unit 6: Hematologic Function questions

a client with leukemia has developed stomatitis and is experiencing a nutritional deficit. an oral anesthetic has consequently been prescribed. what health education should the nurse provide to the client? a. chew with care to avoid inadvertently biting the tongue b. use the oral anesthetic 1 hour prior to mealtime c. brush teeth before and after eating d. swallow slowly and deliberately

A. CHEW WITH CARE TO AVOID INADVERTENTLY BITING THE TONGUE

a client with a documented history of glucose-6-phosphate dehydrogenase deficiency has presented to the emergency department with signs and symptoms including pallor, jaundice, and malaise. which of the nurse's assessment questions relates most directly to this client's hematologic disorder? a. "when did you last have a blood transfusion?" b. "what medications have you taken recently?" c. "have you been under significant stress lately?" d. "have you suffered any recent injuries?"

B. "WHAT MEDICATIONS HAVE YOU TAKEN RECENTLY?" exacerbations of this disease are nearly always precipitated by medications

a nurse has participated in organizing a blood donation drive at a local community center. which client would most likely be disallowed from donating blood? a. a client who is 81 years of age b. a client whose blood pressure is 78/49 mmHg c. a client who donated blood 4 months ago d. a client who has type 1 diabetes

B. A CLIENT WHOSE BLOOD PRESSURE IS 78/49 mmHg

a client with acute kidney injury has decreased erythropoietin production. upon analysis of the client's complete blood count, the nurse will expect which of the following results? a. an increased hemoglobin and decreased hematocrit b. a decreased hemoglobin and hematocrit c. a decreased mean corpuscular volume (MCV) and red cell distribution width (RDW) d. an increased mean corpuscular volume (MCV) and red cell distribution width (RDW)

B. A DECREASED HEMOGLOBIN AND HEMATOCRIT

the nurse is describing the role of plasminogen in the clotting cascade. where in the body is plasminogen present? a. myocardial muscle tissue b. all body fluids c. cerebral tissue d. venous and arterial vessel walls

B. ALL BODY FLUIDS

a client's health history reveals daily consumption of two to three bottles of wine. the nurse would consider increased risk of which hematologic disorder when planning assessments and interventions for this client? a. leukemia b. anemia c. thrombocytopenia d. lymphoma

B. ANEMIA heavy alcohol use is associated with anemia.

a client's blood work reveals a platelet level of 17,000/mm3. when inspecting the client's integumentary system, what finding would be most consistent with this platelet level? a. dermatitis b. petechiae c. urticaria d. alopecia

B. PETECHIAE petechiae results from low platelet counts (less than 20,000)

a client has been scheduled for a bone marrow aspiration and admits to the nurse being worried about the pain involved with the procedure. which statement by the nurse when providing client education would be most accurate? a. "you'll be given painkillers before the test, so there won't likely be any pain" b. "you'll feel some pain when the needle enters your skin, but none during the aspiration" c. "most people feel some brief, sharp pain when the marrow is aspirated" d. "I'll be there with you, and I'll try to help you keep your mind off the pain"

C. "MOST PEOPLE FEEL SOME BRIEF, SHARP PAIN WHEN THE MARROW IS ASPIRATED"

a client with myelodysplastic syndrome (MDS) is being treated on a medical unit. which priority finding should prompt the nurse to contact the client's primary care provider? a. reports of a frontal lobe headache b. an episode of urinary incontinence c. an oral temperature of 37.5 C (99.5 F) d. an oxygen saturation of 91% on room air

C. AN ORAL TEMPERATURE OF 37.5 C (99.5 F)

a client with several chronic health problems has been newly diagnosed with a qualitative platelet defect. what component of the client's previous medication regimen may have contributed to the development of this disorder? a. calcium carbonate b. vitamin B12 c. aspirin d. vitamin D

C. ASPIRIN aspirin may induce a platelet disorder. even small ants can reduce normal platelet aggregation

after receiving a diagnosis of acute lymphocytic leukemia, a client is visibly distraught, stating, "I have no idea where to go from here." how should the nurse prepare to Meet this client's psychosocial needs? a. assess the client's previous experience with the health care system b. reassure the client that treatment will be challenging but successful c. assess the client's specific needs for education and support d. identify the client's plan of medical care

C. ASSESS THE CLIENT'S SPECIFIC NEEDS FOR EDUCATION AND SUPPORT

a nurse at a long term care facility is amending the care plan of a resident who has just been diagnosed with essential thrombocythemia (ET). the nurse should anticipate the administration of which medication? a. dalteparin b. allopurinol c. hydroxyurea d. hydrochlorothiazide

C. HYDROXYUREA

an intensive care nurse is aware of the need to identify clients who may be at risk of developing disseminated intravascular coagulation (DIC). which ICU client most likely faces the highest risk of DIC? a. a client with extensive burns b. a client who has a diagnosis of acute respiratory distress syndrome c. a client who suffered multiple trauma in a workplace accident d. a client who is being treated for septic shock

D. A CLIENT WHO IS BEING TREATED FOR SEPTIC SHOCK sepsis is a common cause of DIC.

following an extensive diagnostic workup, a client has been diagnosed with myelodysplastic syndrome (MDS). which assessment question most directly addresses the potential etiology of this client's health problem? a. "were you ever exposed to toxic chemicals in any of the jobs that you had" b. "when you were younger, did you tend to have recurrent infections of any kind" c. "have you ever smoked cigarettes or used other tobacco products?" d. "would you say that you've had a lot of sun exposure in your lifetime?"

A. "WERE YOU EVER EXPOSED TO TOXIC CHEMICALS IN ANY OF THE JOBS THAT YOU HELD?"

a nurse is planning the care of a client who has been diagnosed with essential thrombocythemia (ET). which nursing diagnosis should the nurse prioritize when choosing interventions? a. risk for ineffective tissue perfusion b. risk for imbalanced fluid volume c. risk for ineffective breathing pattern d. risk for ineffective thermoregulation

A. RISK FOR INEFFECTIVE TISSUE PERFUSION

a group of nurses are learning about the high incidence and prevalence of anemia among different populations. which individual is most likely going to have anemia? a. a 50 year old black woman who is going through menopause b. an 81 year old woman who has chronic heart failure c. a 48 year old man who travels extensively and has a high stress job d. a 13 year old girl who has just experienced menarche

B. AN 81 YEAR OLD WOMAN WHO HAS CHRONIC HEART FAILURE

a client who is undergoing consolidation therapy for the treatment of leukemia has been experiencing debilitating fatigue. how can the nurse best meet the client's needs for physical activity? a. teach the client about the risks of immobility and the benefits of exercise b. assist the client a chair during awake times, as tolerated c. collaborate with the physical therapist to arrange for stair exercises d. teach the client to perform deep breathing and coughing exercises

B. ASSIST THE CLIENT TO A CHAIR DURING AWAKE TIMES, AS TOLERATED

a nurse is providing discharge education to a client who has been recently diagnosed with a bleeding disorder. which topic should the nurse prioritize when teaching this client? a. avoiding buses, subways, and other crowded, public sites b. avoiding activities that carry a risk for injury c. keeping immunizations current d. avoiding foods high in vitamin K

B. AVOIDING ACTIVITIES THAT CARRY A RISK FOR INJURY

a client has a diagnosis of multiple myeloma and the nurse is preparing health education in preparation for discharge from the hospital. which action should the nurse promote? a. daily performance of weight-bearing exercise to prevent muscle atrophy b. close monitoring of urine output and kidney function c. daily administration of warfarin, as prescribed d. safe use of supplementary oxygen in the home setting

B. CLOSE MONITORING OF URINE OUTPUT AND KIDNEY FUNCTION

a nurse is preparing health education for a client who has received a diagnosis of myelodysplastic syndrome (MDS). which of the following topics should the nurse prioritize? a. techniques for energy conservation and activity management b. emergency management of bleeding episodes c. technique for the administration of bronchodilators by metered-dose inhaler d. techniques for self-palpation of the lymph nodes

B. EMERGENCY MANAGEMENT OF BLEEDING EPISODES

a client with sickle cell disease is taking narcotic analgesics for pain control. which intervention by the nurse would decrease the risk for narcotic substance abuse? a. encourage the client to rely on complementary and alternative therapies b. encourage the client to seek care from a single provider for pain relief c. teach the client to accept chronic pain as an inevitable aspect of the disease d. limit the reporting of emergency department visits to the primary health care provider

B. ENCOURAGE THE CLIENT TO SEEK CARE FROM A SINGLE PROVIDER FOR PAIN RELIEF

a client diagnosed with acute myeloid leukemia has just been admitted to the oncology unit. when writing this client's care plan, which potential complication should the nurse address? a. pancreatitis b. hemmorhage c. arteritis d. liver dysfunction

B. HEMMORHAGE

the nurse is describing normal erythrocyte physiology to a client who has a diagnosis of anemia. the nurse should explain that the erythrocytes consist primarily of which substance? a. plasminogen b. hemoglobin c. hematocrit d. fibrin

B. HEMOGLOBIN

a client is undergoing diagnostic testing for chronic lymphocytic leukemia (CLL). which assessment finding is certain to be present if the client has CLL? a. increased numbers of blast cells b. increased lymphocyte levels c. intractable bone pain d. thrombocytopenia with no evidence of bleeding

B. INCREASED LYMPHOCYTE LEVELS

a nurse practitioner is assessing a client who has a fever, malaise, and a white blood cell count that is elevated. what principle should guide the nurse's management of the clients care? a. there is need for the client to be assessed for lymphoma b. infection is the most likely cause of the client's change in health status c. the client is exhibiting signs and symptoms of leukemia d. the client should undergo diagnostic testing for multiple myeloma

B. INFECTION IS THE MOST LIKELY CAUSE OF THE CLIENT'S CHANGE IN HEALTH STATUS

the nurse is providing care for a 73 year old client who has a hematologic disorder. which change in hematologic function is age related? a. bone marrow in older adults produces a smaller proportion of healthy, functional blood cells b. older adults are less able to increase blood cell production when demand suddenly increases c. stem cells in older adults eventually lose their ability to differentiate d. the ratio of plasma to erythrocytes and lymphocytes increases with age

B. OLDER ADULTS ARE LESS ABLE TO INCREASE BLOOD CELL PRODUCTION WHEN DEMAND SUDDENLY INCREASES

a 20 year old client with no medical history arrives at a walk in/urgent care clinic reporting swelling on the left side of the neck. on palpation, the lymph nodes on the neck are painless, firm but not hard. what is the next appropriate intervention for this client? a. recommend immediate and urgent transfer to the nearest trauma center b. perform diagnostic studies to rule out any infectious origin at a hospital c. refer the client to a primary health care provider for a non urgent appointment d. complete a computed tomography scan because the client has Hodgkin lymphoma

B. PERFORM DIAGNOSTIC STUDIES TO RULE OUT ANY INFECTIOUS ORIGIN AT A HOSPITAL

an adult client's abnormal complete blood count and physical assessment have prompted the primary care provider to order a diagnostic workup for Hodgkin lymphoma. the presence of what assessment finding is considered diagnostic of the disease? a. Schwann cells b. Reed-Sternberg cells c. lewy bodies d. Loops of Henle

B. REED-STERNBERG CELLS

the clinical nurse educator is presenting health promotion to a client who will be treated for non-hodgkin lymphoma on an outpatient basis. the nurse should recommend which of the following actions? a. avoiding direct sun exposure in excess of 15 minutes daily b. avoiding grapefruit juice and fresh grapefruit c. avoiding highly crowded public places d. using an electric shaver rather than a razor

C. AVOIDING HIGHLY CROWDED PUBLIC PLACES

the nurse is assessing a new client with reports of acute fatigue and a sore tongue that is visibly smooth and beefy red. the client is demonstrating signs and symptoms associated with what form of hematologic disorder? a. sickle cell disease b. hemophilia c. megaloblastic anemia d. thrombocytopenia

C. MEGALOBLASTIC ANEMIA

a client has received the news that the client's treatment for Hodgkin lymphoma. has been deemed successful and that no further treatment is necessary at this time. the care team should ensure that the client receives regular health assessments in the future due to the risk of which complication? a. iron-deficiency anemia b. hemophilia c. secondary malignancy d. lymphedema

C. SECONDARY MALIGNANCY

a nurse is caring for a client who is undergoing preliminary testing for a hematologic disorder. which sign or symptom of a hematologic disorder is most common? a. sudden change in level of consciousness (LOC) b. recurrent infections c. anaphylaxis d. severe fatigue

D. SEVERE FATIGUE

a client with a recent diagnosis of ITP has asked the nurse why the care team has not chosen to administer platelets, stating, "I have low platelets, so why not give me a transfusion of exactly what I'm missing?" how should the nurse best respond? a. "transfused platelets usually aren't beneficial because they're rapidly destroyed in the body" b. "a platelet transfusion often further blunts your body's own production of platelets" c. "finding a matching donor for a platelet transfusion is exceedingly difficult" d. "a very small percentage of the platelets in a. transfusion are actually functional"

A. "TRANSFUSED PLATELETS USUALLY AREN'T BENEFICIAL BECAUSE THEY'RE RAPIDLY DESTROYED IN THE BODY"

A client is receiving treatment for a new diagnosis of chronic lymphocytic leukemia (CLL). based on known risk factors, age, ethnicity, and accompanying clinical conditions, which client is most likely to have this disease? a. 82 year old Vietnam war veteran with widely disseminated shingles b. 62 year old client of asian descent with a left fractured hip c. 69 year old gulf war veteran with deep vein thrombosis (DVT) d. 85 year old client of Native American/First Nation descent with chest pain

A. 82 YEAR OLD VIETNAM WAR VETERAN WITH WIDELY DISSEMINATED SHINGLES

the nurse is preparing to administer a unit of platelets to an adult client. when administering this blood product, which of the following actions should the nurse perform? a. administer the platelets as rapidly as the client can tolerate b. establish IV access as soon as the platelets arrive from the blood bank c. ensure that the client has a central venous catheter d. aspirate 10 to 15 mL of blood from the client's IV immediately following the transfusion

A. ADMINISTER THE PLATELETS AS RAPIDLY AS THE CLIENT CAN TOLERATE done to diminish platelet clumping during administration

a nurse is caring for a client with Hodgkin lymphoma at the oncology clinic. the nurse should identify what main goal of care? a. cure of the disease b. enhancing the quality of life c. controlling symptoms d. palliation

A. CURE OF THE DISEASE

a client is scheduled to undergo a bone marrow aspiration. when preparing the client for the procedure, which action would the nurse do first? a. ensure informed consent has been obtained b. cleanse the skin with an antiseptic c. administer a local anesthetic d. cover the area with a sterile drape

A. ENSURE INFORMED CONSENT HAS BEEN OBTAINED

a client's most recent blood work reveals low levels of albumin. this assessment finding should suggest the possibility of what nursing diagnosis? a. risk for imbalanced fluid volume related to low albumin b. risk for infection related to low albumin c. ineffective tissue perfusion related to low albumin d. impaired skin integrity related to low albumin

A. RISK FOR IMBALANCED FLUID RELATED TO LOW ALBUMIN albumin is important for maintenance of fluid balance within the vascular system

a nurse at a blood donation clinic has completed the collection of blood from a client. the client reports feeling "light-headed" and appears pale. which action by the nurse is most appropriate? a. help the client to sit, with head lowered below knees b. administer supplementary oxygen by nasal prongs c. obtain a full set of vital signs d. inform a health care provider or other primary care provider

A. HELP THE CLIENT TO SIT, WITH HEAD LOWERED BELOW KNEES

the results of a client's most recent blood work and physical assessment are suggestive of immune thrombocytopenia purpura (ITP). this client should undergo testing for which of the following potential causes? select all that apply. a. hepatitis b. acute kidney injury c. HIV d. malignant melanoma e. cholecystis

A. HEPATITIS C. HIV viral illnesses have the potential to cause ITP

an oncology nurse is caring for a client with multiple myeloma who is experiencing bone destruction. when reviewing the client's most recent blood tests, the nurse should anticipate which imbalance? a. hypercalcemia b. hyperproteinemia c. elevated serum viscosity d. elevated red blood count (RBC)

A. HYPERCALCEMIA

a nurse is caring for a client who has a diagnosis of acute myelocytic leukemia (AML). assessment of which factor most directly addresses the most common cause of death among clients with leukemia? a. infection status b. nutritional levels c. electrolyte levels d. liver function

A. INFECTION STATUS

a client comes to the clinic reporting fatigue and the health interview is suggestive of pica. laboratory findings reveal a low serum iron level and low ferritin level. with what would the nurse suspect the client will be diagnosed? a. iron deficiency anemia b. pernicious anemia c. sickle cell disease d. hemolytic anemia

A. IRON DEFICIENCY ANEMIA

through the process of hematopoiesis, stem cells differentiate into either myeloid or lymphoid stem cells. into what do myeloid stem cells further differentiate? select all that apply. a. leukocytes b. natural killer cells c. cytokines d. platelets e. erythrocytes

A. LEUKOCYTES D. PLATELETS E. ERYTHROCYTES

a client's absolute neutrophil count (ANC) is 440/mm3 but the nurse's assessment reveals no apparent signs or symptoms of infection. what action should the nurse prioritize when providing care for this client? a. meticulous hand hygiene b. timely administration of antibiotics c. provision of a nutrient-dense diet d. maintaining a sterile care environment

A. METICULOUS HAND HYGIENE

an oncology nurse recognizes a client's risk for fluid imbalance while the client is undergoing treatment for leukemia. what related assessments should the nurse include in the client's plan of care? select all that apply. a. monitoring the client's electrolyte levels b. monitoring the client's hepatic function c. measuring the client's weight on a daily basis d. measuring and recording the client's intake and output e. auscultating the client's lungs frequently

A. MONITORING THE CLIENT'S ELECTROLYTE LEVELS C. MEASURING THE CLIENT'S WEIGHT ON A DAILY BASIS D. MEASURING AND RECORDING THE CLIENT'S INTAKE AND OUTPUT E. AUSCULTATING THE CLIENT'S LUNGS FREQUENTLY

a client with a history of cirrhosis is admitted to the ICU with a diagnosis of bleeding esophageal varices; an attempt to stop the bleeding has been only partially successful. what would the critical care nurse expect the care team to prescribe for this client? a. packed red blood cells (PRBCs) b. vitamin K c. oral anticoagulants d. heparin infusion

A. PACKED RED BLOOD CELLS (PRBCs)

a client has been diagnosed with a lymphoid stem cell defect. this client has the potential for a problem involving which of the following? a. plasma cells b. neutrophils c. red blood cells d. platelets

A. PLASMA CELLS

a client with a diagnosis of acute myeloid leukemia (AML) is being treated with induction therapy on the oncology unit. what nursing action should be prioritized in the client's care plan? a. protective isolation and vigilant use of standard precautions b. provision of a high-calorie, low-texture diet and appropriate oral hygiene c. including the family in planning the client's activities of daily living d. monitoring and treating the client's pain

A. PROTECTIVE ISOLATION AND VIGILANT USE OF STANDARD PRECAUTIONS

a client suffers a leg wound which causes minor blood loss. as a result of bleeding, the process of primary hemostasis is activated. what will occur during this process? a. severed blood vessels constrict b. thromboplastin is released c. prothrombin is converted to thrombin d. fibrin is lysed

A. SEVERED BLOOD VESSELS CONSTRICT

a client is receiving a blood transfusion and reports a new onset of slight dyspnea. the nurse's rapid assessment reveals bilateral lung crackles and elevated BP. what is the nurse's most appropriate action? a. slow the infusion rate and monitor the client closely b. discontinue the transfusion and begin resuscitation c. pause the transfusion and administer a 250 mL bolus of normal saline d. discontinue the transfusion and administer a beta-blocker, as prescribed

A. SLOW THE INFUSION RATE AND MONITOR THE CLIENT SLOWLY the client is showing signs of early hypervolemia

an older adult client is exhibiting many of the characteristic signs and symptoms of iron deficiency. in addition to a complete blood count, what diagnostic assessment should the nurse anticipate? a. stool for occult blood b. bone marrow biopsy c. lumbar puncture d. urinalysis

A. STOOL FOR OCCULT BLOOD

the nurse's brief review of a client's electronic health record indicates that the client regularly undergoes therapeutic phlebotomy. which of the following rationales for this procedure is most plausible? a. the client may chronically produce excess red blood cells b. the client may frequently experience a low relative plasma volume c. the client may have impaired stem cell function d. the client may previously have undergone bone marrow therapy

A. THE CLIENT MAY CHRONICALLY PRODUCE EXCESS RED BLOOD CELLS

an oncology nurse is providing health education for a client who has been recently diagnosed with leukemia. what should the nurse explain about commonalities between all of the different subtypes of leukemia? a. the different leukemias all involve unregulated proliferation of white blood cells b. the different leukemias all have unregulated proliferation of red blood cells and decreased bone marrow function c. the different leukemias all result in a decrease in the production of white blood cells d. the different leukemias all involve the development of cancer in the lymphatic system

A. THE DIFFERENT LEUKEMIAS ALL INVOLVE UNREGULATED PROLIFERATION OF WHITE BLOOD CELLS

a 60 year old client with chronic myeloid leukemia (CML) will be treated in the home setting and the nurse is preparing appropriate health education. which topic should the nurse emphasize? a. the importance of adhering to the prescribed drug regimen b. the need to ensure that vaccinations are up to date c. the importance of daily physical activity d. the need to avoid shellfish and raw foods

A. THE IMPORTANCE OF ADHERING TO THE PRESCRIBED DRUG REGIMEN

a client is receiving the first of two prescribed units of PRBCs. shortly after the initiation of the transfusion, the client reports chills and experiences a sharp increase in temperature. what is the nurse's priority action? a. position the client in high fowler position b. discontinue the transfusion c. ausculate the client's lungs d. obtain a blood specimen from the client

B. DISCONTINUE THE TRANSFUSION

a client is admitted to the hospital with pernicious anemia. the nurse should prepare to administer which of the following medications? a. folic acid b. vitamin B12 c. lactulose d. magnesium sulfate

B. VITAMIN B12 pernicious anemia is characterized by vitamin b12 deficiency

a client with a new diagnosis of leukemia is about to start treatment and expresses fear and anxiety with the prognosis. which action is the nurse's most appropriate? a. communicate to the health care provider the need to provide more information to the client and family. b. assess how much information is desired from the client in terms of illness, treatment, and complications c. offer to call pastoral services and review hospice and/or palliative care so the client can have a quiet, dignified death d. encourage the client to call their family and discuss immediate role restructuring in Both their family and professional life

B. ASSESS HOW MUCH INFORMATION IS DESIRED FROM THE CLIENT IN TERMS OF ILLNESS, TREATMENT, AND COMPLICATIONS

a nurse is caring for a client who has been diagnosed with leukemia. the nurse's most recent assessment reveals the presence of ecchymoses on the client's sacral area and petechiae on the forearms. in addition to informing the client's primary care provider, the nurse should perform what action? a. initiate measure to prevent venous thromboembolism (VTE) b. check the client's most recent platelet level c. place the client on protective isolation d. ambulate the client to promote circulatory function

B. CHECK THE CLIENT'S MOST RECENT PLATELET LEVEL

a night nurse is reviewing the next day's medication administration record (MAR) of a hospital client who has hemophilia. the nurse notes that the MAR specifies both oral and subcutaneous options for the administration of a PRN antiemetic. what is the nurse's best action? a. ensure that the day nurse knows not to give the antiemetic b. contact the prescriber to have the subcutaneous option discontinued c. reassess the client's need for antiemetics d. remove the subcutaneous route from the client's MAR

B. CONTACT THE PRESCRIBER TO HAVE THE SUBCUTANEOUS OPTION DISCONTINUED injections must be avoided in clients with hemophilia

a client newly diagnosed with thrombocytopenia is admitted to the medical unit. after the admission assessment, the client asks the nurse to explain the condition. the nurse explains to this client that this condition occurs due to which factor? a. an attack on the platelets by antibodies b. decreased production of platelets c. impaired communication between platelets d. an autoimmune process causing platelet malfunction

B. DECREASED PRODUCTION OF PLATELETS

a client on the medical unit is receiving a unit of packed red blood cells (PRBCs). difficult intravenous (IV) access has necessitated a slow infusion rate, and the nurse notes that the infusion began 4 hours ago. which action by the nurse is the most appropriate? a. apply an icepack to the blood that remains to be infused b. discontinue the remainder of the PRBC transfusion, and inform the health care provider c. disconnect the bag of PRBCs, cool for 30 minutes, and then administer d. administer the remaining PRBCs by the IV direct (IV push) route

B. DISCONTINUE THE REMAINDER OF THE PRBC TRANSFUSION, AND INFORM THE HEALTH CARE PROVIDER PRBC transfusions should not exceed 4 hours because of the increased risk of increased bacterial proliferation and subsequent infection in the client

a client's electronic health record notes that the client has previously undergone treatment for secondary polycythemia. the nurse should assess for which factor? a. recent blood donation b. evidence of lung disease c. a history of venous thromboembolism d. impaired renal function

B. EVIDENCE OF LUNG DISEASE

a client has sustained a cut to the hand, immediately initiating the process of hemostasis. following vasoconstriction, which event in the process of hemostasis will take place? a. fibrin will be activated at the bleeding site b. platelets will aggregate at the bleeding site c. thromboplastin will form a clot d. prothrombin will be converted to thrombin

B. PLATELETS WILL AGGREGATE AT THE INJURY SITE

a client undergoing a hip replacement has autologous blood on standby if a transfusion is needed. what is the primary advantage of autologous transfusions? a. safe transfusion for clients with a history of transfusion reactions b. prevention of viral infections from another person's blood c. avoidance of complications in clients with alloantibodies d. prevention of alloimmunization

B. PREVENTION OF VIRAL INFECTIONS FROM ANOTHER PERSON'S BLOOD

a client is scheduled for a splenectomy. during discharge education, which teaching point should the nurse prioritize? a. adhering to prescribed immunosuppressant therapy b. reporting any signs or symptoms of infection promptly c. ensuring adequate folate, iron, and vitamin B12 intake d. limiting activity postoperatively to prevent hemorrhage

B. REPORTING ANY SIGNS OR SYMPTOMS OF INFECTION PROMPTLY

a nurse is caring for a client with acute myeloid leukemia who is preparing to undergo induction therapy. in preparing a plan of care for this client, the nurse should assign the highest priority to which nursing diagnosis? a. activity intolerance b. risk for infection c. acute confusion d. risk for spiritual distress

B. RISK FOR INFECTION

the nurse is caring for a client receiving a transfusion notes that 15 minutes after the infusion of packed red blood cells (PRBCs) has begun, the client is having difficulty breathing and reports severe chest tightness. what is the most appropriate initial action for the nurse to take? a. notify the client's health care provider b. stop the transfusion immediately c. remove the client's IV access d. assess the client's chest sounds and vital signs

B. STOP THE TRANSFUSION IMMEDIATELY

a client is being treated for the effects of longstanding vitamin B12 deficiency. which aspect of the client's health history would most likely predispose the client to this deficiency? a. the client has irregular menstrual periods b. the client is a vegan c. the client donated blood 60 days ago d. the client frequently smokes marijuana

B. THE CLIENT IS A VEGAN

a client is being treated in the ICU after a medical error resulted in an acute hemolytic transfusion reaction. what was the etiology of this client's adverse reaction? a. antibodies to donor leukocytes remained in the blood b. the donor blood was incompatible with that of the client c. the client had a sensitivity reaction to a plasma protein in the blood d. the blood was infused too quickly and overwhelmed the client's circulatory system

B. THE DONOR BLOOD WAS INCOMPATIBLE WITH THAT OF THE CLIENT

a client's low hemoglobin level has necessitated the transfusion of packed red blood cells. prior to administration, which action should the nurse perform? a. have the client identify the blood type in writing b. ensure that the client has granted verbal consent for transfusion c. assess the client's vital signs to establish baselines d. facilitate insertion fo a central venous catheter

C. ASSESS THE CLIENT'S VITAL SIGNS TO ESTABLISH BASELINES

a woman who is in her third trimester of pregnancy has been experiencing an exacerbation of iron deficiency anemia in recent weeks. when providing the client with nutritional guidelines and meal suggestions, what foods would be most likely to increase the woman's iron stores? a. salmon accompanied by whole milk b. mixed vegetables and brown rice c. beef liver accompanied by orange juice d. yogurt, almonds, and whole grain oats

C. BEEF LIVER ACCOMPANIED BY ORANGE JUICE

a client with a hematologic disorder asks the nurse how the body forms blood cells. the nurse understands that this process takes place primarily in which location? a. spleen b. kidneys c. bone marrow d. liver

C. BONE MARROW

a nurse is planning the care of a client who has been admitted to the medical unit with a diagnosis of multiple myeloma. in the client's care plan, the nurse has identified a diagnosis of risk for injury, which should be attributed to which factor? a. labyrinthtis b. left ventricular hypertrophy c. decreased bone density d. hypercoagulation

C. DECREASED BONE DENSITY

a nurse is providing care to a client with multiple myeloma with reports of nausea, diarrhea, alopecia, and red urine. the client's recent interventions include electrocardiogram (ECG), multicoated acquisition scan (MUGA), and a central line venous access placed on the right chest wall. which medication is the client most likely receiving? a. dexamethasonze b. lenalidomide c. doxorubicin d. etoposide

C. DOXORUBICIN this is a chemotherapeutic drug

a nurse in a long term care facility is admitting a new resident who has a bleeding disorder. when planning this resident's care, the nurse should include which action? a. housing the resident in a private room b. implementing a passive ROM program c. implementing of a plan for fall prevention d. providing the client with a high-fiber diet

C. IMPLEMENTING A PLAN OF CARE FOR FALL PREVENTION

the nurse on the pediatric unit is caring for a 10 year old child with a diagnosis of hemophilia. the nurse should assess carefully for indication of what nursing diagnosis? a. hypothermia b. diarrhea c. ineffective coping d. imbalanced nutrition: less than body requirements

C. INEFFECTIVE COPING

a nurse is planning the care of a client with a diagnosis of sickle cell disease who has been admitted for the treatment of an acute vaso-occlusive crisis. which nursing diagnosis should the nurse prioritize in the client's plan of care? a. risk for disuse syndrome related to ineffective peripheral circulation b. functional urinary incontinence related to urethral occlusion c. ineffective tissue perfusion related to thrombosis d. ineffective thermoregulation related to hypothalamic dysfunction

C. INEFFECTIVE TISSUE PERFUSION RELATED TO THROMBOSIS

a client has come to the OB/GYN clinic due to recent heavy menstrual flow. because of the client's consequent increase in red blood cell production, the nurse should recommend the client increase daily intake of what substance? a. vitamin E b. vitamin D c. Iron d. magnesium

C. IRON

a nurse is providing education to a client with iron deficiency anemia who has been prescribed iron supplements. what should the nurse include in health education? a. take the iron with dairy products to enhance absorption b. increase the intake of vitamin E to enhance absorption c. iron will cause the stools to darken in color d. limit foods high in fiber due to the risk for diarrhea

C. IRON WILL CAUSE THE STOOLS TO DARKEN IN COLOR

an emergency department nurse is triaging a 77 year old client who presents with uncharacteristic fatigue as well as back and rib pain. the client denies any recent injuries. the nurse should recognize the need for this client to be assessed for which health problem? a. hodgkin disease b. non-hodgkin lymphoma c. multiple myeloma d. acute thrombocythemia

C. MULTIPLE MYELOMA

a young man with a diagnosis of hemophilia A has been brought to emergency department after suffering a workplace accident resulting in bleeding. rapid assessment has revealed the source of the client's bleeding and established that his vital signs are stable. what should be the nurse's next action? a. position the client in a prone position to minimize bleeding b. establish IV access for the administration of vitamin K c. prepare for the administration of factor VIII d. administer a normal saline bolus to increase circulatory volume

C. PREPARE FOR THE ADMINISTRATION OF FACTOR VIII factor VIII is a clotting factor

a nurse is caring for a client who is being treated for leukemia in the hospital. the client was able to maintain nutritional status for the first few weeks following the diagnosis but is now exhibiting early signs and symptoms of malnutrition. in collaboration with the dietitian, the nurse should implement what intervention? a. arrange for total parenteral nutrition (TPN) b. facilitate placement of a percutaneous endoscopic gastrostomy (PEG) tube c. provide the client with several small, soft-textured meals each day d. assign responsibility for the client's nutrition to the client's friends and family

C. PROVIDE THE CLIENT WITH SEVERAL SMALL, SOFT-TEXTURED MEALS EACH DAY

fresh-frozen plasma (FFP) has been prescribed for a hospital client. prior to the administration of this blood product, the nurse should prioritize which client education? a. infection risks associated with FFP administration b. physiologic functions of plasma c. signs and symptoms of a transfusion reaction d. strategies for managing transfusion-associated anxiety

C. SIGNS AND SYMPTOMS OF A TRANSFUSION REACTION

the nurse's review of a client's most recent blood work reveals a significant increase in the number of band cells. the nurse's subsequent assessment should focus on which of the following? a. respiratory function b. evidence of decreased tissue perfusion c. signs and symptoms of infection d. recent changes in activity tolerance

C. SIGNS AND SYMPTOMS OF INFECTION

a nurse is admitting a client with immune thrombocytopenia purpura to the unit. in completing the admission assessment, the nurse must be alert for what medications that potentially alter platelet function? select all that apply. a. antihypertensives b. penicillins c. sulfa-containing medications d. aspirin-based drugs e. NSAIDs

C. SULFA-CONTAINING MEDICAITONS D. ASPIRIN-BASED DRUGS E. NSAIDs

which of the following circumstances would most clearly warrant autologous blood donation? a. the client has type-O blood b. the client has sickle cell disease or a thalassemia c. the client has elective surgery pending d. the client has hepatitis C

C. THE CLIENT HAS ELECTIVE SURGERY PENDING

a client with a history of atrial fibrillation has contacted the clinic reporting an accidental overdose on prescribed warfarin. the nurse should recognize the possible need for which antidote? a. intravenous immunoglobulins (IVIG) b. factor IX c. vitamin K d. factor VIII

C. VITAMIN K

Two units of Packed Red Blood Cells have been prescribed for a client who has experienced a gastrointestinal bleed. The client is highly reluctant to receive a transfusion, stating, "I'm terrified of getting HIV/AIDS from a blood transfusion." How can the nurse best address the client's concerns? a. "All donated blood is treated with anti-retroviral medications before it is used" b." That did happen in the past, but it is not longer a possibility" c."HIV was eradicated from the blood supply in the early 2000s." d."All blood donations are tested and the chances of contracting HIV from blood transfusions are very low"

D. "DONATED BLOOD IS SCREENED FOR HUMAN IMMUNODEFICIENCY VIRUS (HIV), AND THE RISK OF CONTRACTION IS VERY LOW"

a client with Hodgkin lymphoma is receiving information from the oncology nurse. the client asks the nurse why it is necessary to stop drinking and smoking and stay out of the sun. which response by the nurse would be best? a. "avoiding these factors can reduce the risk of Reed-Sternberg cells developing" b. "these behaviors can reduce the effectiveness of your chemotherapy" c. "engaging in these activities increases your risk of hemorrhage" d. "it's important to reduce other factors that increase the risk of second cancers"

D. "IT'S IMPORTANT TO REDUCE OTHER FACTORS THAT INCREASE THE RISK OF SECOND CANCERS"

a client comes into the clinic reporting fatigue. blood work shows an increased bilirubin concentration and an increased reticulocyte count. which condition should the nurse most suspect the client has? a. a hypoproliferative anemia b. a leukemia c. thrombocytopenia d. a hemolytic anemia

D. A HEMOLYTIC ANEMIA

a nurse is planning the care of a client with a nutritional deficit and a diagnosis of megaloblastic anemia. the nurse should recognize that this client's health problem is due to which issue with the red blood cells (RBCs)? a. production of inadequate quantities of RBCs b. premature release of immature RBCs c. injury to the RBCs in circulation d. abnormalities in the structure and function of RBCs

D. ABNORMALITIES IN THE STRUCTURE AND FUNCTION OF RBCs

a 35 year old client is admitted to the hospital reporting severe headaches, vomiting, and testicular pain. the client's blood work shows reduced numbers of platelets, leukocytes, and erythrocytes, with a high proportion of immature cells. the nurse caring for this client suspects which diagnosis? a. acute myeloid leukemia (AML) b. chronic myeloid leukemia (CML) c. myelodysplastic syndromes (MDS) d. acute lymphocytic leukemia (ALL)

D. ACUTE LYMPHOCYTIC LEUKEMIA in this form, infiltration into other organs are more common than with other forms of leukemia

diagnostic testing has resulted in a diagnosis of acute myeloid leukemia (AML) in an adult client who is otherwise healthy. the client and the care team have collaborated and the client will soon begin induction therapy. the nurse should prepare the client for: a. daily treatment with targeted therapy medications b. radiation therapy on a daily basis c. hematopoietic stem cell transplantation d. an aggressive course of chemotherapy

D. AN AGGRESSIVE COURSE OF CHEMOTHERAPY

a nurse is educating a client about the role of B lymphocytes. the nurse's description will include which of the following physiologic processes? a. stem cell differentiation b. cytokine production c. phagocytosis d. antibody production

D. ANTIBODY PRODUCTION

when teaching a client with sickle cell disease about strategies to prevent crises, what measures should the nurse recommend? a. using prophylactic antibiotics and performing meticulous hygiene b. maximizing physical activity and taking OTC iron supplements c. limiting psychosocial stress and eating a high protein diet d. avoiding cold temperatures and ensuring sufficient hydration

D. AVOIDING COLD TEMPERATURES AND ENSURING SUFFICIENT HYDRATION

An interdisciplinary team has been commissioned to create policies and procedures aimed at preventing acute hemolytic transfusion reactions. What action has the greatest potential to reduce the risk of this transfusion reaction? A) Ensure that blood components are never infused at a rate greater than 125 mL/hr. B) Administer prophylactic antihistamines prior to all blood transfusions. C) Establish baseline vital signs for all patients receiving transfusions. D) Be vigilant in identifying the patient and the blood component.

D. BE VIGILANT IN IDENTIFYING THE PATIENT AND THE BLOOD COMPONENT

an adult client has been diagnosed with iron deficiency anemia. what nursing diagnosis is most likely to apply to this client's health status? a. risk for deficient fluid volume related to impaired erythropoiesis b. risk for infection related to tissue hypoxia c. acute pain related to uncontrolled hemolysis d. fatigue related to decreased oxygen carrying capacity

D. FATIGUE RELATED TO DECREASED OXYGEN CARRYING CAPACITY

A home health nurse is caring for a client with multiple myeloma. what intervention should the nurse prioritize when addressing the client's severe bone pain? a. implementing distraction techniques b. educating the client about the effective use of hot and cold packs c. teaching the client to use NSAIDs effectively d. helping the client manage the opioid analgesic regimen

D. HELPING THE CLIENT MANAGE THE OPIOID ANALGESIC REGIMEN

a 25 year old client comes to the emergency department with excessive bleeding from a cut sustained when cleaning a knife. blood work shows a prolonged prothrombin time (PT), but a vitamin K deficiency is ruled out. when assessing the client, areas of ecchymosis are noted on other areas of the body. which of the following is the most plausible cause of the client's signs and symptoms? a. lymphoma b. leukemia c. hemophilia d. hepatic dysfunction

D. HEPATIC DYSFUNCTION

the nurse educating a client with anemia is describing the process of red blood cell production. when the client's kidneys sense a low level of oxygen in circulating blood, which physiologic response is initiated? a. increased stem cell synthesis b. decreased respiratory rate c. arterial vasoconstriction d. increased levels of erythropoietin

D. INCREASED LEVELS OF ERYTHROPOIETIN

a client is being treated on the medical unit for a sickle cell crisis. the nurse's most recent assessment reveals a fever and a new onset of fine crackles on lung auscultation. which action by the nurse would be most appropriate? a. apply supplementary oxygen by nasal cannula b. administer bronchodilators by nebulizer c. liaise with the respiratory therapist and consider high flow oxygen d. inform the health care provider that the client may have an infection

D. INFORM THE HEALTH CARE PROVIDER THAT THE CLIENT MAY HAVE AN INFECTION

the client lives with a diagnosis of sickle cell disease and receives frequent blood transfusions. the nurse should recognize the client's consequent risk of what complication of treatment? a. hypovolemia b. vitamin B12 deficiency c. thrombocytopenia d. iron overload

D. IRON OVERLOAD

the nurse is caring for a client who has developed scar tissue in many of the areas that normally produce blood cells. what organs can become active in blood cell production by the process of extra medullary hematopoiesis? a. spleen and kidneys b. kidneys and pancreas c. pancreas and liver d. liver and spleen

D. LIVER AND SPLEEN

a nurse is planning the care of a client who has a diagnosis of hemophilia A. when addressing the nursing diagnosis of acute pain related to joint hemorrhage, what principle should guide the nurse's choice of interventions? a. gabapentin (Neurontin) is effective because of the neuropathic nature of the client's pain b. opioids partially inhibit the client's synthesis of clotting factors c. opioids may cause vasodilation and exacerbate bleeding d. NSAIDs are contraindicated due to the risk for bleeding

D. NSAIDs ARE CONTRAINDICATED DUE TO THE RISK FOR BLEEDING

a client's wound has begun to heal and the blood clot which formed is no longer necessary. when a blood clot is no longer needed, the fibrinogen and fibrin will be digested by which of the following? a. plasminogen b. thrombin c. prothrombin d. plasmin

D. PLASMIN

a client's diagnosis of atrial fibrillation has prompted the primary care provider to prescribe warfarin. when assessing the therapeutic response to this medication, which action by the nurse is the most appropriate? a. assess for signs of myleosuppression b. review the client's platelet level c. assess the client's capillary refill time d. review the client's international normalized ration (INR)

D. REVIEW THE CLIENT'S INTERNATIONAL NORMALIZED REFILL TIME (INR) INR and activated partial thromboplastin time serves as a useful tool for evaluating the client's clotting ability and monitoring the therapeutic effectiveness for anticoagulant medications.

a client has been living with a diagnosis of anemia for several years and has experienced recent declines in hemoglobin levels despite active treatment. which assessment finding would signal complications of anemia? a. venous ulcers and visual disturbances b. fever and signs of hyperkalemia c. epistaxis and gastroesophageal reflux d. shortness of breath and peripheral edema

D. SHORTNESS OF BREATH AND PERIPHERAL EDEMA

A critical care nurse is caring for a client with immune hemolytic anemia. the client is not responding to conservative treatments, and the client's condition is now becoming life-threatening. the nurse is aware that a treatment option in this case may include which intervention? a. hepatectomy b. vitamin K administration c. platelet transfusion d. splenectomy

D. SPLENECTOMY