401 Hematology Quiz
112. A client is started on a continuous infusion of heparin. Which finding does the nurse use to conclude that the intervention is therapeutic? 1. INR is between 2 and 3 2. PT is 2 /21 times the control value 3. APTT is 2 times the control value 4. ACT is in the range of 70 and 120
3. APTT is 2 times the control value
Which disorder creates the highest risk for the patient to develop infection? a. Sickle cell crisis b. Vitamin B12 deficiency anemia c. Polycythemia vera d. Thrombocytopenia
a. Sickle cell crisis
Which drug disrupts platelet action? a. Vitamin K b. Ibuprofen c. Methydopa d. Azathioprine
b. Ibuprofen
A patient reports fatigue, bone pain, and frequent bacterial infections. Further investigation reveals anemia, hypercalcemia, and x-ray findings show bone thinning with areas of bone loss that resemble Swiss cheese. The signs/symptoms and diagnostic findings are consistent with which disorder? a. Acute leukemia b. Multiple myeloma c. Non-Hodgkin's lymphoma d. Sickle cell anemia
b. Multiple myeloma
A client has a low hemoglobin level, which is attributed to nutritional deficiency, and the nurse provides dietary teaching. Which food choices by the client indicate that the nurse's instructions are effective? Select all that apply. 1. Raisins 2. Squash 3. Carrots 4. Spinach 5. Apricots
1. Raisins 4. Spinach
A client is receiving epoetin (Epogen) for the treatment of anemia associated with chronic renal failure. Which client statements indication to the nurse that further teaching about this medication is necessary? 1. " I realize it is important to take this medication because it will cure my anemia." 2. "I know many way to protect my self from injury because I know I am at risk for seizures." 3 "I recognize I may still need a blood transfusion if my blood values are low." 4. "I understand that is will still need to take supplemental iron therapy with this medication."
1. " I realize it is important to take this medication because it will cure my anemia."
A client who is to receive radiation therapy for cancer says to the nurse, "My family said I will get radiation burn." What is the BEST response? 1. "Your skin will look like a sunburn." 2. "A localized skin reaction usually occurs." 3. "A daily application of an emollient will prevent a burn." 4. "Your family must have experience with radiation therapy'"
2. "A localized skin reaction usually occurs."
A nurse caring for a client with a diagnosis of polycythemia vera. The client asks, "Why do I have an increased tendency to develop blood clots?" Which effect of the polycythemia vera should the nurse explain increases the risk of blood clots? 1. Elevated blood pressure 2. Increased blood viscosity 3. Fragility of the blood cells 4. Immaturity of red blood cells
2. Increased blood viscosity
What group of clients should the nurse anticipate to have the highest incidence of non-Hodgkin lymphomas? 1. Children 2. Older adults 3. Young adults 4. Middle-aged persons
2. Older adults
197. A nurse is caring for a client who has a radium implant for cancer of the cervix. What is the priority nursing action? 1. Store urine in lead-lined containers. 2. Restrict visitors to a ten-minute stay. 3. Wear a lead-lined apron when giving care. 4. Avoid giving injections in the gluteal muscle
2. Restrict visitors to a ten-minute stay.
198. A client was treated with a radium implant for cancer of the cervix. What information is important for the nurse to teach the client when giving discharge instructions? 1. Limit daily fluid intake. 2. Return for follow-up care. 3. Continue a low-residue diet. 4. Take daily mineral supplements
2. Return for follow-up care.
A nurse is teaching a client with Hodgkin disease about responses to whole-body radiation. Which clinical indicator increase should the nurse include? 1. Blood viscosity 2. Susceptibility to infection 3. Red blood cell production 4. Tendency for pathologic fractures
2. Susceptibility to infection
195. Radium inserted in the vagina of a client is now being removed. What safety precaution should the nurse employ when assisting with the radium removal? 1. Clean the radium in ether or alcohol. 2. Wear foil-lined rubber gloves while handling the radium. 3. Ensure that long forceps are available for removing the radium. 4. Document how long the radium was in place and when it was removed.
3. Ensure that long forceps are available for removing the radium.
A client is admitted with a higher than expected red blood cell count. What physiological alteration does the nurse expect will result from this clinical finding? 1. Increased serum pH 2. Decreased hematocrit 3. Increased blood viscosity 4. Decreased immune response
3. Increased blood viscosity
A client with upper GI bleeding develops mild anemia. What should the nurse expect to be prescribed for this client? 1. Epogen 2. Dextran 3. Iron Salts 4. Vitamin B12
3. Iron Salts
A transfusion of packed red blood cells is ordered for a client with anemia. List the following actions in the order in which they should be performed by the nurse. 1. Don a pair of clean gloves. 2. Run the transfusion slowly. 3. Determine the client's vital signs. 4. Ensure that the client signed a consent for the transfusion. 5. Compare the number on the blood product and the lab record.
4. Ensure that the client signed a consent for the transfusion. 3. Determine the client's vital signs. 5. Compare the number on the blood product and the lab record. 1. Don a pair of clean gloves. 2. Run the transfusion slowly.
A client is receiving coumadin (warfarin). The nurse explains the need for careful regulation of dietary intake of vitamin K. What physiologic process does vitamin K promote that make this instruction essential? 1. Platelet aggreagtion 2. Ionization of blood calcium 3. Fibrinogen formation by the liver 4. Prothrombin formation by the liver
4. Prothrombin formation by the liver
A client is diagnosed with Hodgkin disease. Which lymph nodes does the nurse expect to be affected first? I . Cervical 2. Axillary 3. Inguinal 4. Mediastinal
I . Cervical
The nurse is interviewing a patient with iro deficiency anemia. Which symptom is the patient most likely to report? a. Fatigue b. Night sweats c. Calf pain d. Blood in urine
a. Fatigue
196. A nurse checking the perineum of a client with a radium implant for cervical cancer observes the packing protruding from the vagina. Why must the nurse notifr the health care provider to remove it immediately? 1. The radioactive packing will injure healthy tissue. 2. Removal of the packing will prevent excessive blood loss. 3. Flhe exposure of radium to the environment will diminish its effectiveness.
1. The radioactive packing will injure healthy tissue.
194. A nurse is caring for a client who had an insertion of radium for cancer of the cervix. For what radium reaction should the nurse assess the client? 1. Pain 2. Nausea 3. Excoriation 4. Restlessness
1. Pain
A female client has a low hemoglobin level, which attributed to an iron deficiency. Which foods should the nurse recommend that the client increase in the diet? (select all that apply) 1. Spinach 2. Broccoli 3. Beef Liver 4. Baked Beans 5. Chicken Breast
1. Spinach 3. Beef Liver 4. Baked Beans
A client expresses concern about being exposed to radiation therapy because it can cause cancer. What should the nurse emphasize when informing the client about exposure to radiation? 1. The dosage is kept to a minimum 2. Only a small part of the body is irradiated. 3. The client's physical condition is not a risk factor. 4. Nutritional environment of the affected cells is a risk factor.
2. Only a small part of the body is irradiated.
200. A postmenopausal woman who has cancer of the breast decides to have a lumpectomy followed by chemotherapy. After receiving chemotherapy for several weeks, she says to a nurse at the clinic, "I don't feel well." nurse reviews the chemotherapeutic medications the client is receiving, checks the laboratory results, and obtains the client's vital signs. Based on this information, what does the nurse conclude is the client's priority need? Client Chart Medications cyclophosphamide (Cytoxan) DOXOrubicin fluorouracil (5-FU) Laboratory Results RBC: 4.2 WBC: 3000 Hb: 12.5 g/dL Platelets: 190,000 Vital Signs Temperature (oral): 99.80 F Pulse: 88 beats/min Resp: 24 breaths/min Blood pressure: 126/88 mm Hg 1. Promoting rest 2. Preventing infection 3. Avoiding bodily harm 4. Maintaining fluid balance
2. Preventing infection
A client has a bone marrow aspiration performed. After the procedure, what is the first nursing action? 1. Position the client on the affected side. 2. Cleanse the site with an antiseptic solution. 3. Briefly apply pressure over the aspiration site. 4. Begin frequent monitoring of the client's vital signs
3. Briefly apply pressure over the aspiration site.
A patient has been taught how to care for his central venous catheter at home. Which statements by the patient indicate that further instruction is necessary? (Select all that apply.) a. "1 will flush the catheter with heparin three times a day." b. "I will change the Luer-Lok cap on each catheter daily." c. "I will tape the catheter to my skin." d. "If the catheter lumen breaks or punctures, I will immediately clamp the catheter between myself and the opening." e. "I will wash my hands before working with the catheter."
a. "1 will flush the catheter with heparin three times a day." b. "I will change the Luer-Lok cap on each catheter daily."
In assessing the patient's hematologic status which questions would the nurse include? (select all that apply) a. "Have you ever had unusual or increased fatigue?" b. Have you ever had any radiation therapy?" c. Have you ever had a job that exposed you to chemicals?" d. "Do you have a personal or family history of blood disorders?" e. "What drugs have you used in the past three days?"
a. "Have you ever had unusual or increased fatigue?" b. Have you ever had any radiation therapy?" c. Have you ever had a job that exposed you to chemicals?" d. "Do you have a personal or family history of blood disorders?"
The nurse is interviewing a patient who reports dizziness and lightheadedness, and bleeding gum every time she brushes her teeth. Which questions does the nurse ask the patient in order to focus on the problem? (select all that apply) a. "How often do you take aspirin or any other nonsteroidal antiinflammatory drug?" b. "Do you have swollen glands or a sore throat?" c. "How much meat do you eat in a week?" d. " Are you having trouble swallowing?" e. "Does your heart ever seem to pound?"
a. "How often do you take aspirin or any other nonsteroidal antiinflammatory drug?" c. "How much meat do you eat in a week?" e. "Does your heart ever seem to pound?"
The new registered nurse is giving a blood transfusion to a patient. Which statement by the new nurse indicates the need for action by the supervising nurse? a. "I will complete red blood cell transfusion within 6 hours." b. "I will check the patient verification with another registered nurse." c. "I will use normal saline solution to dilute the blood." d. "I will remain with the patient for the first 15 to 30 minutes of the infusion."
a. "I will complete red blood cell transfusion within 6 hours."
The nurse has instructed a patient at risk for bleeding about techniques to manage this condition. Which statements by the patient indicate that teaching has been successful? (Select all that apply.) a. "I will take a stool softener to prevent straining during a bowel movement." b. "I won't take aspirin or aspirin-containing products." c. "I won't participate in any contact sports." d. "I will report a headache that is not responsive to acetaminophen." e. "I will avoid bending over at the waist." f. "If I am bumped, I will apply ice to the sitefor at least 10 minutes."
a. "I will take a stool softener to prevent straining during a bowel movement." b. "I won't take aspirin or aspirin-containing products." c. "I won't participate in any contact sports." d. "I will report a headache that is not responsive to acetaminophen." e. "I will avoid bending over at the waist."
A nursing student asks the registered nurse why D5W is contraindicated when transfusing blood. How does the nurse respond? a. "It causes hemolysis of blood cells." b. "It dilutes the cells." c. "It shrinks the blood cells." d. "It is in the procedure manual."
a. "It causes hemolysis of blood cells."
A patient has polycythemia vera. Which action by the UAP requires intervention by the supervising nurse? a. Assisting the patient to floss his teeth b. Using an electric shaver on the patient c. Using a soft-bristled toothbrush on the patient d. Assisting the patient to don support hose
a. Assisting the patient to floss his teeth
Which patient is most likely to have severe manifestations of sickle cell disease even when triggering conditions are mild? a. Both parents have hemoglobin S gene alleles b. Mother has hemoglobin S gene alleles and father has hemoglobin A gene alleles c. Mother has sickle cell trait and father has hemoglobin A gene alleles d. Both parents have hemoglobin A gene alleles
a. Both parents have hemoglobin S gene alleles
The nurse is interviewing a patient who is newly admitted to the unit with a diagnosis of anemia. Which assessment findings does the nurse expect? (Select all that apply.) a. Dyspnea on exertion b. Systolic hypertension c. Intolerance to heat d. Concave appearance of the nails e. Pallor of the ears f. Headache
a. Dyspnea on exertion d. Concave appearance of the nails e. Pallor of the ears f. Headache
In the bone marrow of an older adult, what would be consider a normal physiologic change related to aging? a. Fatty tissue replaces bone marrow. b. Bone marrow cells become smaller. c. Weakened bones absorb bone marrow. d. Bone marrow cells fail to function.
a. Fatty tissue replaces bone marrow.
The nurse is caring for a patient who has donated bone marrow. In addition to having the aspiration sites monitored, the nurse will anticipate the need for which interventions? (Select all that apply.) a. Fluid for hydration b. Pain management c. Possible RBC infusion d. Prophylactic antibiotic therapy e. Assessment for complications of anesthesia
a. Fluid for hydration b. Pain management c. Possible RBC infusion e. Assessment for complications of anesthesia
The nurse is caring for a patient with acute leukemia. Which signs/symptoms is the nurse most likely to observe during the assessment? (Select all that apply.) a. Hematuria b. Orthostatic hypotension c. Bone pain d. Joint swelling e. Fatigue f. Weight gain
a. Hematuria b. Orthostatic hypotension c. Bone pain d. Joint swelling e. Fatigue
An older patient has been receiving frequent blood transfusions without any complications or adverse reactions; however, the nurse carefully monitors the patient during the current transfusion. Which signs/symptoms suggest that the patient is experiencing circulatory overload? a. Hypertension, bounding pulse, and distended neck veins b. Fever, chills, and tachycardia c. Urticaria, itching, and bronchospasm d. Headache, chest pain, and hemoglobinuria
a. Hypertension, bounding pulse, and distended neck veins
Which factors are associated with an increased risk for lymphoma? (Select all that apply.) a. Immunosuppressive disorders b. Chronic infection from Helicobacter pylori c. Epstein-Barr viral infection d. Chronic alcoholism e. Pesticides and insecticides
a. Immunosuppressive disorders b. Chronic infection from Helicobacter pylori c. Epstein-Barr viral infection e. Pesticides and insecticides
A patient is at high risk for the development of venoocclusive disease (VOD). What assessments does the nurse perform for early detection of this disorder? (Select all that apply.) a. Jaundice b. Weight loss c. Hepatomegaly d. Right upper quadrant abdominal pain e. Ascites
a. Jaundice c. Hepatomegaly d. Right upper quadrant abdominal pain e. Ascites
The student nurse is caring for a patient in sickle cell crisis. Which action by the student nurse warrants intervention by the supervising nurse? a. Keeping the patient's room cool b. Using distraction and relaxation techniques c. Positioning painful areas of the patient with support d. Using therapeutic touch
a. Keeping the patient's room cool
The nurse is caring for a patient in sickle cell crisis. What are priority interventions for this patient? (Select all that apply.) a. Managing pain b. Managing nutrition c. Ensuring hydration d. Administering platelets e. Assessing oxygen saturation
a. Managing pain c. Ensuring hydration e. Assessing oxygen saturation
A patient is receiving a blood transfusion through a single-lumen peripherally inserted central catheter. The patient has two other peripheral IVs: one is capped and the other has 1)5/.45 NS running at a rate of 50 mL/hr. What can be given concurrently through the line that is selected for the blood product? a. Normal saline b. Piggyback of 10 mEq potassium chloride c. Total parenteral nutrition d. Furosemide (Lasix) 5 mg IV push
a. Normal saline
Experienced nurse A is supervising new nurse B. In which circumstance would nurse A intervene? a. Nurse B prepares to use blood administration tubing to infuse stems cells. b. Nurse B obtains Y-tubing with a blood filter to administer packed red blood cells. c. Nurse B uses a special shorter tubing with a smaller filter to deliver platelets. d. Nurse B rapidly delivers fresh frozen plasma through regular straight filtered tubing.
a. Nurse B prepares to use blood administration tubing to infuse stems cells.
The nurse is reviewing the patient's mediation list and sees the patient is receiving parenteral enoxaparin (Lovenox). Which outcome statement is the target of the enoxaparin therapy? a. Patient will not develop signs/symptoms of a blood clot. b. Patient will report a decrease in fatigue and dizziness. c. Patient will not develop sings/symptoms of infection. d. Patient will demonstrate no shortness of breath on exertion.
a. Patient will not develop signs/symptoms of a blood clot.
Patients with sickle cell disease are more susceptible to infections. Which actions help prevent infection? (Select all that apply.) a. Perform consistent thorough handwashing b. Encourage yearly flu vaccination c. Administer twice-daily oral penicillin d. Administer NSAIDs three times a day e. Monitor CBC and differential white cell count f. Assess vital signs at least every 4 hours
a. Perform consistent thorough handwashing b. Encourage yearly flu vaccination c. Administer twice-daily oral penicillin e. Monitor CBC and differential white cell count f. Assess vital signs at least every 4 hours
The nurse is performing a hematologic assessment of an older adult patient. Which findings does the nurse identify as normal changes in the older adult? (select all the apply) a. Progressive loss of body hair b. Thickened or discolored nails c. Yellowing of the skin d. Dryness of the skin e. Ecchymosis
a. Progressive loss of body hair b. Thickened or discolored nails c. Yellowing of the skin d. Dryness of the skin
In caring for a patient with acute leukemia, what is the priority collaborative problem? a. Protecting the patient from infection b. Minimizing the side effects of chemotherapy c. Controlling the patients pain d. Assisting the patient to cope with fatigue
a. Protecting the patient from infection
A deficiency in any of the anticlotting factors, such as protein C, protein S, and antithrombin III increases the patient's risk the which disorder(s)? (select of the apply) a. Pulmonary embolism b. Myocardial infarction c. Sepsis d. Pernicious anemia e. Stroke
a. Pulmonary embolism b. Myocardial infarction e. Stroke
Which medication increases the risk for the patient to develop infection? a. Steroids b. Aspirin c. Iron solutions d. Heparin
a. Steroids
The home care nurse is visiting a patient who had a stem cell transplant. Which observation by the nurse requires immediate action? a. The patient's grandson is visiting receiving a MMR vaccine. b. The patient bumps his toe on a chair and applies pressure to the toe for 10 minutes. c. The patient with a platelet count of 48,000/mm3 follows platelet precautions. d. The patient avoids going out to grocery shop in the winter months.
a. The patient's grandson is visiting receiving a MMR vaccine.
A patient undergoing hematopoietic stem cell transplantation reports severe fatigue. To assist the patient with energy management, what does the nurse encourage the patient to do? (Select all that apply.) a. Verbalize feelings about limitations. b. Monitor nutritional intake to ensure adequate energy resources. c. Avoid napping throughout the day. d. Limit the number of visitors as appropriate. e. Plan activities for periods when the patient has the most energy. f. Monitor overall response to self-care activities.
a. Verbalize feelings about limitations. b. Monitor nutritional intake to ensure adequate energy resources. d. Limit the number of visitors as appropriate. e. Plan activities for periods when the patient has the most energy. f. Monitor overall response to self-care activities.
A patient with sickle cell crisis is admitted to the hospital. Which questions does the nurse ask the patient to elicit information about the cause of the current crisis? (Select all that apply.) a."Have you recently traveled on an airplane?" b. "Have you ever had radiation therapy?" c. "In the past 24 hours, has any activity made you short of breath?" d. "Have you recently consumed alcohol or used recreational drugs?" e. "Have you had any symptoms of infection, such as fever?"
a."Have you recently traveled on an airplane?" c. "In the past 24 hours, has any activity made you short of breath?" d. "Have you recently consumed alcohol or used recreational drugs?" e. "Have you had any symptoms of infection, such as fever?"
A patient admitted for sickle cell crisis is being discharged home. Which statement by the patient indicates the need for further postdischarge instruction? a. "I will stop running 2 miles every morning." b. "I will visit my friends in Denver." c. "I will avoid the sauna at the gym." d. "I will not drink alcoholic beverages."
b. "I will visit my friends in Denver."
The nurse is inserting an intravenous needle into an older patient for the purpose of administering a blood transfusion. Which size needle should the nurse select? a. 22-gauge needle b. 20-gauge needle c. 19-gauge needle d. 23-gauge butterfly needle
b. 20-gauge needle
A patient with a low white blood cell count is being discharged home. In which situations will the patient be instructed by the nurse to contact his or her health care provider? (Select all that apply.) a. When temperature goes over 1020 F (38.90 C) b. A persistent cough develops with or without sputum c. Pus or foul-smelling drainage develops from open skin or a body opening d. Whenever exposed to fresh fruit or vegetables or live plants e. Urine is cloudy or foul-smelling, or if burning on urination is experienced
b. A persistent cough develops with or without sputum c. Pus or foul-smelling drainage develops from open skin or a body opening e. Urine is cloudy or foul-smelling, or if burning on urination is experienced
The patient is admitted for a chronic liver disorder and will be receiving vitamin K to address one of the problems associated with the disorder. Which clinical manifestation is the nurse most likely to observe before the vitamin k therapy is initiated? a. Sore throat and a smooth tongue b. Bruising and bleeding at venipuncture sites c. Fever and increase in WBC count d. Calf swelling due to deep vein thrombosis
b. Bruising and bleeding at venipuncture sites
Based on the knowledge of albumin's role in maintaining osmotic pressure of the blood, which sign/symptom would the nurse observe for if the patient has low albumin levels? a. Fever b. Edema c. Dizziness d. Pain
b. Edema
For a patient who has a dysfunction of the bone marrow, which sign/symptom is the nurse most likely to observe? a. Long bone pain b. Fatigue c. Loss of appetite d. Weight gain
b. Fatigue
A patient with lymphoma requires a hemato- poietic stem cell transplant and a donor is be- ing sought. Which type of transplant is likely to yield the best results? a. Synthetic human leukocyte antigen (HLA) b. HLA-identical twin sibling c. HLA-matched first-degree relative d. HLA-matched stem cells from an umbilical cord of a related donor
b. HLA-identical twin sibling
While being interviewed for admission, a patient tells the nurse that he has Christmas disease. What does the nurse document this as? a. Hemophilia A b. Hemophilia B c. Thrombocytopenia d. Sickle cell disease
b. Hemophilia B
A patient is receiving a blood transfusion. Which solution does the nurse administer with the blood? a. Ringer's lactate b. Normal saline c. Dextrose in water d. Dextrose in saline
b. Normal saline
The home health nurse is reviewing the patient's medication list and sees that new medications were added during a recent hospitalization. In addition, the patient reports he takes a low dose of aspirin, but the aspirin is not on the final discharge list. Because of the aspirin usage, the nurse is most likely to call the prescribing health care provider for clarification of which type of drug? a. Vitamin supplement b. Platelet inhibitor c. Antihypertensive d. Erythrocyte stimulating agent
b. Platelet inhibitor
The nurse is helping a patient prepare for induction therapy for acute leukemia. What information will the nurse give to the patient? a. A donor is needed for hematopoietic stem b. Prolonged hospitalization is common to protect against infection. c. The therapy may last from months to years to maintain remission. d. Success of the therapy results in remission and the intent is to cure.
b. Prolonged hospitalization is common to protect against infection.
The patient reports a history of splenectomy. Based on this information, what is the nurse most likely to assess for? a. Signs of bleeding b. Signs of infection c. Digestive problems d. Jaundice of the skin
b. Signs of infection
Which outcome indicates that engraftment of transplanted cells in the patient's bone marrow has been successful? a. There is no evidence of graft-versus-host disease. b. WBC, RBC, and platelet counts begin to rise. c. Laboratory results indicate probable regressive chimerism. d. Laboratory results show decreasing percentage of donor cells.
b. WBC, RBC, and platelet counts begin to rise.
The nurse has taught the patient about dietary modifications for his vitamin B12 deficiency anemia. Which statement by the patient indicates that additional teaching is needed? a. "Dairy products are a good source of vitamin B b. "Dried beans taste okay if they are prepared correctly." c. "Leafy green vegetables interfere with my therapy." d. "I like nuts and I will gladly eat them."
c. "Leafy green vegetables interfere with my therapy."
When caring for a patient after bone marrow stem cell transplantation, when does the nurse expect engraftment (the settling in of stem cells and the start of producing new cells) to occur? a. 8 to 12 hours after infusion b. 7 days after infusion c. 21 days after infusion d. 6 weeks after infusion
c. 21 days after infusion
The nurse is caring for a patient with thrombocytopenia. Which order does the nurse question? a. Test all urine and stool for occult blood. b. Avoid 1M injections. c. Administer enemas. d. Apply ice to areas of trauma.
c. Administer enemas.
Based on knowledge of physionlogic triggers for RBC production, the nurse would anticipate which chronic health condition to be associated with an increase in RBC production? a. diabetes mellitus b. Osteoarthritis c. Chronic obstructive pulmonary disease d. Chronic kidney disease
c. Chronic obstructive pulmonary disease
Which type of medication is used for patients receiving a platelet transfusion as premedication to prevent a reaction? a. Vitamin K and a diuretic b. Aspirin and hydroxyurea c. Diphenhydramine and acetaminophen d. Hydrocortisone and an antihypertensive
c. Diphenhydramine and acetaminophen
A patient with acute leukemia has been receiving an erythropoiesis-stimulating agent. When would the nurse call the health care provider to have this order discontinued? a. Hemoglobin level is 6 mg/dL. b. Hematocrit is 20%. c. Hemoglobin level is 10.5 mg/dL. d. Platelet count is 50,000/mm3.
c. Hemoglobin level is 10.5 mg/dL.
Which hematologic disorder is most likely to cause the patient to have joint problems? a. Thrombocytopenia b. Aplastic anemia c. Hemophilia d. Warm antibody anemia
c. Hemophilia
Which laboratory result would indicate the the prescription for Epogen is having the desired therapeutic effect? a. Increase in platlet count b. Increase in WBC count c. Increase in RBC count d. Increase in iron level
c. Increase in RBC count
The nurse sees that a 45-year-old woman has a low hemoglobin level. The nurse would perform a dietary assessment to identify a possible deficiency in which nutrient? a. Calcium b. Vitamin K c. Iron d. Vitamin D
c. Iron
The nurse is performing the immediate post procedure care for a bone marrow donor. What is the priority assessment that the nurse will perform? a. Monitoring for activity intolerance b. Monitoring for infection c. Monitoring for fluid loss d. Monitoring CBC and platelet counts
c. Monitoring for fluid loss
The unlicensed assistive personnel (UAP) is providing care to a patient in sickle cell crisis. Which action by the UAP requires intervention by the supervising nurse? a. Elevating the head of the bed to 25 degrees b. Assisting to remove any restrictive clothing c. Obtaining the blood pressure with an external cuff d. Offering the patient her beverage of choice
c. Obtaining the blood pressure with an external cuff
A patient is diagnosed with iron deficiency anemia. Which assessment finding is the nurse most likely to observe in this patient? a. Neck veins are distended and edema is present. b. Lower extremities show signs of phlebitis. c. Systolic blood pressure is lower than normal. d. Palpation of ribs or sternum elicits tenderness.
c. Systolic blood pressure is lower than normal.
To assist the health care provider in determining whether a patient is a candidate for fibrinolytic therapy, the nurse is interviewing the patient diagnosed with a myocardial infarction. Why is determining the time of symptom onset essential in decision making? a. Fibrinolytic drugs will not dissolve clots that are older than six hours. b. Clots that are older than six hours and too large and tightly meshed. c. Tissue that is anoxic for more than six hours in unlikely to benefit. d. After six hours, the patient is more likely to have excessive bleeding.
c. Tissue that is anoxic for more than six hours in unlikely to benefit.
The new registered nurse is identifying a patient for blood transfusion. Which action by the new nurse warrants intervention by the supervising nurse? a. Checks the health care provider's order be- fore the blood transfusion b. Compares the hospital identification band name and number to those on the blood component tag c. Uses the patient's room number as a form of identification d. Examines blood bag tag and attached tag to ensure that the ABO and Rh types are compatible
c. Uses the patient's room number as a form of identification
The nurse would measure abdominal girth to monitor for which complication of hematopoietic stem cell transplantation? a. Failure to engraft b. Graft-versus-host disease c. Venoocclusive disease d. Septic shock
c. Venoocclusive disease
To avoid transfusion reaction, the nurse is carefully monitoring the patient during a blood transfusion. When are hemolytic reactions to blood transfusion most likely to occur? a. I mL is sufficient b. 5 mL is typical c. Within the first 50 mL d. Occurs after 100 mL
c. Within the first 50 mL
Which statement about hematologic changes associated with aging is true? a. The older adult has increase blood volume. b. the older adult has increased levels of plasma proteins. c. Platelet count decrease with age. d. Antibody levels and responses are lower and slower in older adults.
d. Antibody levels and responses are lower and slower in older adults.
The nurse knows that erythropoietin is a growth factor that is required for stem cells specialization. Which sign/symptom would the nurse observer for if erythropoietin is lacking or not performing it role? a. Elevated body temperature. b. Bruising and ecchymosis. c. Swelling of the lymph nodes. d. Easily fatigued.
d. Easily fatigued.
A patient has a suspected hematologic problem. Which instruction is the nurse most likely to give to the UAP? a. Record urine output for the shift b. Take the vital signs every 2 hours c. Assess the patient for fatigue after exertion d. Handle the patient gently to avoid bruising
d. Handle the patient gently to avoid bruising
A patient is scheduled to undergo diagnostic testing for sickle cell anemia. For which diagnostic test does the nurse provide patient teaching? a. Bone marrow biopsy b. Platelet count c. Philadelphia chromosome analysis d. Hemoglobin S
d. Hemoglobin S
Venous stasis in considered an intrinsic factor that could result in activating which physiological process? a. Increase RBC production b. Adjustment of osmotic fluid c. Initiation of anticlotting forces d. Initiation blood clotting cascade
d. Initiation blood clotting cascade
Severe anemia could cause enlargement of which organ? a. Gallbladder b. Kidneys c. Colon d. Liver
d. Liver
When assessing a patient with darker skin for pallor and cyanosis, which area would the nurse examine? a. Chest and abdomen b. General appearance of face c. Fingertips and toes d. Oral mucous membranes
d. Oral mucous membranes
An experienced nurse is supervising a new nurse who is assessing a patient with a suspected hematologic problem. The experienced nurse would intervene if the new nurse performed what action? a Palpated the edge of the liver in the right upper quadrant. b. Auscultated the heart for abnormal heart sounds or irregular rhythms. c. Use the fingertips to firmly press over the ribs or sternum. d. Palpated the left upper quadrant to locate an enlarged spleen.
d. Palpated the left upper quadrant to locate an enlarged spleen.
Which food should a patient with a low white blood cell count be encouraged to eat? a. Fresh strawberries b. Raw carrots c. Green leaf lettuce d. Well-done poultry
d. Well-done poultry
