exam 5 AH prep U

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."

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

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'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 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 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 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

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

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

Hematocrit

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

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 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

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

Lymphocyte

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

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

Oral iron supplementation

Place the clotting cascade in the correct order.

Prothrombin activator Prothrombin Thrombin Fibrinogen Fibrin

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).

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

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

Splenectomy

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

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.

Which type of lymphocyte is responsible for cellular immunity?

T lymphocyte

Which cells are called white blood cells?

leukocytes

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 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

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 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 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