalanced nutrition, less than body requirements, related to inadequate intake of essential nutrients c) Risk for falls related to complaints of dizziness d) Ineffective tissue perfusion related to inadequate hemoglobin and hematocrit

d) Ineffective tissue perfusion related to inadequate hemoglobin and hematocrit