HIV, Oncology, Hematology
The registered nurse is teaching a novice nurse about transfusion in older patients. Which statement by the novice nurse indicates effective learning?
"2 to 4 hours should be taken to administer one unit of blood."
The nurse is teaching a patient about induction therapy for acute leukemia. Which patient statement indicates a need for additional education?
"After this therapy, I will not need to have any more."
The provider has recommended chemotherapy for a patient diagnosed with chronic lymphocytic leukemia (CLL). What does the nurse tell the patient about this treatment?
"Chemotherapy may produce remission of CLL."
The nurse is assessing the endurance level of a patient in a long-term care facility. What question does the nurse ask to get this information?
"Do you feel more tired after you get up and go to the bathroom?"
The nurse is providing teaching for a patient who follows a lacto-ovo vegetarian diet. Which statement by the nurse is most appropriate regarding a sufficient intake of vitamin B 12?
"Egg yolks contain a high amount of vitamin B 12."
A patient who is scheduled to undergo bone marrow transplant will have high-dose chemotherapy followed by total body irradiation (TBI) just prior to the transplant. Which statement by the patient indicates a need for further teaching about the purpose of this therapy?
"Graft-versus-host disease will control the cancer."
The nurse is providing discharge teaching for a patient who has repeated vasoocclusive episodes caused by sickle cell disease (SCD). Which statement by the patient indicates a need for further teaching?
"I can drink beer in moderation."
What statement by a patient diagnosed with hemophilia indicates a need for further teaching?
"I have been flossing my teeth once a day."
The nurse is teaching a patient who has just been diagnosed with polycythemia vera (PV) about long-term management of this disease. Which statement by the patient indicates a need for further teaching?
"I should floss my teeth to promote good dental health."
The nurse is educating a patient who is taking an anticoagulant drug. Which patient statement indicates a need for further teaching?
"I should take aspirin whenever I have severe pain."
Which patient statement indicates that stem cell transplantation that is scheduled to take place in his home is not a viable option?
"I was a nurse, so I can take care of myself."
The nurse is providing teaching for a female patient diagnosed with hemophilia A. What statement by the patient indicates a need for further teaching?
"I will be able to use steroids to help my body create the clotting factors."
The registered nurse teaches a student nurse about the actions to be followed after an infusion of blood products. Which statement made by the student nurse shows ineffective understanding?
"I will monitor the vital signs of the patient after the transfusion."
The registered nurse teaches a student nurse about nursing actions to be taken before and during the transfusion therapy of pooled platelets in an older patient. Which statement made by the student nurse shows ineffective understanding?
"I will use a 2 hour infusion rate."
A hematology unit is staffed by RNs, LPN/LVNs, and unlicensed assistive personnel (UAP). When the nurse manager is reviewing documentation of staff members, which entry indicates that the staff member needs education about his or her appropriate level of responsibility and patient care?
"Patient reporting increased shortness of breath; oxygen increased to 4 L by nasal cannula. M.N., UAP"
The nurse is teaching a patient with newly diagnosed anemia about conserving energy. What should the nurse tell the patient? Select all that apply.
"Provide yourself with four to six small, easy-to-eat meals daily." "Stop activity when shortness of breath or palpitations are present." "Allow others to perform your care during periods of extreme fatigue." "Drink small quantities of protein shakes and nutritional supplements daily."
The nurse educator is teaching a nursing student about the transfusion of blood products. Which statement made by the student nurse regarding the transfusion of red blood cells indicates effective learning?
"Red blood cell transfusions should be completed within 4 hours of removal from refrigeration."
A nurse reports having withheld intravenous opioid pain medication from a young African American patient who has sickle cell disease (SCD). The nurse states that she believes the patient is addicted. What is the nurse manager's most appropriate response?
"The incidence of opioid addiction in SCD patients is actually rare."
A patient with leukemia is being discharged from the hospital. After hearing the nurse's instructions to keep regularly scheduled follow-up provider appointments, the patient says, "I don't have transportation." How does the nurse respond?
"The local American Cancer Society may be able to help."
The nurse is reinforcing information about genetic counseling to a patient with sickle cell disease (SCD) who has a healthy spouse. What information does the nurse include?
"The sickle cell trait will be inherited by your children."
The nurse is counseling an African American couple who both have hemoglobin S (HbS). What does the nurse tell this couple about the risk of sickle cell disease for their children?
"There is a 50% chance for each child to have the sickle cell trait."
A patient who is pregnant with a girl has a family history of hemophilia. The patient knows she is a carrier and is worried that her daughter will be a carrier and/or be hemophilic. What can the nurse tell her?
"There's a 50% chance she will be a carrier but is unlikely to be hemophilic."
A patient with thrombocytopenia is being discharged. What information does the nurse incorporate into the teaching plan for this patient?
"Use a soft-bristled toothbrush."
A patient recently diagnosed with polycythemia vera (PV) has a serum hemoglobin of 20 g/dL, elevated leukocytes and platelets, a purplish flushed appearance, and reports intense itching. A family member asks the nurse if the patient will get better. How does the nurse respond?
"With aggressive management, people can live for over 10 years."
A patient with multiple myeloma reports bone pain that is unrelieved by analgesics. How does the nurse respond to this patient's problem?
"Would you like to try some relaxation techniques?"
The nurse is counseling a 65-year-old patient diagnosed with a myelodysplastic syndrome who has severe pancytopenia and a high number of blast cells. The patient wants to know if this will eventually cause cancer. How does the nurse respond?
"You have a high risk for developing cancer.
What percentage of patients diagnosed with hemophilia account for the form of hemophilia called "Christmas disease"?
20%
A patient with anemia is prescribed a transfusion of packed red blood cells (PRBCs) to be administered over 4 hours. What is the approximate volume to be transfused?
200 to 250 mL
Which patient does the nurse assign as a roommate for the patient with aplastic anemia?
28-year-old with glucose-6-phosphate deficiency (G6PD) anemia who is receiving mannitol
A nurse is counseling a patient who wishes to donate blood for autologous use during surgery. The nurse advises the patient that the blood can be stored for how long?
40 days
A registered nurse (RN) from pediatrics has "floated" to the medical-surgical unit. Which patient should be assigned to the float nurse?
42-year-old with sickle cell disease receiving a transfusion of packed red blood cells
The nurse assesses the patient with which hematologic problem first?
81-year-old with thrombocytopenia and an increase in abdominal girth
Which patient is at highest risk for development of idiopathic thrombocytopenic purpura?
A 30-year-old female with Hashimoto's thyroiditis
The nurse is caring for four patients. Which patient should the nurse assess first?
A patient diagnosed with hemophilia who is complaining of knee pain
. What patient is at a lower risk for febrile transfusion reactions?
A patient receiving leukocyte-reduced red blood cell transfusion
Which patient is least likely to require red blood cell transfusion therapy?
A patient with a hemoglobin level of 8 g/dL.
What patient is an ideal candidate for plasma transfusion therapy?
A patient with a prothrombin deficiency
A patient who has chronic myelogenous leukemia (CML) is experiencing intermittent fevers, night sweats, and weight loss. The nurse explains to the patient that these symptoms indicate which phase of this type of leukemia?
Accelerated phase
Which type of leukemia most commonly has its onset during adulthood?
Acute myelogenous leukemia (AML)
A nurse is caring for a group of patients who are all about to receive transfusions. Which order requires correction?
Administer platelets with Ringer's lactate solution
A patient admitted to the hospital for vasoocclusive crisis with sickle cell disease (SCD) describes moderate to severe pain that is treated with intravenous opioid analgesics. The nurse notes that the provider has ordered routine administration of intravenous hydromorphone rather than a PRN schedule. Which action by the nurse is correct?
Administer the medication and monitor the patient's response
Which intervention may increase the risk of fluid overload during transfusion therapy in older adults?
Administering normal saline concurrently in a second intravenous site
Which description most accurately explains induction chemotherapy for the treatment of acute leukemia?
Aggressive combination of chemotherapy given to achieve a rapid, complete remission of symptoms
A patient develops urticaria, itching, bronchospasm, and anaphylaxis 24 hours after a blood transfusion therapy. What could be the possible reason behind this?
Allergic transfusion reactions
A patient reports severe chest pain, back pain, joint pain, hypertension, and redness of the head and neck after receiving a transfusion therapy. The primary health care provider diagnoses it as an acute pain transfusion reaction (APTR). Which drug therapy would be beneficial to the patient?
Analgesics
Which condition is contraindicated for acute normovolemic hemodilution autologous blood transfusion therapy?
Anemia
A diagnosis of autoimmune thrombocytopenic purpura is made after detection of what finding in the blood?
Antiplatelet antibodies
The nurse is caring for a female patient who has been receiving prophylactic heparin following surgery 10 days ago. The patient has swelling and tenderness in the right leg, and laboratory results show low platelets. What drugs are most likely to be prescribed for this patient? Select all that apply.
Argatroban (Acova) Lepirudin (Refludan)
A patient who has had stem cell implantation after unsuccessful chemotherapy with an alkylating agent has had a sudden increase in weight. Which physical assessment does the nurse expect in this patient?
Ascites with right upper quadrant pain
A patient is being treated for thrombotic thrombocytopenic purpura. What does the nurse anticipate administering to reduce the clumping of the platelets? Select all that apply.
Aspirin Alprostadil
Which nursing intervention is priority when caring for a patient diagnosed with thrombotic thrombocytopenic purpura?
Assessing for headache and confusion
Which disorder causes antiplatelet antibody formation even when platelet production is normal?
Autoimmune thrombocytopenic purpura
A patient with leukemia is undergoing hematopoietic stem cell transplantation using stem cells harvested from the patient prior to high-dose chemotherapy. Which type of transplantation procedure is being used for this patient?
Autologous
What interventions does the nurse include when planning care for a patient diagnosed with thrombocytopenia? Select all that apply.
Avoid venipuncture Apply ice to areas of trauma Use the smallest gauge needle possible
Which type of unrelated transplant donor matches are most difficult to find for African American patients?
Bone marrow
.A 56-year-old patient admitted with a diagnosis of acute myelogenous leukemia (AML) is prescribed intravenous cytosine arabinoside for 7 days and an infusion of daunorubicin for the first 3 days. What is the major side effect of this therapy?
Bone marrow suppression
A 56-year-old patient admitted with a diagnosis of acute myelogenous leukemia (AML) is prescribed intravenous cytosine arabinoside for 7 days and an infusion of daunorubicin for the first 3 days. An infection develops. What knowledge does the nurse use to determine that the appropriate antibiotic has been prescribed for this patient?
Checking the culture and sensitivity test results
An older adult who is receiving rapid a whole blood transfusion develops hypertension, bounding pulse, distended neck veins, and confusion. What could be the cause of the patient's condition?
Circulating overload
The student nurse starts the infusion of packed red blood cells in a patient who is already on intravenous (IV) antibiotic therapy; the infusion goes through the same IV line. What complication would be expected?
Clotting
A patient develops fever, chills, and shock rapidly after initiation of infusion therapy. The primary health care provider diagnoses the condition as a bacterial infection and advises termination of the therapy. Which assessment finding supports the diagnosis?
Cloudiness of the product in the blood bag
Which laboratory parameter helps to differentiate between classic hemophilia and Christmas disease?
Coagulation factor
Which symptom is a sign that the patient is experiencing circulatory overload when receiving a blood transfusion?
Confusion
While caring for a patient diagnosed with hemophilia, the nurse notices swelling around the ankle and knee. What action should the nurse take first?
Contact the health care provider
The nurse is caring for a patient diagnosed with idiopathic thrombocytopenic purpura (ITP). The patient's platelet count is 38,000/mm 3. What treatment does the nurse anticipate for this patient?
Corticosteroids
What laboratory reports should be assessed for complications secondary to thrombotic thrombocytopenic purpura? Select all that apply.
Creatinine Blood urea nitrogen (BUN)
The nurse is teaching a patient with vitamin B 12 deficiency anemia about dietary intake. Which type of food does the nurse encourage the patient to eat?
Dairy products
Which laboratory value may be normal for an asymptomatic patient with sickle cell disease (SCD) during non-sickle cell crisis times?
Decreased hematocrit
The registered nurse teaches a student nurse about nursing interventions to be taken before starting transfusion therapy. Which intervention made by the student nurse shows ineffective understanding?
Diluting the blood products with normal saline before infusing
A patient diagnosed with septic shock should be assessed for which complication?
Disseminated intravascular coagulation
The nurse is caring for a patient diagnosed with septic shock. The patient develops bleeding from puncture sites after a blood draw. What complications does the nurse suspect?
Disseminated intravascular coagulation
What are the risk factors for the development of leukemia? Select all that apply.
Down syndrome Correct2 Ionizing radiation Chemical exposure Bone marrow hypoplasia
Which factor is a possible cause of sickle cell crisis in a patient with sickle cell disease?
Dysuria with cloudy urine
A patient with leukemia has a blood pressure of 170/95 mm Hg along with a bounding pulse. The nurse suspects that these findings are most likely related to which hematologic changes in this patient?
Elevated white blood cells
The nurse is caring for a patient with polycythemia vera. Which nursing intervention is a priority for this patient?
Elevating the feet while sitting
Which intervention most effectively protects a patient with thrombocytopenia?
Encouraging the use of an electric shaver
A patient who has undergone bone marrow transplantation 21 days prior is receiving growth factors. The patient's blood test reveals mixed chimerism with a greater percentage of donor cells than 1 week prior. How does the nurse interpret this result?
Engraftment appears to be successful.
A 50-year-old patient is diagnosed with chronic myelogenous leukemia (CML) and is told that the disease is in the chronic phase. The nurse notices that the patient has been crying and appears anxious. Which action by the nurse is correct?
Explore the patient's feelings about the diagnosis and expectations for the future
What risk factors are associated with higher incidence of development of heparin-induced thrombocytopenia in patients?
Exposure to unfractionated heparin
Which signs are neurologic manifestations of acute leukemia? Select all that apply.
Fever Fatigue Headache
A patient is prescribed a 200 mL infusion of packed red blood cells to be administered over 2 hours. What would be the consequence if the blood product is diluted with normal saline and infused at a rate of 3 mL/min?
Fluid overload
What intervention performed during a transfusion reaction may further complicate the condition?
Flushing the intravenous contents of the tubing with normal saline before removing
The primary health care provider prescribes a blood transfusion for a patient with anemia. What would be the consequences if the blood transfusion is performed along with the administration of lactated Ringer's solution? Select all that apply.
Formation of clots Destruction of red blood cells
Which statement indicates a failure of blood clotting as a result of hemophilia?
Formation of the fibrin mesh is inadequate to stop the bleeding.
The nurse is caring for a patient with sickle cell disease (SCD). Which action is most effective in reducing the potential for sepsis in this patient?
Frequent and thorough handwashing
Which blood product may be administered to a patient diagnosed with thrombotic thrombocytopenic purpura?
Fresh frozen plasma
An African American patient taking a thiazide diuretic develops hemolytic anemia. The nurse notifies the provider and anticipates an order to test this patient for which type of anemia?
G6PD deficiency
The nurse is educating a group of young women who have sickle cell disease (SCD). Which comment from a class member requires correction?
Getting an annual 'flu shot' would be dangerous for me."
The nurse is teaching the family and patient newly diagnosed with leukemia about the disease's complications and its treatment. Which teaching point is essential for the nurse to emphasize?
Handwashing
Which drug has a recombinant antihemophilic factor?
Helixate FS
What laboratory reports should be used to assess a patient diagnosed with idiopathic thrombocytopenic purpura who is symptomatic? Select all that apply.
Hematocrit Hemoglobin
What findings indicate significant blood loss in a patient diagnosed with idiopathic thrombocytopenic purpura? Select all that apply.
Hematocrit 25% Hemoglobin 9 g/dL
Which changes should be monitored during the first 15 to 30 minutes in a patient who is undergoing blood transfusion?
Hemolytic reaction
What type of transfusion reaction is characterized by disseminating intravascular coagulation?
Hemolytic transfusion reactions
A patient diagnosed with acute liver failure should be assessed for what coagulation disorder?
Hemophilia
Which clotting disorder may be caused by X-linked inheritance?
Hemophilia A
A patient with leukemia who is undergoing chemotherapy reports increasing fatigue. A family member tells the nurse that the patient has difficulty eating and asks what the patient should eat to help improve energy. What does the nurse recommend for this patient?
High-carbohydrate and high-protein foods
A patient with a large, painless lymph node has a biopsy that reveals Reed-Sternberg cells. Which form of cancer does this finding indicate?
Hodgkin's lymphoma
Which antihemophilic drug is obtained from animal serum?
Hyate: C
A 32-year-old patient is recovering from a sickle cell crisis. His discomfort is controlled with pain medications, and he is to be discharged. What medication does the nurse expect to be prescribed for the patient before discharge?
Hydroxyurea
An 82-year-old patient with anemia is requested to receive 2 units of whole blood. Which assessment findings cause the nurse to discontinue the transfusion because it is unsafe for the patient? Select all that apply.
Hypotension Hypertension Rapid, bounding pulse
A patient presents to the emergency department with a new onset of bruising and a petechial rash around the upper chest and arms. The patient's lab demonstrates a platelet count of 51,000 platelets per milliliter. What action by the nurse is most appropriate?
Implement bleeding precautions
A patient with iron deficiency anemia has a prescription for ferrous sulfate. Which finding by the nurse indicates a positive outcome from the medication?
Increased energy
Which assessment finding is consistent with polycythemia vera (PV)?
Increased hematocrit
Which laboratory value indicates hemophilia?
Increased partial thromboplastin time
Which statements are true regarding blood group compatibility? Select all that apply.
Individuals with a positive Rh factor have the Rh antigen. Individuals with blood type A have A antigens and anti-B antibodies. Individuals with blood type B have B antigens and anti-A antibodies.
A patient who has been newly diagnosed with leukemia is admitted to the hospital. Avoiding which potential problem takes priority in the patient's nursing care plan?
Infection
In caring for a patient with sickle cell disease, what does the nurse suggest can help with preventing future sickle cell crises?
Influenza vaccine
A nurse is caring for a patient who received a blood transfusion four hours ago and is experiencing shortness of breath. Oxygen saturation is at 89%. What is the nurse's priority intervention?
Inform the physician and prepare for intubation
The nurse is infusing platelets to a patient who is scheduled for a hematopoietic stem cell transplant (HSCT). What procedure does the nurse follow?
Infuse the transfusion over a 15- to 30-minute period.
The nurse is assessing a patient who will be undergoing a hematopoietic stem cell transplantation. The medical history of the patient shows past allergic reactions to this type of transfusion therapy. What would be the correct line of treatment?
Infusion of leukocyte-reduced red blood cells
A patient diagnosed with thrombocytopenia is advised transfusion therapy with platelets from a single donor. Which nursing intervention helps in improving the effectiveness of the therapy?
Initiating the therapy immediately after receiving the product
A recently admitted patient who is in sickle cell crisis requests "something for pain." What does the nurse administer?
Intravenous (IV) hydromorphone
What medication is used to prevent the destruction of antibody-coated platelets in a patient with idiopathic thrombocytopenic purpura?
Intravenous (IV) immunoglobulin
A nurse is caring for a patient who has weakness, pallor, fatigue, reduced exercise tolerance, and fissures at the corners of the mouth. The nurse recognizes these symptoms are associated with which condition?
Iron deficiency anemia
Which clinical manifestations are associated with sickle cell crisis in a patient with sickle cell disease? Select all that apply.
Jaundice Pallor Dyspnea Joint pain
What symptom is priority for the nurse to assess for in a patient diagnosed with hemophilia A?
Joint swelling
What are serious side effects of hydroxuria prescribed for a patient with sickle cell anemia? Select all that apply.
Leukemia Bone marrow suppression
Which organ systems are usually the first to sustain long-term damage as a result of vasoocclusive crises associated with sickle cell disease? Select all that apply.
Liver Spleen
What findings are consistent with a diagnosis of hemophilia? Select all that apply.
Long-term joint problems Tendency to bruise easily Excessive bleeding from minor cuts
What clinical manifestation is associated with hemolytic transfusion reactions?
Low back pain
What findings are consistent with a diagnosis of idiopathic thrombocytopenic purpura (ITP)? Select all that apply.
Low platelet count Antiplatelet antibodies High megakaryocyte count
What should be assessed when ruling out intracranial bleeding in a patient diagnosed with idiopathic thrombocytopenic purpura (ITP)? Select all that apply.
Mental status Neurologic function
A patient who is donating stem cells via apheresis reports tingling in the fingers and toes and muscle cramping. Which action by the nurse is correct?
Monitor the patient closely for symptoms of hypotension
The patient with which condition is at increased risk for developing cancer later in life?
Myelodysplastic syndrome
A patient will undergo testing of an involved lymph node, lactate dehydrogenase (LDH) levels, and beta2-microglobulin levels based on the World Health Organization (WHO) classification system. Which medical condition does the nurse suspect the patient has?
Non-Hodgkin lymphoma (NHL)
Which intravenous solution is compatible for administration with blood products?
Normal saline
The nurse is assessing a newly admitted patient with thrombocytopenia. Which factor needs immediate intervention?
Nosebleed
The nurse knows that a patient with a B-negative blood type can receive which blood product?
O-negative
A patient with leukemia has a platelet count of 7000/mm 3. Which intervention does the nurse implement to prevent injury?
Obtain an order for stool softeners
The nurse is caring for a patient with neutropenia who has a suspected infection. Which intervention does the nurse implement first?
Obtain requested cultures
Which would be an appropriate task to delegate to unlicensed assistive personnel (UAP) working on a medical-surgical unit?
Obtaining vital signs on a patient receiving a blood transfusion
What is a possible complication if a filtered, straight, long tubing with a 19-gauge needle is used to transfuse pooled platelets?
Occlusion of the lumen of tubing
The nurse is caring for a patient with sickle cell disease. Which drug in the patient's care plan indicates the need to carefully watch the patient's behavior?
Opioids
A patient complains of cold intolerance, severe fatigue, and difficulty breathing. While taking the history of the patient, it is revealed that she has been experiencing excessive menstrual bleeding for a few months and has no history of allergic response. A complete blood count shows 5 g/dL of hemoglobin and a platelet count of 50,000 mm 3. Which type of transfusion is needed for the patient in the given scenario?
Packed red blood cells
Which assessment findings are consistent with a diagnosis of leukemia? Select all that apply.
Pallor Brown urine Frequent colds Multiple bruises
What are the typical clinical manifestations of anemia? Select all that apply.
Pallor Tachycardia Fatigue Dyspnea on exertion
Which patient's data indicates that the patient is in danger?
Patient A
Which patient does the nurse identify as at risk for iron deficiency anemia?
Patient who has undergone a Roux-en-Y procedure for obesity
Which patient does the nurse consider at risk for folic acid deficiency anemia?
Patient with Crohn's disease
A 32-year-old patient recovering from a sickle cell crisis is to be discharged. The nurse says, "You and all patients with sickle cell disease are at risk for infection because of your decreased spleen function. For this reason, you will most likely be prescribed an antibiotic before discharge." Which drug does the nurse anticipate the health care provider will request?
Penicillin V
A patient with leukemia has raised red spots on the legs, but the nurse notes no injury or trauma. How does the nurse identify this finding?
Petechiae
The nurse is caring for a patient diagnosed with idiopathic thrombocytopenic purpura (ITP). What manifestations of this diagnosis should the patient be assessed for? Select all that apply.
Petechiae Ecchymosis Mucosal bleeding
A patient with neutropenia who is receiving amphotericin B therapy is prescribed white blood cell (WBC) transfusion therapy. Which intervention needs correction?
Placing a long filtered tubing for infusion
Which clotting factor is deficient in patients with hemophilia B?
Plasma thromboplastin
Which type of transfusion is preferred to replace blood volume and clotting factors?
Plasma transfusions
Where are the level defects that cause coagulation disorders? Select all that apply.
Platelet Vascular Clotting factor
What treatment does the nurse anticipate for a patient with a platelet count of 8,000 mm 3?
Platelet transfusion
Which types of transfusions do not require the recipient and donor to have the same blood type? Select all that apply.
Platelet transfusions white blood cell transusions
4. A nurse is caring for a patient with a gastrointestinal (GI) bleed and a history of thrombocytopenia. The physician orders a transfusion. The nurse prepares for which type of transfusion?
Platelets
The nurse is caring for a patient diagnosed with autoimmune idiopathic thrombocytopenic purpura (ITP). The patient's platelet count is 6,000/mm 3. What treatment should be administered first?
Platelets
A patient has aplastic anemia. The nurse regularly assesses which diagnostic test results? Select all that apply.
Platelets White blood cells Hemoglobin/hematocrit
A patient who is actively bleeding has a platelet count of 40,000 per microliter of blood. The patient has a history of febrile transfusion reactions. Which blood product would be safe for transfusion in this patient?
Platelets from a single donor
What vaccinations are recommended for a patient who is scheduled for a splenectomy? Select all that apply.
Pneumococcal Meningococcal Haemophilus influenza
Which transfusion procedure often causes transfusion-induced reactions like fever and chills?
Pooled donor platelet transfusion
Which type of transfusion therapy may be safe even if the ABO factors are incompatible?
Pooled platelets
What is the focus of management of thrombotic thrombocytopenic purpura (TTP)? Select all that apply.
Prevention of platelet clumping Stopping the autoimmune process
What lab result would the nurse expect to find in a patient diagnosed with hemophilia A?
Prolonged activated partial thromboplastin time (aPTT)
The nurse is caring for a patient who is in sickle cell crisis. Which nursing action is a priority?
Provide pain medications as needed
A patient with leukemia will begin induction therapy with a combination of chemotherapeutic agents. The nurse explains to the patient that induction therapy has which treatment goal?
Remission of all disease manifestations
Which nursing intervention is effective in helping promote peripheral perfusion in a patient who has sickle cell disease?
Remove constrictive clothing
A patient diagnosed with thrombotic thrombocytopenic purpura should be assessed for which complications? Select all that apply.
Renal failure Myocardial infarction Cerebrovascular accident
The complete blood count results for a patient with acute myelogenous leukemia shows a platelet count of 40,000/mm 3. Which activity would the nurse instruct the patient to perform?
Report any abdominal distention immediately
A patient with leukemia is admitted to the hospital with a temperature of 97.8° F (36.6° C). Later that evening, the patient's temperature is 99.0° F (37.2° C). Which action by the nurse is correct?
Report the temperature increase to the provider
A patient who had gastrointestinal surgery has an oxygen saturation of 91%, a heart rate of 98 beats/min, and dyspnea with mild exertion, but has clear breath sounds and a normal respiratory effort. The patient's nail beds are pale. Which action does the nurse take next?
Request an order for a complete blood count
What is the priority for the nurse in caring for a patient with sickle cell anemia who is in crisis?
Restoring tissue perfusion
The nurse is to administer packed red blood cells to a patient. How does the nurse ensure proper patient identification?
Reviews all information with another registered nurse
The nurse is providing teaching to a patient scheduled for a splenectomy secondary to idiopathic thrombocytopenic purpura (ITP). What teaching is priority?
Risk for infection
The nurse is caring for a patient with multiple sclerosis who presents with a petechial rash on the upper chest and neck. Laboratory results show low platelets, hemoglobin, and hematocrit, as well as high megakaryocytes in the bone marrow. What drugs are most likely to be prescribed for this patient? Select all that apply.
Rituximab (Rituxan) Azathioprine (Imuran)
The nurse is teaching a patient with iron deficiency anemia about increasing the intake of dietary iron. The nurse considers the teaching successful when the patient makes which food selection?
Roast beef
A patient has been diagnosed with immunohemolytic anemia. What does the nurse anticipate administering to the patient to treat this disorder?
Steroids
What treatment does the nurse expect a patient diagnosed with hemophilia to receive?
Synthetic factor VIII
The nurse is preparing to administer a bone marrow transplant using peripheral blood stem cells (PBSCs) to a patient with leukemia. Which action is necessary for safe administration of this product?
Thawing the peripheral blood stem cells prior to infusion
The nurse finds that the contents of the blood bag are cloudy and discolored and observes the presence of gas bubbles. What would the nurse infer from these findings? Select all that apply.
The blood bag has bacterial growth The contents of the blood bag are hemolyzed
A patient is prescribed anti Rh-immunoglobulin (RHoGAM) immediately after the delivery of her baby. What could have been the assessment?
The patient is Rh-negative and the baby is Rh-positive.
Which patient is at increased risk for development of hemophilia?
The son of the woman who is a carrier
What disorder is classified by less than 150,000 platelets per microliter?
Thrombocytopenia
Which platelet disorder involves the failure of blood to clot after a trauma, in spite of having the ability to form blood clots?
Thrombotic thrombocytopenic purpura
A patient who has undergone stem cell transplantation develops graft-versus-host disease (GVHD) and is prescribed cyclosporine. The nurse teaches the patient that this drug is given for which purpose?
To inhibit immune activity of donor T-cells
Why is filtered tubing used during infusion of blood products?
To remove aggregates
A 35-year-old female complains of bruises on her legs, arms, and thighs and has heavy menstrual bleeding. While taking the medical history of patient, the nurse finds that the patient had a history of frequent nose and gum bleeding. A complete blood count revealed the platelet count to be 10,000 mm 3. What should be the immediate intervention given to the patient?
Transfusing platelets
A patient reports anorexia, nausea, and vomiting. The laboratory findings of the patient show decreased levels of platelets and chronic hepatitis. The patient had received transfusion therapy 2 weeks before the manifestations appeared. What could be the possible reason behind the patient's condition?
Transfusion-associated graft-versus-host disease (TA-GVHD)
What type of transfusion reaction can be prevented by using irradiated blood products?
Transfusion-associated graft-versus-host disease (TA-GVHD)
What type of transfusion reaction is characterized by rapid onset of dyspnea and hypoxia within 6 hours of transfusion?
Transfusion-related acute lung injury (TRALI)
A patient who has undergone an allogeneic stem cell transplant is showing regressive chimerism 4 weeks after the graft. The nurse anticipates preparing the patient for which procedure?
Transplantation of more stem cells
A patient has a glucose-6-phosphate dehydrogenase (G6PD) deficiency. The nurse teaches the patient to avoid which substance?
Trimethoprim-sulfamethoxazole
The nurse is teaching a patient about pharmacologic and nonpharmacologic pain management during a sickle cell crisis. Which method does the nurse encourage?
Use a warm compress on swollen joints
A patient develops chills, tachycardia, fever, hypotension, and tachypnea after the initiation of blood infusion therapy, due to anti-white blood cell (WBC) antibodies. What intervention before initiation of the therapy could have minimized the risk of this complication?
Using WBC reduced blood
A patient's laboratory report shows increased potassium serum levels after receiving whole-blood transfusion therapy. Which nursing intervention might have caused hyperkalemia?
Using an intravenous catheter smaller than 22-guage
Which nursing action during the transfusion therapy of fresh frozen plasma may lead to complications?
Using small filters with shorter tubing
A patient diagnosed with idiopathic thrombocytopenic purpura is scheduled for a splenectomy. What interventions are priority?
Vaccinations two weeks prior to surgery
What is the priority action performed by the nurse to avoid blood transfusion complications?
Verify the patient's name and number, check blood compatibility, and note the expiration date.
The nurse is mentoring a recent graduate RN about administering blood and blood products. What does the nurse include in the data?
Verify with another RN all of the data on blood products.
What trigger is suspected in the production of autoimmune antibodies in autoimmune thrombocytopenic purpura?
Virus
A patient has pallor; jaundice; a smooth, beefy-red tongue; has been experiencing difficulty with balance and reports tingling of the hands and feet. The patient's lab work indicates macrocytic anemia. The nurse notifies the provider of these findings and anticipates an order for which medication?
Vitamin B 12
While performing an admission assessment on a 55-year-old woman, the nurse notes a serum hemoglobin level that indicates anemia. What does the nurse ask this patient about first?
Whether she has noticed blood in her stools
Which type of transfusion requires more stringent monitoring every 15 minutes throughout the transfusion?
White blood cell transfusions
