Chp. 32 PrepU Questions: Assessment of Hematologic Function and Treatment Modalities (Exam 1)
A client verbalizes fear of infection from a blood transfusion. What is the nurse's best response?
"Every unit of donated blood is typed and tested for antibodies to infections."
A pt will need a blood transfusion for the replacement of blood loss from the GI tract. the pt states, "That stuff isn't safe!" What is the best response by the nurse?
"I understand your concern. The blood is carefully screened but is not completely risk free."
The nurse begins a routine blood transfusion of packed RBCs at 1100. To ensure client safety, the unit of blood should be completely transfused by what time?
1500
What client is not a candidate for blood donating according to the American Heart Association?
26 yr lf female with hemoglobin of 11.0 g/dL
A nurse is reviewing the patient's morning lab results and notes a left shit in the band cells. Based on this observation, what interpretation can the nurse make from these results?
The pt may be developing an infection
One hr after completion of a fresh frozen plasma transfusion, a pt complains of SOB and is very anxious. The pt's vital signs are B 98/62, HR 110, temp of 99.4 F, and SaO2 88%. Auscultation of the lungs reveals posterior coarse crackles to the mid and lower lobes bilaterally. Based on the symptoms, the nurse suspects the pt is experiencing what kind of problem?
Transfusion-related acute lung injury
A client complains of extreme fatigue. Which system should the nurse suspect is most likely affected?
hematolotigcal
The nurse obtains a unit of blood for the client, Donald A. Smith. the name on the label on the unit of blood reads Donald A. Smith. All the other identifiers are correct. The nurse should...
refuse to administer the blood
A nurse is working at a blood donation clinic. What teaching should the nurse provide to the donor immediately after blood donation?
remain for obsevation after eating and drinking
A nurse is administering a blood transfusion to a pt over 4 hrs. After 2 hours, the pt complains of chills and has a fever of 101 F, an increase from a previous temp of 99.2 F. What does the nurse recognize is occurring with this pt?
the pt is having a febrile nonhemolytic reaction
The nurse is caring for a client who had undergone hemodilution during surgery. Immediately after surgery, the nurse expects to see which lab result?
Decreased hematocrit
Albumin is important for the maintenance of fluid balance within the vascular system. Albumin is produced by which of the following?
Liver
A client is planned to have a splenectomy. The nurse should prepare which medication to administer to this client?
Pneumococal vaccine
A client in end-stage renal disease is prescribed epoetin alfa (Epogen) and oral iron supplements. Before admin. the next dose of epoetin alfa and oral iron supplement, the nurse...
Assesses teh hemoglobin level
A client with a hx. of sickle cell anemia has developed iron overload from repeated blood transfusions. What treatment does the nurse anticipate will be prescribed?
Chelation therapy
A client with a hx. of sickle cell anemia has developed iron overload from repeasted blood trasnfusions. What treatment does the nurse anticipate will be prescribed?
Chelation therapy (chemical process in which a synthetic solution- EDTA is injected into the bloodstream to remove heavy metals and/or minerals from the body)
A pt with chronic kidney disease is being examined by the nurse practitioner for anemia. The nurse has reviewed the lab data for hemoglobin and RBC count. What other test results would the nurse anticipate observing.
decreased level of erythropoietin
The client is a young, thin woman who is prescribed iron dextran intramuscularly. The nurse, uses what technique?
employs the Z-track technique.
A pt is undergoing platelet pheresis at the outpatient clinic. What does the nurse know is most likely the clinical disorder the pt is being treated for?
essential thormbocytopenia
A nursing instructor in a BSN program is preparing for a lecture on disorders fo the hematopietic system. Included in the lecture are conditions caused by reduced levels or absence of blood-clotting proteins. Which of the following is the instructor most likely referring to?
Coagulopathy
A nurse is instructing the client with polycythemia vera how to perform isometric exercises such as contracting and relaxing the quadriceps and gluteal muscle during periods of inactivity. What does the nurse understand is the rationale for this type of exercise?
Contraction of skeletal muscle compresses the walls of
A nurse is instructing the client with polycythemia vera how to perform isometric exercises such as contracting and relaxing the quadriceps and gluteal muscle during periods of inactivity. What does the nurse understand is the rationale for this type of exercise?
Contraction of skeletal muscle compresses the walls of veins and increases the circulation of venous blood as it returns to the heart
Post transfusion, the donor stands up immediately after the needle is withdrawn. The nurse should be alert for which vital sign change?
Decreased BP
A pt who has long-term packed RBCs transfusions has developed symptoms of iron toxicity that affect liver function. What immediate treatment should the nurse anticipate preparing the pt for that can help prevent organ damage?
Iron Chelation therapy
A pt. who has long-term packed RBC (PRBC) transfusions has developed symptoms of iron toxicity that affect liver function. What immediate treatment should the nurse anticipate preparing the pt. for that can help prevent organ damage?
Iron chelation therapy
the nurse should notify the healthcare provider before administering fresh frozen plasma (FFP) based on which assessment finding?
Jugular vein distention
A client in acute renal failure has been prescribed 2 units of packed RBCs. The nurse explains to the client that the blood transfusion is most likely needed for what reason?
Lack of erythropoitein
The nurse is preparing a pt for a bone marrow aspiration and biopsy from the site of the posterior superior iliac crest. What position will the nurse place the pt in?
Lateral position with one leg flexed
Which of the following terms refers to a form of WBCs involved in immune response?
Lymphocyte
Vitamin B and folic acid deficiencies are characterized by production of abnormally large erythrocytes called what?
Megaloblasts
The nurse expects which assessment finding of the oral cavity when the client is diagnosed with pernicious anemia?
Smooth tongue
Which type of lymphocyte s responsible for cellular immunity?
T lymphocyte
A nurse, caring for a pt with HIV, reviews the pt's differential WBC count to check the level of what?
T lymphocytes
A nurse, caring for a pt with HIV, reviews the pt's differnetial WBC count to check the level of which of the following?
T lymphocytes
The physician believes that the pt has a deficiency in the leukocyte responsible for cell-mediated immunity. What should the nurse check the WBC count for?
T lymphocytes
A nurse is assigned to care for a pt with ascites, secondary to cirrhosis. The nurse understands that the fluid accumualtion in the peritoneal cavity results from a combination of factors including an alteration in oncotic pressure gradients and increased capillary permeability. Therefore, the nurse monitors the serum level of the plasma protein responsible for maintaining oncotic pressure, which is...
Albumin
A 67-year-old clinet at the free clinic where you practice nursing has a history of seizures and presents with severe fatigue, frequent headache, and a sore and beefy tongue. Which of the following could be causing her current condition? (multiple)
Alcoholism, intestinal disorders
The physician performs a bone marrow biopsy from the posterior iliac crest on a pt. with pancytopenia. What intervention should the nurse perform following the procedure?
Apply pressure over the site for 5-7 min.
The nurse is caring for a client who had undergone hemodilution during surgery. Immediately after surgery, the nurse expects to see....
Decreased hematocrit
A patient with chronic kidney disease is being examined by the nurse practitioner for anemia. The nurse has reviewed the lab data for hemoglobin and RBC count. What other test results would the nurse anticipate observing?
Decreased level of erythropoietin
A charge nurse should intervene when observing a new nurse perform which action after a client has suffered a possible hemolytic blood transfusion reaction?
Disposing of the blood container and tubing in biohazard waste
A client receiving a blood transfusion complains of shortness of breath, appears anxious, and has a pulse of 125 beats/min. What is the BEST action for the nurse to take after stopping the transfusion and awaiting further instruction from the healthcare provider?
Ensure there is an oxygen delivery device at the bedside
A patient with severe anemia is admitted to the hospital. Due to religious beliefs, the patient is refusing blood transfusions. The nurse anticipates drug therapy with which drug to stimulate the production of RBCs?
Epoetin alfa (Epogen)
A pt with chronic kidney disease has chronic anemia. What pharmacologic alternative to blood transfusion may be used for this pt?
Erythropoietin (Epogen)
A client tells the nurse that he would like to donate blood before his abdominal surgery next week. What should be the nurse's first action?
Explain the time frame needed for autologous donation
A nurse is completing a detailed health history and assessment in the electronic medical record (EMR) on a pt with a disorder of the hematopoietic system. Based on the pt's responses, what symptom is the most common complain associated with meatologic diseases?
Extreme fatigue
The nurse caring for a clinet with acute liver failure should expect which assessment finding?
Generalized edema
A nurse is caring for a pt who has had a bone marrow aspiration with biopsy. What complication should the nurse be aware of and monitor the pt for?
Hemorrhage
Vitamin B and folic deficiencies are characterized by production of abnormally large erythrocytes called which of the following?
Megaloblasts
Which cell of haematopoiesis is responsible for the production of RBCs and platelets?
Myeloid stem cell
The body responds to infection by increasing the production of WBCs. The nurse knows to evaluate the differential count for the level of ______ the first WBCs to respond to an inflammatory event.
Neutrophils
The body responds to infection by increasing the production of WBCs. The nurse knows to evaluate the differential count for the level of _______, the first WBCs to respond to inflammatory event.
Neutrophils
A client involved in a vehicle accident arrives at the ED unconscious and severely hypotensive. The nurse suspects he has several fractures in the pelvis and legs. Which parenteral fluid is the best choice for the client's current condition?
Packed RBC's
Which of the following is a symptom of severe thrombocytopenia?
Petechiae
The nurse is working at a blood donation clinic. What teaching should the nurse provide to the donor immediately after blood donation?
Remain for observation after eating and drinking
The client is to receive a unit of packed RBCs. The first intervention of the nurse is to...
Verify that the client has signed a written consent form
The client is to receive a unit of packed RBCs. the first intervention of the nurse is to...
Verify that the client has signed a written consent form
A nurse is screening donors for blood donation. Is a clinet who reports having a cold 1 month ago that resolved quickly, an acceptable donor?
Yes
