NCLEX WEEK #8 ANEMIA AND BLOOD
A clinic nurse instructs the mother of a child with sickle cell disease about the precipitating factors related to pain crisis. Which of the following, if identified by the mother as a precipitating factor, indicates the need for further instructions?
Fluid overload
The nurse has just admitted a 35 year old female pt who has a serum b12 concentration of 800pg/mL. Which of the following laboratory findings would cue the nurse to focus the pt history on specific drug or alcohol abuse?
Folate 1.5 ng/mL
A pt comes into the health clinic 3 years after undergoing a resection of the terminal ileum complaining of weakness, shortness of breath and a sore tongue. Which pt statement indicates a need for intervention and pt teaching?
I take a vitamin B12 tablet every day
The nurse understands that the pt with pernicious anemia will have which distinguishing laboratory findings?
Intrinsic factor, absent
Which of the following foods would the nurse encourage the mother to offer to her child with iron deficiency anemia?
Potato, peas, and chicken
A vegetarian pt was referred to a dietitian for nutritional counseling for anemia. Which pt outcome indicates that the pt does not understand nutritional counseling?
Pt drinks coffee or tea with meals
The nurse is assessing a pt activity intolerance by having the pt walk on a treadmill for 5 minutes. Which of the following indicates an abnormal response?
Respiratory decrease by 5 breaths per minute
A child suspected of having sickle cell disease is seen in a clinic, and laboratory studies are performed. A nurse checks the lab results, knowing that which pf the following would be increased in this disease?
Reticulocyte count
The nurse implements which of the following for the pt who is starting a Schilling test?
Starting a 24 to 48 hours urine specimen collection
Which statements by the mother of a toddler would lead the nurse to suspect that the child has iron-deficiency anemia? select all that apply
"He drinks over 3 cups of milk per day" "I cant keep enough apple juice in the house; he must drink over 10 oz per day"
a pt with iron deficiency anemia is scheduled for discharge. Which instruction about prescribed ferrous gluconate therapy should the nurse include in the teaching plan?
"Take the medication on an empty stomach"
The mothers asks the nurse why her childs hemoglobin was normal at birth but now the child has S hemoglobin. Which of the following responses by the nurse is most appropriate?
"The newborn has a high concentration of fetal hemoglobin in the blood for some after birth"
A pt with pernicious anemia asks why she must take vitamin b12 injections for the rest of her life. What is the nurses best response?
"The reason for your vitamin deficiency is an inability to absorb the vitamin because the stomach is not producing sufficient intrinsic factor."
A pt states that she is afraid of receiving vitamin B12 injections because of the potential toxic reactions. What is the nurses best response to relieve these fears?
"Vitamin B12 is generally free of toxicity because it is water soluble"
A pt was admitted with iron deficiency anemia and blood streaked emesis. Which question is most appropriate for the nurse to ask in determining the extent of the pt activity intolerance
"What activities were you able to do 6 months ago compared to the present?"
The nurse is teaching a pt with polycythemia vera about potential complications from this disease. Which manifestations would the nurse include in the pt teaching plan? select all that apply
*Visual disturbances *Headache *Orthopnea *Gout
The primary purpose of the Schilling test is to measure the pt ability to:
Absorb vitamin b12
The nurse devices a teaching plan for the pt with aplastic anemia. Which of the following is the most important concept to teach for health maintenance?
Avoid exposure to others with acute infection
When the pt is diagnosed with aplastic anemia, the nurse monitors for changes in which of the following physiological functions?
Bleeding tendencies
A pt with mycrocit anemia is having trouble selecting food items from the hospital menu. Which food is best for the nurse to suggest for satisfying the pt nutritional needs and personal preferences?
Brown rice
A pt with macrocytic anemia has a burn on her foot and states that she had been watching television while lying on a heating pad. What is the nurses first response?
Check for diminished sensations
A mother asks the nurse if her childs iron deficiency anemia is related to the childs frequent infections. The nurse responds based on the understanding of which of the following?
Children with iron deficiency anemia are more susceptible to infection than are other children
Which of the following assessments in a child with hemophilia would lead the nurse to suspect early hemarthrosis?
Childs reluctanse to move a body part
When comparing the hematocrit levels of a post-op pt the nurse notes that the hematocrit decreased from 36 to 34% on the third day even though the RBC and hemoglobin values remained stable at 4.5 million and 11.9 g/dL respectively. Which nursing intervention is most appropriate?
Continue to monitor VS
Which of the following diagnostic findings are most likely for a pt with aplastic anemia?
Decreased levels of white blood cells. red blood cells and platelets
The nurse is preparing to teach a pt with microcytic hypochromic anemia about the diet to follow after discharge. Which of the following foods should be included in the diet?
Eggs
Which of the blood components is decreased in anemia?
Erythrocytes
A pt is to receive Epoetin (Epogen) injections. What laboratory value should the nurse assess before giving the injection?
Hematocrit
Which of the following disorders results from a deficiency of factor VIII?
Hemophilia A
A pediatric nurse health educator provides a teaching session to the nursing staff regarding hemophilia. which of the following information regarding this disorder would the nurse plan to include in the discussion?
Hemophilia A results from a deficiency of factor VIII
The nurse would instruct the pt to eat which of the following foods to obtain the best supply of vitamin b12?
Meats and dairy products
The nurse explains to the parents of a 1 year old child admitted to the hospital in a sickle cell crisis that the local tissue damage the child has on admission is caused by which of the following?
Obstruction to circulation
A pt with anemia may be tired due to a tissue deficiency of which of the following substances?
Oxygen
Which of the following would the nurse identify as the priority nursing diagnosis during a toddlers vaso-occlusive sickle cell crisis?
Pain related to tissue anoxia
The physician has ordered several laboratory tests to help diagnose an infants bleeding disorder. Which of the following tests, if abnormal, would the nurse interpret as most likely to indicate hemophilia?
Partial Thromboplastin time
Which of the following nursing assessments is a late symptom of polycythemia vera?
Pruritus
Laboratory studies are performed for a child suspected of having iron deficiency anemia. The nurse reviews the laboratory results, knowing that which of the following results would indicate this type of anemia?
Red blood cells that are microcytic and hypochromic
Which of the folowing cells is the precursor to the red blood cell?
Stem cell
Because of the risk associated with administration of factor VIII concentrate, the nurse would teach the pt family recognize and report the following?
Yellowing of the skin
Which of the following symptoms is expected with hemoglobin of 10 g/dL?
none
