exam 5 AH prep U

An adult client reports that it is taking longer than usual for minor cuts and injuries to clot. Which of the following questions would the nurse most likely ask the client?

"Are you regularly taking aspirin?"

A patient will need a blood transfusion for the replacement of blood loss from the gastrointestinal tract. The patient states, "That stuff isn't safe!" What is the best response from the nurse?

"I understand your concern. The blood is carefully screened but is not completely risk free."

The nurse should provide further teaching about post bone-marrow biopsy procedures when the client makes which statement?

"I'll ask someone to drive me home when I awake from general anesthesia."

A nurse is caring for a client who will undergo total knee replacement and will have an autologous transfusion. Which statement will the nurse include when teaching the client about the transfusion?

"You typically donate blood 4 to 6 weeks before the surgery."

Which client is not a candidate for blood donation according to the American Heart Association?

26 year old female with hemoglobin 11.0 g/dL

A client with a history of congestive heart failure has an order to receive 1 unit of packed red blood cells (RBCs). If the nurse hangs the blood at 12:00 pm, by what time must the infusion be completed?

4pm

An instructor asks students approximately how long platelets last? What would the students correctly identify? Fill in the blank with a number.

7.5

A nurse is reviewing blood count values for a female client. Which value would necessitate notifying the client's health care provider?

70,000/mm3 platelets

A nurse is discussing the difference between blood and plasma with a client. Which best represents the components of plasma?

90% water, 10% proteins, blood cells, clotting factors, hormones, enzymes

Which cell types are produced from pluripotential stem cells?

All options are correct.

A physician has arrived on the floor to perform a bone marrow aspiration. The nurse first

Ensures that the client has signed the informed consent form

Which of the following reports from the client during the health history would lead the nurse to suspect that the client has a disorder of the hematopoietic or lymphatic system? Select all that apply.

Experiences prolonged bleeding from an obvious injury. Has unexplained blood loss, as in rectal bleeding, nosebleeds, bleeding gums, or vomiting blood. Feels fatigued with normal activities.

A patient has come to the Ob-Gyn clinic with complaints of a heavy menstrual flow. The nurse knows that red blood cell production will be increased in the patient's body. Because of this, the nurse is aware that the patient may need to increase her daily intake of what?

Iron

A client has a leukocyte count of 13,000/mm3. How would the nurse document the client's condition?

Leukocytosis

A nurse cares for several mothers and babies in the postpartum unit. Which mother does the nurse recognize as being most at risk for a febrile nonhemolytic reaction?

Rh-negative mother; Rh-positive child

A client's most recent blood work reveals low levels of albumin. This assessment finding should suggest the possibility of what nursing diagnosis?

Risk for imbalanced fluid volume related to low albumin

During physical examination, the nurse notes that a client's tonsils are touching. How would the nurse grade these findings?

Stage 4

Which term is used to refer to a primitive cell that is capable of self-replication and differentiation?

Stem cell

While caring for a client, the nurse notes petechiae on the client's trunk and lower extremities. What precaution will the nurse take when caring for this client?

Use an electric razor when assisting client with shaving.

A client's health history reveals daily consumption of two to three bottles of wine. The nurse should plan assessments and interventions in light of the client's increased risk for what hematologic disorder?

Anemia

75-year-old woman visited her health care provider for an annual check-up. She told the doctor that she feels exhausted all the time and barely has the energy to go out of her home, run errands, and visit friends. The nurse expects that the health care provider will order which of the following lab studies based on the most common hematologic condition affecting the elderly?

Complete blood count

Which term refers to the percentage of blood volume that consists of erythrocytes?

Hematocrit

A client with a hematologic disorder asks the nurse how the body forms blood cells. The nurse should describe a process that takes place where?

In the bone marrow

The nurse educating a client with anemia is describing the process of RBC production. When the client's kidneys sense a low level of oxygen in circulating blood, what physiologic response is initiated?

Increased production of erythropoietin

Which cell of hematopoiesis is responsible for the production of red blood cells (RBCs) and platelets?

Myeloid stem cell

Which type of white blood cell (WBC) is the most numerous?

NEUTROPHIL

Place the clotting cascade in the correct order.

Prothrombin activator Prothrombin Thrombin Fibrinogen Fibrin

Which of the following in a client's health history would the nurse recognize as potentially compromising the client's blood cell volume?

Splenectomy

A client is being treated for the effects of a longstanding vitamin B12 deficiency. What aspect of the client's health history would most likely predispose her to this deficiency?

The client is a vegan.

A client receives a blood transfusion after the nurse confirms a successful match. Which of the following conditions did the transfusion meet? Select all that apply.

The donor's and recipient's blood was type compatible. The donor's and recipient's blood was Rh compatible. The client and donor both had Rh negative blood.

Which cells are called white blood cells?

leukocytes

Which cells are also known as thrombocytes?

platelets

Which cells have the lifespan of approximately 7.5 days, and one-third of their population remains in the spleen (unless needed to fight significant bleeding)?

platelets

A nurse has participated in organizing a blood donation drive at a local community center. Which of the following individuals would most likely be disallowed from donating blood?

A woman whose blood pressure is 88/51 mm Hg

A client with Hodgkin disease had a bone marrow biopsy yesterday and reports aching at the biopsy site, rated a 5 (on a 1-10 scale). After assessing the biopsy site, which nursing intervention is most appropriate?

Administer acetaminophen 500 mg po, as ordered

Plasma proteins play an essential role in maintaining water balance and blood pressure. Select the laboratory analysis that a nurse should review to check the levels of the most abundant plasma protein.

Albumin

A nurse is assigned to care for a patient with ascites, secondary to cirrhosis. The nurse understands that the fluid accumulation 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 client has an increased number of eosinophils. Which of the following disorders would the nurse expect the client to have?

Allergy

A public health nurse is planning community teaching for a group of older adults regarding aging and hematological conditions. What condition will the nurse identify as most common among this population?

Anemia

A nurse is educating a client about the role of B lymphocytes. The nurse's description will include which of the following physiologic processes?

Antibody production

The physician performs a bone marrow biopsy from the posterior iliac crest on a client with pancytopenia. What intervention should the nurse perform after the procedure?

Apply pressure over the site for 5-7 minutes

A client's low hemoglobin level has necessitated transfusion of PRBCs. Prior to administration, what action should the nurse perform?

Assess the client's vital signs to establish baselines.

A client with a history of sickle cell anemia has developed iron overload from repeated blood transfusions. What treatment does the nurse anticipate will be prescribed?

Chelation therapy

A nurse is caring for a client with a low platelet count. The nurse understands that a low platelet count affects which of the following?

Clotting of blood

A volunteer wanting to donate blood for the first time wishes to know more about the various blood groups. The nurse educating the volunteer regarding the blood groups should mention which of the following as the determining factor that classifies blood into groups A, B, AB, and O?

Combinations of antigens and antibodies

A 66-year-old man underwent a successful partial gastrectomy for the treatment of stomach cancer 3 years ago. The man had a scheduled follow-up appointment with his primary caregiver and had blood work completed. The results of the man's blood work indicated anemia. The nurse who is contributing to the patient's care should recognize that this patient's anemia may be attributable to what factor?

Decreased vitamin B12 absorption

An 8-year-old client is scheduled to undergo a tonsillectomy for chronic tonsillitis. The symptoms given below are related to tonsil disorders. The nurse caring for this client should know that which of the following symptoms is specifically related to tonsillitis?

Difficulty swallowing

A client on the medical unit is receiving a unit of PRBCs. Difficult IV access has necessitated a slow infusion rate and the nurse notes that the infusion began 4 hours ago. What is the nurse's most appropriate action?

Discontinue the remainder of the PRBC transfusion and inform the health care provider.

A client needs increased production of red blood cells. Which of the following drugs would the nurse expect to be prescribed for the client?

Epoetin alfa

A client with severe anemia is admitted to the hospital. Because of religious beliefs, the client is refusing blood transfusions. The nurse anticipates pharmacologic therapy with which drug to stimulate the production of red blood cells?

Epoetin alfa

A client with chronic kidney disease has chronic anemia. What pharmacologic alternative to blood transfusion may be used for this client?

Erythropoietin

A client undergoing a complete blood cell (CBC) count for the detection of anemia wants to know more about hemoglobin. Which should the nurse explain to the client as being the main function of hemoglobin?

Gives its oxygen to cells of the body and picks up carbon dioxide

A nurse administers blood products to a client with Hodgkin disease. During the administration, the nurse notes the client has a fever and diffuse reddened skin rash. From what condition does the nurse suspect the client is suffering?

Graft-versus-host disease

The nurse is describing normal RBC physiology to a client who has a diagnosis of anemia. The nurse should explain that the RBCs consist primarily of which of the following?

Hemoglobin

A nurse is caring for a patient who has had a bone marrow aspiration with biopsy. What complication should the nurse be aware of and monitor the patient for?

Hemorrhage

The nurse is caring for a patient with a hematologic disorder. The patient asks the nurse where the body forms blood cells. Where should the nurse tell the patient that blood cells are formed?

In the bone marrow

The client's CBC with differential reveals small-shaped hemoglobin molecules. The nurse expects to administer which medication to this client?

Iron

A patient 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 patient for that can help prevent organ damage?

Iron chelation therapy

A client in acute renal failure has been prescribed 2 units of packed red blood cells (PRBCs). The nurse explains to the client that the blood transfusion is most likely needed for which reason?

Lack of erythropoietin

Which blood cell type is matched correctly with its function?

Leukocyte: Fights infection

Albumin is important for the maintenance of fluid balance within the vascular system. Albumin is produced by which of the following?

Liver

Immunity to a disease after recovery is possible because the first exposure to the pathogen has stimulated the formation of which of the following?

Lymphocyte

A client in critical condition arrives to the ED needing an immediate blood transfusion, but there isn't time to perform a type and crossmatch. Which blood type can be safely transfused until lab results are obtained?

O, RH negative

A client develops a hemolytic reaction to a blood transfusion. What actions should the nurse take after this occurs? Select all that apply.

Obtain appropriate blood specimens Collect a urine sample to detect hemoglobin Document the reaction according to policy

A nurse cares for an older adult client with acute myeloid leukemia (AML). What concept does the nurse understand leads to the increased risk of an older adult acquiring myeloid malignancies such as AML?

Older adults acquire damage to the DNA of stem cells over time.

The nurse is providing care for an older adult who has a hematologic disorder. What age-related change in hematologic function should the nurse integrate into care planning?

Older adults are less able to increase blood cell production when demand suddenly

A nurse cares for a client with iron-deficiency anemia. Which treatment will the nurse anticipate the client receiving?

Oral iron supplementation

Knowledge regarding hematopoiesis is essential in postsurgical client care. Which statement about the variation in the normal number of erythrocytes is true?

People who engage in strenuous activity have an increased number of erythrocytes.

A nurse is transfusing whole blood to a client with impaired renal function. During the transfusion, the client tells the nurse, "I feel very short of breath all of a sudden." What is the nurse's primary action?

Stop the infusion.

Place the following steps in order when determining the type and severity of a transfusion reaction. Use all options.

Stop the transfusion. Assess the client. Notify the health care provider. Notify the blood bank. Send the tubing and container to the blood bank.

Which type of lymphocyte is responsible for cellular immunity?

T lymphocyte

A nurse, caring for a client with human immunodeficiency virus (HIV), reviews the client's differential WBC count. What type of WBC will the nurse check the level of?

T lymphocytes

The nurse recognizes that the most common cause of iron deficiency anemia in an adult is

bleeding

A nurse in the ED is caring for a trauma client following a motor vehicle accident. The client's blood donor card indicates type AB blood. People with type AB blood are:

universal recipients.

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 extramedullary hematopoiesis?

Liver and spleen

Which term refers to a form of white blood cell involved in immune response?

Lymphocyte

The nurse is administering 2 units of packed RBCs to an older adult patient who has a bleeding duodenal ulcer. The patient begins to experience difficulty breathing and the nurse assesses crackles in the lung bases, jugular vein distention, and an increase in blood pressure. What action by the nurse is necessary if the reaction is severe? (Select all that apply.)

Place the patient in an upright position with the feet dependent. Discontinue the transfusion. Administer oxygen. Administer diuretics as prescribed.

While hospitalized, a client accidentally injures his finger and begins to bleed. What substance does the nurse recognize as naturally rushing to the site of injury before any other action takes place?

Platelets

A nurse is performing an initial assessment and notes the client's skin is a gray-tan color, especially on the scars of the client's arms. Which hematological condition does the nurse suspect?

Hemochromatosis

Which type of white blood cell (WBC) is the most numerous?

Neutrophil

The body responds to infection by increasing the production of white blood cells (WBCs). The nurse should evaluate the differential count for what type of WBCs, which are the first WBCs to respond to an inflammatory event?

Neutrophils

An individual has accidentally cut his hand, immediately initiating the process of hemostasis. Following vasoconstriction, what event in the process of hemostasis will take place?

Platelets will aggregate at the injury site.

The nurse is assisting with preparation for a client about to undergo a Schilling test. Which of the following actions by the nurse is correct?

Prepare to collect urine from the client for 24 to 48 hours.

An older adult client presents to the health care provider's office and reports exhaustion. The nurse, aware of the most common hematologic condition affecting the elderly, knows that which laboratory values should be assessed?

RBC count

A client's diagnosis of atrial fibrillation has prompted the primary care provider to prescribe warfarin, an anticoagulant. When assessing the therapeutic response to this medication, what is the nurse's most appropriate action?

Review the client's international normalized ratio (INR).

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?

Severed blood vessels constrict.

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?

Signs and symptoms of infection