nur 2990 - prepu - nonmalignant hematologic disorders

A client's family member asks the nurse why disseminated intravascular coagulation (DIC) occurs. Which statement by the nurse correctly explains the cause of DIC? "DIC occurs when the immune system attacks platelets and causes massive bleeding." "DIC is caused by abnormal activation of the clotting pathway, causing excessive amounts of tiny clots to form inside organs." "DIC is caused when hemolytic processes destroy erythrocytes." "DIC is a complication of an autoimmune disease that attacks the body's own cells."

"DIC is caused by abnormal activation of the clotting pathway, causing excessive amounts of tiny clots to form inside organs."

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

"Eat small amounts of bland, soft foods frequently."

A few minutes after beginning a blood transfusion, a nurse notes that a client has chills, dyspnea, and urticaria. The nurse reports this to the health care provider immediately because the client probably is experiencing which problem? A hemolytic reaction to mismatched blood A hemolytic allergic reaction caused by an antigen reaction A hemolytic reaction caused by bacterial contamination of donor blood A hemolytic reaction to Rh-incompatible blood

A hemolytic allergic reaction caused by an antigen reaction

A clinical nurse specialist (CNS) is orienting a new graduate registered nurse to an oncology unit where blood product transfusions are frequently administered. In discussing ABO compatibility, the CNS presents several hypothetical scenarios. The new graduate knows that the greatest likelihood of an acute hemolytic reaction would occur when giving: B-positive blood to an AB-positive client. O-negative blood to an O-positive client. A-positive blood to an A-negative client. O-positive blood to an A-positive client.

A-positive blood to an A-negative client.

A client's low prothrombin time (PT) was attributed to low vitamin K levels and the client's PT normalized after administration of vitamin K. When performing discharge education in an effort to prevent recurrence, what should the nurse emphasize? Adequate nutrition Avoidance of NSAIDs Constant access to clotting factor concentrates Meticulous hygiene

Adequate nutrition

The nurse is talking with the parents of a toddler who was diagnosed with hemophilia A. What instruction should the nurse give to the parents? Administer factor VIII intravenously at the first sign of bleeding Use nasal packing for any nose bleeds Administer over-the-counter preparations for a cold Encourage the toddler to participate in playground activities with other toddlers

Administer factor VIII intravenously at the first sign of bleeding

A nurse caring for a client who has hemophilia is getting ready to take the client's vital signs. What should the nurse do before taking a blood pressure? Ask if taking a blood pressure has ever produced bleeding under the skin or in the arm joints. Ask if taking a blood pressure has ever produced pain in the upper arm. Ask if taking a blood pressure has ever caused bruising in the hand and wrist. Ask if taking a blood pressure has ever produced the need for medication.

Ask if taking a blood pressure has ever produced bleeding under the skin or in the arm joints.

The nurse is caring for a client with type 2 diabetes who take metformin to manage glucose levels. The nurse recognizes the client may be most at risk for which vitamin deficiency? A Folate C B12

B12

Which is a symptom of hemochromatosis? Bronzing of the skin Weight gain Inflammation of the tongue Inflammation of the mouth

Bronzing of the skin

A client is being treated for DIC and the nurse has prioritized the nursing diagnosis of Risk for Deficient Fluid Volume Related to Bleeding. How can the nurse best determine if goals of care relating to this diagnosis are being met? Assess for edema. Assess skin integrity frequently. Assess the client's level of consciousness frequently. Closely monitor intake and output.

Closely monitor intake and output.

A patient with end-stage kidney disease (ESKD) has developed anemia. What laboratory finding does the nurse understand to be significant in this stage of anemia? Calcium level of 9.4 mg/dL Magnesium level of 2.5 mg/dL Potassium level of 5.2 mEq/L Creatinine level of 6 mg/100 mL

Creatinine level of 6 mg/100 mL

A client is found to have a low hemoglobin and hematocrit when laboratory work was performed. What does the nurse understand the anemia may have resulted from? Select all that apply. Destruction of normally formed red blood cells Infection Abnormal erythrocyte production Inadequate formed white blood cells Blood loss

Destruction of normally formed red blood cells Abnormal erythrocyte production Blood loss

The nurse observes the laboratory studies for a client in the hospital with fatigue, feeling cold all of the time, and hemoglobin of 8.6 g/dL and a hematocrit of 28%. What finding would be an indicator of iron-deficiency anemia? Erythrocytes that are microcytic and hypochromic Clustering of platelets with sickled red blood cells An increased number of erythrocytes Erythrocytes that are macrocytic and hyperchromic

Erythrocytes that are microcytic and hypochromic

A client who is diagnosed multiple myeloma experiences decreased production of red blood cells (RBCs). Which prescribed medication should the nurse prepare to administer to increase the production of erythrocytes? Pegfilgrastim Filgrastim Erythropoietin Dexamethasone

Erythropoietin

A nurse cares for a client with severe hemoglobinuria after an upper respiratory infection and fever. Diagnostic testing reveals degraded hemoglobin within the client's erythrocytes. Which hematological condition does the nurse suspect the client has? Aplastic anemia Polycythemia vera Sickle cell disease Glucose-6-phosphate dehydrogenase deficiency

Glucose-6-phosphate dehydrogenase deficiency

When assessing a client with anemia, which assessment is essential? Family history Health history, including menstrual history in women Lifestyle assessments, such as exercise routines Age and gender

Health history, including menstrual history in women

A patient with End Stage Kidney Disease is taking recombinant erythropoietin for the treatment of anemia. What laboratory study does the nurse understand will have to be assessed at least monthly related to this medication? Folate levels Hemoglobin level Potassium level Creatinine level

Hemoglobin level

Which of the following describes a red blood cell (RBC) that has pale or lighter cellular contents? Microcytic Hypochromic Normocytic Hyperchromic

Hypochromic

The nurse is performing an assessment for a client with anemia admitted to the hospital to have blood transfusions administered. Why would the nurse need to include a nutritional assessment for this patient? It is part of the required assessment information. It may indicate deficiencies in essential nutrients. It is important for the nurse to determine what type of foods the patient will eat. It will determine what type of anemia the patient has.

It may indicate deficiencies in essential nutrients.

The nurse, caring for a client in the emergency room with a severe nosebleed, becomes concerned when the client asks for a bedpan. The nurse documents the stool as loose, tarry, and black looking. The nurse suspects the client may have thrombocytopenia. What should be the nurse's priority action? Put in an IV line Notify the physician Ask someone to clean the bedpan Stop the nosebleed

It may indicate deficiencies in essential nutrients.

During the review of morning laboratory values for a client reporting severe fatigue and a red, swollen tongue, the nurse suspects chronic, severe iron deficiency anemia based on which finding? Elevated hematocrit concentration Enlarged mean corpuscular volume (MCV) Low ferritin level concentration Elevated red blood cell (RBC) count

Low ferritin level concentration

A client with a diagnosis of pernicious anemia comes to the clinic reporting of numbness and tingling in his arms and legs. What do these symptoms indicate? Neurologic involvement Loss of vibratory and position senses Insufficient intake of dietary nutrients Severity of the disease

Neurologic involvement

A nurse suspects that a patient may have aplastic anemia based on clinical manifestations and assessment. Which one of the following lab results would be consistent with this diagnosis? Hemoglobin level of 15 g/dL Neutrophil count of 50% Erythrocyte count of 5.3 m/?L Platelet level of 275,000/mm3

Neutrophil count of 50%

A client with multiple myeloma is complaining of severe pain when the nurse comes in to give a bath and change position. What is the priority intervention by the nurse? Obtain the pain medication and delay the bath and position change until the medication reaches its peak. Inform the client that she will feel better after receiving a bath and clean sheets. Inform the client that the bath and positioning is an important part of client care and will be done right after pain medication administration. Inform the client that the position must be changed, and then you will give her pain medication and omit the bath.

Obtain the pain medication and delay the bath and position change until the medication reaches its peak.

A nurse is caring for a client with iron deficiency anemia. Which food or beverage will the nurse suggest to the client to eat or drink when taking supplemental iron? Orange juice Kidney beans Milk Leafy green vegetables

Orange juice

Which of the following is considered an antidote to heparin? Ipecac Vitamin K Protamine sulfate Narcan

Protamine sulfate

A client has hereditary hemochromatosis. Laboratory test results indicate an elevated serum iron level, high transferrin saturation, and normal complete blood count (CBC). What is most important action for the nurse to take? Inform the client to limit ingestion of alcohol. Educate about precautions to follow after a liver biopsy. Remove the prescribed one unit of blood. Instruct the client to limit iron intake in the diet.

Remove the prescribed one unit of blood.

The nurse is screening donors for blood donation. Which client is an acceptable donor for blood? Received a blood transfusion within 1 year Had a dental extraction 2 days ago for caries in a tooth Reports having a cold 1 month ago that resolved quickly Has a history of viral hepatitis as a teenager 10 years ago

Reports having a cold 1 month ago that resolved quickly

A pregnant woman is hospitalized as the result of sickle-cell crisis. Which finding indicates the outcome has been achieved for this client? Reports joint pain less than 3 on a scale of 0 to 10 Describes the importance of staying cool Exhibits a temperature more than 100.3°F Takes hydroxyurea during her pregnancy

Reports joint pain less than 3 on a scale of 0 to 10

A patient is taking prednisone 60 mg per day for the treatment of an acute exacerbation of Crohn's disease. The patient has developed lymphopenia with a lymphocyte count of less than 1,500 mm3. What should the nurse monitor the client for? Abdominal pain Bleeding The onset of a bacterial infection Diarrhea

The onset of a bacterial infection

A nurse is doing a physical examination of a child with sickle cell anemia. When the child asks why the nurse auscultates the lungs and heart, what would be best the response by the nurse? To detect the evidence of dehydration that might have triggered a sickle cell crisis To detect the abnormal sounds suggestive of acute chest syndrome and heart failure To detect the evidence of infection such as fever and tachycardia To detect the motor strength and stroke-related signs and symptoms

To detect the abnormal sounds suggestive of acute chest syndrome and heart failure

When evaluating a patient's symptoms that are consistent with a diagnosis of leukemia, the nurse is aware that all leukemias have which common feature? Compensatory polycythemia stimulated by thrombocytopenia Reduced plasma volume in response to a reduced production of cellular elements Increased blood viscosity, resulting from an overproduction of white cells Unregulated accumulation of white cells in the bone marrow, which replace normal marrow elements

Unregulated accumulation of white cells in the bone marrow, which replace normal marrow elements

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? Use a disposable razor when shaving. Avoid contact with family/friends who are sick. Encourage frequent handwashing. Plan for frequent periods of rest.

Use a disposable razor when shaving.

During preparation for bowel surgery, a client receives an antibiotic to reduce intestinal bacteria. The nurse knows that hypoprothrombinemia may occur as a result of antibiotic therapy interfering with synthesis of which vitamin? Vitamin A Vitamin K Vitamin E Vitamin D

Vitamin K

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

Women lose iron through menstrual cycles

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? amount and quality of factor VIII quality of factor XI quality of factor VIII amount and quality of factor IX

amount and quality of factor VIII

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

hemoglobin S

A client with sickle cell anemia has a normal blood smear. normal hematocrit. low hematocrit. high hematocrit.

low hematocrit.