Med-Surg Chpt 11,27,28
The nurse is caring for a patient with chronic episodes of hypoxia secondary to chronic obstructive pulmonary disease. The nurse will monitor the patient's laboratory results for increased RBCs due to the low oxygen levels. Which of the following blood disorders will the nurse expect to find? A. Aplastic anemia B. DIC C. Chronic lymphatic leukemia (CLL) D. PV
A. Aplastic anemia
The nurse is providing education to a patient taking tamoxifen (Nolvadex). Which topic should the nurse include in the teaching? A. Avoid antacids within 2 hours of tamoxifen. B. Take with mesna (Mesnex) to protect the bladder. C. Monitor daily weights. D. Watch for changes in neurologic status.
A. Avoid antacids within 2 hours of tamoxifen.
The nurse is caring for a patient who has been recently diagnosed with aplastic anemia. Which of the following are indicators of this disease process? (Select all that apply.) A. Bone marrow that is pale, fatty, and fibrous B. A CBC with all low values C. Presence of Reed-Sternberg cells D. Decreased serum iron levels E. Increased total iron-binding capacity (TIBC)
A. Bone marrow that is pale, fatty, and fibrous B. A CBC with all low values E. Increased total iron-binding capacity (TIBC)
The nurse is caring for a patient who has CLL when the patient suddenly develops petechiae, nausea, and severe back pain. The nurse recognizes this life-threatening event as which of the following? A. DIC B. Sickle cell crisis C. Thrombocytopenia D. Pancytopenia
A. DIC
The nurse is preparing to teach a client with microcytic hypochromic anemia about the diet to follow after discharge. Which of the following foods should be included in the diet? A. Eggs B. Lettuce C. Citrus fruits D. Cheese
A. Eggs
The nurse is providing education to the patient with the nursing diagnosis of impaired oral membrane integrity related to chemotherapy and pancytopenia. The nurse is aware that the patient understands the teaching by which of the following actions? A. The patient keeps her dentures in at all times except for cleaning. B. The patient chooses orange juice and hot coffee for breakfast. C. The patient avoids smoking and commercial mouthwash. D. The patient chooses ice cream and popsicles for between-meal snacks.
A. The patient keeps her dentures in at all times except for cleaning.
The nurse caring for a patient with chronic leukemia in an acute care setting. The patient asks the nurse to observe the patient's last bowel movement as it is very dark. The nurse immediately contacts the primary health care provider (HCP). What would explain the nurse's action? A. The patient may have a gastrointestinal bleed. B. The patient may have overdosed on iron supplements. C. The patient is most likely severely dehydrated. D. The patient is ready for discharge to home.
A. The patient may have a gastrointestinal bleed.
A patient is diagnosed with a malignant tumor of the bone. Which term should the nurse consider when documenting this patient's health problem? A. Sarcoma B. Osteoma C. Adenoma D. Carcinoma
A. Sarcoma
The nurse is teaching a patient with sickle cell anemia how to prevent crises. Which foods should the nurse teach the patient to avoid? a. Citrus fruits b. Alcoholic beverages c. Chocolates and colas d. Whole grain products
B. Alcoholic beverages
The nurse is concerned that a patient is demonstrating signs of red blood cell production. What laboratory value did the nurse most likely use to make this decision? A. Iron B. Bilirubin C. Thrombin D. Intrinsic factor
B. Bilirubin
A client with microcytic anemia is having trouble selecting food items from the hospital menu. Which food is best for the nurse to suggest for satisfying the client's nutritional needs and personal preferences? A. Egg yolks B. Brown rice C. Vegetables D. Tea
B. Brown rice
The nurse is caring for a patient with thrombocytopenia. Which of the following products would the nurse anticipate being prescribed? A. Albumin B. Cryoprecipitate C. Lactated Ringer's D. Packed RBCs
B. Cryoprecipitate
The nurse is caring for the patient who recently underwent a colectomy due to a bowel perforation and peritonitis. The nurse is preparing to administer the anticoagulant heparin to prevent which of the following blood disorders? A. PV B. DIC C. Pancytopenia D. Thrombocytopenia
B. DIC
The nurse is providing education to a patient newly diagnosed with iron deficiency anemia. Which of the following would be a component of the education? A. Avoid green leafy vegetables as they will counteract the medication. B. Include citrus fruits while taking the medication for the disorder C. Avoid immunizations with live viruses for 3 months. D. Avoid intramuscular (IM) injections while on the medication.
B. Include citrus fruits while taking the medication for the disorder
A patient on chemotherapy after surgery develops thrombocytopenia. Which manifestation should the nurse report immediately to the physician? A. Headache B. Tarry stools C. Pain at the surgical site D. Blood pressure 136/88 mm Hg
B. Tarry stools
The nurse is providing care to the patient with suspected aplastic anemia. The HCP has completed a bone marrow biopsy. Which of the following would be a description of the bone marrow that would signify a positive diagnosis of aplastic anemia? A. The bone marrow is red and gelatinous. B. The bone marrow is pale, fatty, and fibrous. C. The bone marrow is thin and serosanguinous. D. The bone marrow is pale pink and serous.
B. The bone marrow is pale, fatty, and fibrous.
The nurse is assisting the patient with multiple myeloma in arranging a meal plan to lower the risk of complications from hypercalcemia. Which of the following would be the most important component of the patient's intake? A. The patient should increase intake of fresh fruits. B. The patient should increase intake of fluids. C. The patient should decrease intake of red meat. D. The patient should avoid alcoholic beverages.
B. The patient should increase intake of fluids.
The nurse is providing a blood transfusion and sets the infusion pump to run at 300 mL/hr for 15 minutes. What is the amount of blood that will be transfused at that time (in mL)?
75
The nurse is triaging several patients in an urgent care center. One patient states that he has hemophilia and is bleeding, with no apparent signs of bleeding. Which action by the nurse is most appropriate at this time? A. Palpate the suspected area of bleeding for tenderness and edema. B. Have the patient take a number and stay in the waiting area. C. Place the patient in an examination room immediately and notify the physician of a potential bleeding crisis. D. Send the patient for routine x-rays to locate the source of bleeding and place him in an examination room.
C. Place the patient in an examination room immediately and notify the physician of a potential bleeding crisis.
The nurse is caring for a patient with lung cancer who reports chest pain, dyspnea, facial redness, and swollen neck veins. Which oncological emergency does the nurse suspect this patient is experiencing? A. Thrombocytopenia B. Spinal cord compression C. Superior vena cava syndrome (SVCS) D. Hypercalcemia
C. Superior vena cava syndrome (SVCS)
The nurse is caring for the patient who is 1 day status postsplenectomy. The patient complains of pain with breathing especially with inspiration. What would be the most appropriate nursing intervention for this patient? A. Medicate with opioids for pain and assist the patient to deep breathe, cough, and ambulate. B. Contact the surgeon to obtain orders for a nebulizer treatment from respiratory therapy. C. Provide the patient with a heating pad alternated with a cold pack for incisional pain. D. Contact the surgeon to request a chest x-ray and a laboratory draw for CBC with differential.
A. Medicate with opioids for pain and assist the patient to deep breathe, cough, and ambulate.
The nurse is caring for a patient with a bleeding disorder. Which manifestation might first alert the nurse to the possibility of disseminated intravascular coagulation? a. Petechiae b. Absence of pulses in extremities c. Weakness or paralysis on one side d. Increasing blood pressure and pulse
A. Petechiae
The nurse is preparing an oral chemotherapeutic medication for a patient's cancer treatment. What should the nurse do to ensure personal safety when preparing this medication? A. Wear gloves while preparing. B. Wash hands before administering. C. Apply a lead apron when providing. D. Crush the medication before providing.
A. Wear gloves while preparing.
The nurse is caring for a patient with a clotting disorder. Which blood product should the nurse anticipate being prescribed? a. Albumin b. Normal saline c. Cryoprecipitates d. Packed WBCs
C. Cryoprecipitates
The nurse is providing care to the patient who has arrived at the clinic to discuss his diagnostic results. The HCP suspects multiple myeloma. Which of the following results may confirm the HCP's suspicions? (Select all that apply.) A. Reed-Stenberg cells are present in the bone marrow. B. Magnetic resonance imaging (MRI) shows diffuse osteoporosis in the bones. C. Blood chemistries reveal an increase in serum calcium. D. Lymph node biopsies reveal Philadelphia chromosome. E. Blood and urine studies are positive for M-type globulins.
B. Magnetic resonance imaging (MRI) shows diffuse osteoporosis in the bones. C. Blood chemistries reveal an increase in serum calcium. E. Blood and urine studies are positive for M-type globulins.
The nurse is caring for a patient who is prescribed cyclophosphamide (Cytoxan). Which medication should the nurse expect to administer to protect the bladder? A. Dexrazoxane (Zinecard) B. Mesna (Mesnex) C. Filgrastim (Neupogen) D. Doxorubicin (Adriamycin)
B. Mesna (Mesnex)
A patient with cancer is scheduled for palliative surgery. Which explanation should the nurse use to describe the purpose of this surgery? A. Palliative surgery is done to reconstruct tissues damaged by the cancer. B. Palliative surgery is done to increase the patient's comfort when cure is not possible. C. Pallative surgery is done to remove a cancer completely and increase the chances for care. D. Pallative surgery is done to remove surrounding limph nodes, reducing the risk for spread of the primary tumor.
B. Palliative surgery is done to increase the patient's comfort when cure is not possible.
Which of the following foods would the nurse encourage the mother to offer to her child with iron deficiency anemia? A. Rice cereal, whole milk, and yellow vegetables B. Potato, peas, and chicken C. Macaroni, cheese, and ham D. Pudding, green vegetables, and rice
B. Potato, peas, and chicken
he nurse is caring for a patient with a folic acid deficiency. What foods should the nurse encourage the patient to improve this deficiency? (Select all that apply.) A. Almond milk and toasted white bread B. Split pea soup with whole grain crackers C. Garden salad with green leafy vegetables D. Cereals made with fortified grain and wheat germ E. Yogurt and aged cheeses with crackers
B. Split pea soup with whole grain crackers C. Garden salad with green leafy vegetables D. Cereals made with fortified grain and wheat germ
What is a grave disease process in which the patient experiences both bleeding and intravascular clotting at the same time?
Disseminated intravascular coagulation (DIC)
When inspecting the IV site of a patient receiving a vesicant chemotherapy agent, the licensed practical nurse (LPN) notes a small area of swelling. What should the LPN do first? A. Check the site every hour. B. Document the finding in the chart. C. Discontinue the infusion and notify the registered nurse (RN). D. No action is needed; this is an expected finding.
C. Discontinue the infusion and notify the registered nurse (RN).
The nurse is assisting in the development of a care plan for a patient with pernicious anemia. Which of the following would be the most common nursing diagnosis with this medical condition? A. Activity intolerance related to tissue hypoxia B. Ineffective airway clearance related to dyspnea. C. Chronic pain related to bone marrow dysfunction D. Risk for infection related to reduction in white blood cells (WBCs)
A. Activity intolerance related to tissue hypoxia
The home care nurse is providing teaching to the family of a patient with multiple myeloma. Which nursing diagnosis should guide the nurse for this teaching? A. Ineffective airway clearance related to swelling of the lymph nodes B. Ineffective tissue perfusion related to vascular occlusion C. Risk for deficit fluid volume related to a bleeding disorder D. Risk for injury related to compromised bone integrity
D. Risk for injury related to compromised bone integrity
The nurse is providing care to the patient with Hodgkin disease who has cervical lymph node enlargement. Which of the following symptoms should the nurse attend to first? A. Pain B. Fever C. Fatigue D. Stridor
D. Stridor
The nurse is teaching a patient regarding iron administration. Which teachings should the nurse include to promote the health of the patient? Select all that apply.
Do not be distressed if stools are black colored. Continue the medication in spite of missing a dose. Avoid administration of iron preparations with antacids. Iron is best absorbed in an acidic environment.
A patient with abdominal injuries from a motor vehicle crash is scheduled for surgery to remove the spleen. What bodily function will be affected by the removal of this organ? a. Filtration of waste products b. Removal of old red blood cells from circulation c. Clearance of mucous in the tracheobronchial tree d. Facilitation of glucose to be used by the cell for energy
b. Removal of old red blood cells from circulation
The nurse is assessing a patient with chronic lung disease. Which finding indicates long-term hypoxia? a. Pallor b. Dyspnea c. Clubbed fingertips d. Pulmonary crackles
c. Clubbed fingertips
A patient has an altered level of T and B cells. The nurse realizes that these cells are members of which cell type? a. Platelets b. Eosinophils c. Lymphocytes d. Red blood cells
c. Lymphocytes
A nurse is preparing to assist with a bone marrow biopsy. Which anatomical site should the nurse anticipate will be used to obtain the specimen? a. Ribs b. Humerus c. Posterior iliac crest d. Long bones in the legs
c. Posterior iliac crest
The nurse is reviewing the parts of the complete blood count and differential with a patient. Where should the nurse state that neutrophils, eosinophils, and basophils are produced? a. Spleen b. Thymus c. Lymph nodes d. Red bone marrow
d. Red bone marrow
The IV line of a patient receiving a vesicant chemotherapy agent has disconnected and is lying on the floor. The medication is dripping all over the floor. Which action should the nurse take first? A. Reconnect the IV tubing immediately. B. Wipe it up as quickly as possible with disposable cloths. C. No special precautions are needed for vesicant drug cleanups. D. Use gloves and a protective gown to clean the spill according agency policy.
D. Use gloves and a protective gown to clean the spill according agency policy.
The nurse is providing education to a patient with mild hemophilia on how to avoid bleeding episodes. Which one of the following would be most appropriate to include in the teaching plan? A. Administer desmopressin intranasally prior to any dental procedure or sports. B. Carry an epinephrine pen (EpiPen) that is readily available for emergencies. C. Maintain compression to injection sites for at least 4 hours with a sterile pads. D. Prepare for blood transfusions after any invasive procedure such as dental extractions.
A. Administer desmopressin intranasally prior to any dental procedure or sports.
The nurse is caring for a patient with cancer of the lymph tissue. What is the correct term for this cancer? A. Melanoma B. Sarcoma C. Lymphoma D. Carcinoma
C. Lymphoma
The nurse would instruct the client to eat which of the following foods to obtain the best supply of vitamin B12? A. Whole grains B. Green leafy vegetables C. Meats and dairy products D. Broccoli and Brussels sprouts
C. Meats and dairy products
The nurse is caring for a patient with a platelet count of <20,000/mm3. Which of the following precautions should the nurse take in providing care for this patient? (Select all that apply.) A. Immediately report any fever to the HCP. B. Administer NSAIDs for pain control. C. Monitor for black tarry stools. D. Avoid blood draws when possible. E. Use soft toothbrush to clean the teeth.
C. Monitor for black tarry stools. D. Avoid blood draws when possible. E. Use soft toothbrush to clean the teeth.
Which is the branch of medicine that deals with the prevention, diagnosis, and treatment of tumors or malignancies? A. Cardiology B. Podiatry C. Oncology D. Endocrinology
C. Oncology
The nurse is caring for a patient with thrombocytopenia. Which activity should be avoided? A. Ambulation B. Intramuscular injections C. Visits from family members D. Eating fresh fruits and vegetables
B. Intramuscular injections
A patient is admitted to the hospital with pernicious anemia. The nurse should prepare to administer which of the following medications?
Vitamin B12
The nurse is caring for a group of patients. Place in order, from 1 to 5, the nurse should see the patients. A. A patient who underwent a mastectomy awaiting discharge teaching B. A patient with multiple myeloma who just received a blood transfusion| C. A patient with neutropenia who has a fever of 102.8°F D. A patient with thrombocytopenia who received two units of platelets E. A patient with colon cancer reporting level 6 pain on a 0-to-10 scale
A. A patient who underwent a mastectomy awaiting discharge teaching B. A patient with multiple myeloma who just received a blood transfusion| C. A patient with neutropenia who has a fever of 102.8°F D. A patient with thrombocytopenia who received two units of platelets E. A patient with colon cancer reporting level 6 pain on a 0-to-10 scale
The nurse is providing education regarding skin care to a patient undergoing radiation therapy. Which statement made by the patient indicates a need for further teaching? A. "I should wear tight clothing to protect my skin." B. "I will wear a hat and use sunscreen when going outside." C. "I need to be careful to not wash off the radiation markings." D. "I will avoid using baby powder after my shower."
A. "I should wear tight clothing to protect my skin."
A patient with pernicious anemia. The patient asks why this happened when she has regularly taken iron supplements while following a strict vegetarian diet. Which of the following would be the nurse's most appropriate response? A. "Increase dairy products such as yogurt to increase your intake of vitamin B12." B. "Drinking a glass of orange juice would facilitate the absorption of the iron supplements." C. "Would you be able to take liver tablets to increase your intake of Vitamin B12?" D. "Perhaps your HCP will prescribe an injection of erythropoietin."
A. "Increase dairy products such as yogurt to increase your intake of vitamin B12."
A patient with prostate cancer asks the nurse the meaning of his high prostate-specific antigen (PSA) level. Which response by the nurse is correct? A. "PSA is a tumor marker that is elevated in patients with prostate cancer." B. "PSA levels are done routinely to determine whether your prostate cancer has spread to a new site." C. "The doctor orders PSA measurements to monitor the level of chemotherapy medication in your blood." D. "A PSA test allows the pathologist to view the cancer cells under the microscope to monitor the progression of cancer."
A. "PSA is a tumor marker that is elevated in patients with prostate cancer."
The nurse is providing care to a patient with a hematological disorder. Which of the following would be a manifestation of disseminated intravascular coagulation (DIC)? A. Absent peripheral pulses B. Hypertension and bounding pulses C. Presence of scattered petechiae D. Weakness or one-sided paralysis
A. Absent peripheral pulses
A patient asks the nurse what is meant by the term benign. Which response by the nurse is best? A. "Benign tumors spread to other organs and lymph nodes." B. "An organ with a benign tumor will continue to function normally" C. "It is a cluster of cells not normal to the body and is cancerous." D. "These types of tumors grow much quicker than cancer cells."
B. "An organ with a benign tumor will continue to function normally"
The nurse is assisting in developing a plan of care for the patient with hemophilia who is experiencing severe acute pain. Which of the following would be the most appropriate intervention based on the nursing diagnosis acute pain related to bleeding into tissues? A. Administer desmopressin injections as prescribed prior to any invasive procedure. B. Administer opioids as prescribed, avoiding IM injections. C. Instruct the patient on bleeding precautions and signs and symptoms of bleeding. D. Instruct the patient on community services and hemophilia treatment centers.
B. Administer opioids as prescribed, avoiding IM injections.
A nurse is providing education to a patient with iron deficiency anemia who has been prescribed iron supplements. What should the nurse include in health education? A) Take the iron with dairy products to enhance absorption. B) Increase the intake of vitamin E to enhance absorption. C) Iron will cause the stools to darken in color. D) Limit foods high in fiber due to the risk for diarrhea.
C. Iron will cause the stools to darken in color
The nurse is caring for a group of patients. Which patient should the nurse see first? A. A patient with a calcium level of 9.2 mg/dL B. A patient with a platelet level of 250,000/mm3 C. A patient with a white blood cell count of 2,000 cells/uL D. A patient with a hemoglobin of 14.5g/dL
C. A patient with a white blood cell count of 2,000 cells/uL
The nurse is caring for a patient who is receiving chemotherapy for breast cancer and states she is too nauseated to eat. Which intervention should the nurse implement first? A. Prepare to start the patient on total parenteral nutrition (TPN). B. Encourage the patient to brush her teeth before eating. C. Administer promethazine (Phenergan) 1 hour before meals as ordered. D. Bring the patient food she enjoys eating.
C. Administer promethazine (Phenergan) 1 hour before meals as ordered.
A woman who is in her third trimester of pregnancy has been experiencing an exacerbation of iron-deficiency anemia in recent weeks. When providing the patient with nutritional guidelines and meal suggestions, what foods would be most likely to increase the woman's iron stores? A) Salmon accompanied by whole milk B) Mixed vegetables and brown rice C) Beef liver accompanied by orange juice D) Yogurt, almonds, and whole grain oats
C. Beef liver accompanied by orange juice
The nurse is reviewing orders for a patient with suspected cancer. The nurse notes an order for carcinoembryonic antigen (CEA). For which cancer does this test? A. Breast cancer B. Liver cancer C. Colon cancer D. Ovarian cancer
C. Colon cancer
A vegetarian client was referred to a dietician for nutritional counseling for anemia. Which client outcome indicates that the client does not understand nutritional counseling? The client: A. Adds dried fruit to cereal and baked goods B. Cooks tomato-based foods in iron pots C. Drinks coffee or tea with meals D. Adds vitamin C to all meals
C. Drinks coffee or tea with meals
The nurse is caring for the patient who underwent emergency treatment for DIC. The patient voices concern over how to explain the tubes and extensive bruising to his family members. Which of the following would be an appropriate nursing intervention for disturbed body image related to physical evidence of aggressive treatment procedures? A. Cover the ecchymotic areas with bandages and disconnect the IV tubes temporarily. B. Limit the number of visitors to two at a time for short intervals. C. Enlist the aid of other members of the health care team to support the family. D. Place educational materials in the waiting area prior to visitor's arrival.
C. Enlist the aid of other members of the health care team to support the family.
The nurse is providing teaching for a patient with thrombocytopenia. Which statement made by the patient indicates a need for further teaching? A. "I should avoid taking my daily aspirin while my platelets are low." B. "I should use an electric razor instead of a regular one." C. "I will be careful when I blow my nose." D. "I need to be sure and floss every day."
D. "I need to be sure and floss every day."
The nurse is reviewing orders for a patient receiving doxorubicin (Adriamycin). Which order should the nurse anticipate implementing before starting the chemotherapy? A. A positron emission tomography (PET) scan B. Kidney function tests C. A chest x-ray D. An echocardiogram
D. An echocardiogram
A nurse is educating a patient with iron deficiency on foods high in iron. Which meal, if chosen by the patient, demonstrates an understanding of iron-rich foods?
Grilled chicken thigh, sautéed spinach, and whole-grain bread.
A client has been diagnosed with polycythemia vera. What is the best instruction for the nurse to give to this client?
Maintain adequate blood pressure control
A nurse is caring for a client with multiple myeloma. Which nursing intervention is most appropriate for this client?
Preventing bone injury
The nurse is assisting the client with multiple myeloma to ambulate. What is the most important nursing intervention to help prevent fractures in the client?
Promote safety
A patient with a bleeding disorder is prescribed an infusion of plasma. What should the nurse explain as being the purpose of this infusion? a. Contains clotting factors b. Carries oxygen to the tissues c. Supports cellular metabolism d. Removes waste products from cells
a. Contains clotting factors
A patient is admitted to determine why red blood cells are being quickly destructed in the body. What finding should the nurse associate with this patients health problem? a. Jaundice b. Bleeding c. Diarrhea d. Cyanosis
a. Jaundice
The nurse is caring for a patient having a bone marrow biopsy. What nursing action is the most important following the biopsy? a. Observe for bleeding. b. Encourage oral fluids. c. Administer an analgesic for pain d. Monitor the puncture site for infection.
a. Observe for bleeding
A patient who has been treated for breast cancer is undergoing routine laboratory work. Which laboratory finding would cause the nurse to be most concerned about metastasis? A. Elevated serum calcium B. Decreased serum calcium C. Elevated serum potassium D. Decreased serum potassium
A. Elevated serum calcium
A patient with multiple myeloma is at risk for hypercalcemia. Which nursing intervention is most important for the patient with hypercalcemia? a. Encourage fluids. b. Offer citrus juices and fruits. c. Place the patient on a low-sodium diet. d. Discourage intake of alcoholic beverages.
A. Encourage fluids
The nurse is planning a teaching seminar for members of a Native American tribal community on ways that to prevent the development of cancer. What should the nurse include in this teaching? (Select all that apply.) A. Encourage traditional customs of physical fitness and exercise. B. Provide teaching materials in the participants native language C. Identify healing practices. that can be incorporated into tribal customs. D. Emphasize the use of same-sex-caregivers when seeking preventive care E. Discuss the importance of dietary portion control and healthy food preparation.
A. Encourage traditional customs of physical fitness and exercise. C. Identify healing practices. that can be incorporated into tribal customs. E. Discuss the importance of dietary portion control and healthy food preparation.
A patient with iron-deficiency anemia has been taking oral iron supplements. Which test should the nurse review to determine the effectiveness of this intervention? A. Hemoglobin and hematocrit B. WBC and platelet counts C. Electrolytes, blood urea nitrogen (BUN), and creatinine D. Thrombin clotting time (TCT) and prothrombin time (PT)
A. Hemoglobin and hematocrit
The nurse is caring for a patient receiving chemotherapy who is in the nadir period. For which complication is the nurse at risk? A. Infection B. Stomatitis C. Alopecia D. Diarrhea
A. Infection
The nurse is caring for a patient with iron deficiency anemia, which of the following would be the most appropriate nursing intervention for this patient? A. Instruct the patient to notify the HCP of nausea or constipation. B. Take the iron supplement at the same time every day with meals. C. Stop taking the iron supplement when symptoms are resolved. D. Take advantage of energy spurts and cluster activities at that time.
A. Instruct the patient to notify the HCP of nausea or constipation.
A patient comes to the clinic complaining of fatigue and the health interview is suggestive of pica. Laboratory findings reveal a low serum iron level and a low ferritin level. With what would the nurse suspect that the patient will be diagnosed? A) Iron deficiency anemia B) Pernicious anemia C) Sickle cell anemia D) Hemolytic anemia
A. Iron deficiency
The nurse is caring for a patient with stage IV Hodgkin disease. Where should the nurse expect to find enlarged lymph nodes during the assessment? A. Two or more areas on the same side of the diaphragm B. Localized in the cervical neck area only C. Generalized throughout the body within multiple organs D. Two areas of lymph nodes above and below the diaphragm
C. Generalized throughout the body within multiple organs
The nurse is assessing the patient recently diagnosed with chronic myelogenous leukemia (CML). What of the following indicates a positive diagnosis for CML? A. CBC reveals decrease of platelets and RBCs. B. Lumbar puncture shows presence of Reed-Sternberg cells. C. Genetic analysis of bone marrow reveals Philadelphia chromosome. D. Laboratory results reveal a prolonged PTT and low factor IX.
C. Genetic analysis of bone marrow reveals Philadelphia chromosome.
The nurse is caring for the patient with hemoglobin less than 6 g/dL. Which of the following clinical manifestations would the nurse expect the patient to present? A. Mild palpitations, thirst, and fatigue B. Tachycardia, fatigue, and exertional dyspnea C. Orthopnea, blurred vision, and pruritus D. Petechiae, ecchymosis, and restlessness
C. Orthopnea, blurred vision, and pruritus
A patient walks into the urgent care clinic, stating that he has hemophilia and that he is bleeding. The triage nurse does a quick assessment and sees no signs of active bleeding. Several patients are already in the waiting area. Which action by the nurse is most appropriate? a. Palpate the suspected area for tenderness and edema. b. Ask the patient to sit in the waiting room until his name is called. c. Place the patient in an examination room and tell the physician that the patient may be bleeding. d. Send the patient for routine x-rays according to clinic protocol to look for a source of bleeding, and then place him in an examination room.
C. Place the patient in an examination room and tell the physician that the patient may be bleeding
The nurse is assessing a patient in a family practice clinic. The patient had extensive testing to rule out Hodgkin disease. Which of the following characteristics would indicate Hodgkin disease? (Select all that apply.) A. The patient complained of blurred vision and excessive thirst. B. The patient complained of skeletal and generalized pain. C. The laboratory results show presence of Reed-Sternberg cells. D. The patient has painless swelling of the cervical and axillary nodes. E. The patient's laboratory results indicate presence of Philadelphia chromosomes.
C. The laboratory results show presence of Reed-Sternberg cells. D. The patient has painless swelling of the cervical and axillary nodes.
The nurse is preparing to provide therapeutic treatment to the patient with an exacerbation of polycythemia vera (PV). Which of the following is the expected treatment for this patient? A. Alternated heat and cold packs B. Schedule for a splenectomy C. Therapeutic phlebotomy D. Weekly injections of erythropoietin
C. Therapeutic phlebotomy
The medical nurse is aware that patients with sickle cell anemia benefit from understanding what situations can precipitate a sickle cell crisis. When teaching a patient with sickle cell anemia about strategies to prevent crises, what measures should the nurse recommend? A) Using prophylactic antibiotics and performing meticulous hygiene B) Maximizing physical activity and taking OTC iron supplements C) Limiting psychosocial stress and eating a high-protein diet D) Avoiding cold temperatures and ensuring sufficient hydration
D. Avoiding cold temperatures and ensuring sufficient hydration
The nurse is caring for a patient receiving treatment for a hemolytic anemia due to a reaction from a mismatched blood transfusion. The nurse understands that hemolytic anemia is a definition of what type of anemia? A. Malformed RBCs B. An abundance of immature RBCs C. A deficiency in vitamin B12 D. Destruction of RBCs
D. Destruction of RBCs
The nurse is reviewing laboratory results for a patient with a blood disorder. Reduced fibrinogen and platelet levels, increased thrombin time, and reduced factor assays are laboratory results associated with which hematological disorders? a. Aplastic anemia b. Sickle cell anemia c. PV d. Disseminated intravascular coagulation
D. Disseminated intravascular coagulation
A patient develops fatigue related to radiation therapy. Which intervention is the most appropriate for this patient? A. Discuss the patient's views concerning blood transfusion. B. Encourage moderate exercise between radiation treatments. C. Encourage larger portions of foods rich with calories and protein. D. Encourage the patient to prioritize activities around frequent rest periods.
D. Encourage the patient to prioritize activities around frequent rest periods.
The nurse is caring for a patient in sickle cell crisis. What is the rationale for providing warm compresses and blankets for this patient? A. Sickle cell crisis pain can be exacerbated with shivering. B. Heat relaxes the muscles and distracts the patient from the pain. C. Heat promotes proper formation of red blood cells (RBCs) and prevents sickling. D. Heat increases circulation by preventing vasoconstriction.
D. Heat increases circulation by preventing vasoconstriction.
The nurse is providing care to the patient with thrombocytopenia. Which of the following activities should the patient avoid? A. Planting tulip bulbs in the garden B. Using an electric razor to shave C. Attending church services D. Receiving an influenza vaccination
D. Receiving an influenza vaccination
A client with multiple myeloma reports severe paresthesia in the feet. When planning care for the client, which priority nursing diagnosis will the nurse choose?
Risk for falls
A nurse is caring for a patient with idiopathic thrombocytopenia purpura (ITP) who has required multiple blood transfusions. The nurse anticipates the removal of which organ to decrease the need for blood transfusions in the future?
Spleen
The nurse is explaining the role of red blood cells with oxygen transport in the body with a nursing student. Which term should the nurse use to describe hemoglobin that has given up its oxygen to the bodys cells? a. Reduced b. Detached c. Oxyhemoglobin d. Hypoxyhemoglobin
a. Reduced
The nurse is documenting findings after completing data collection with a patient. What term should the nurse use to document a large area of discoloration from hemorrhage under the skin? a. Pallor b. Rubor c. Petechiae d. Ecchymosis
d. Ecchymosis
The nurse is providing dietary teaching to help a patient reduce the risk of cancer. Which foods should the nurse instruct the patient to avoid? (Select all that apply.) A. Alcohol B. Whole grains C. Smoked meats D. Root vegetables E. Charbroiled meat F. Cruciferous vegetables
A. Alcohol C. Smoked meats E. Charbroiled meat
The nurse is reviewing laboratory results and becomes concerned about one patient being treated for cancer. Which patient does the nurse suspect is in need of nutritional support? A. An 18-year-old with an albumin of 2.5 g/dL B. A 60-year-old with a calcium level of 8 mg/dL C A 43-year-old with a platelet level of 180,000/mm3 D. A 56-year-old with a white cell count of 6,000/mm
A. An 18-year-old with an albumin of 2.5 g/dL
The nurse is planning care for a patient with leukopenia caused by chemotherapy. Which nursing intervention is most important for the nurse to include in this patient's plan of care? A. Protect the patient from injury. B. Observe for bruising or bleeding. C. Ensure that staff members practice good hand washing. D. Assist the patient with activities of daily living (ADLS).
C. Ensure that staff members practice good hand washing
The nurse is providing dietary teaching to an individual with iron-deficiency anemia. Which patient statement indicates that teaching has been effective? a. "I know I need to eat more green vegetables and dairy products." b. "Berries and natural cereals are good for me because of my low iron levels." c. "I'm going to drink orange juice for breakfast and increase red meats in my diet." d. "Yellow vegetables and green tea will be important to help build up my blood levels."
C."I'm going to drink orange juice for breakfast and increase red meats in my diet."
The nurse is following the care plan risk for ineffective peripheral perfusion related to sickled cells and infarction. Which of the following would be the most appropriate intervention? A. Increase the patient's activity daily to achieve previous energy levels. B. Provide 325 mg aspirin between doses of narcotic pain medications. C. Apply cold compresses and maintain a cool environment. D. Avoid restrictive clothing and raising the knee gatch in the bed.
D. Avoid restrictive clothing and raising the knee gatch in the bed.
The nurse is caring for a patient who must undergo a splenectomy for treatment for idiopathic thrombocytopenic purpura (ITP).Which of the following statements best describes the rationale for the splenectomy? A. The spleen becomes engorged and ischemic during an ITP crisis. B. The spleen causes an overabundance of immature platelets. C. The spleen is at risk for infection due to the critical loss of WBCs. D. The spleen is the primary site for platelet destruction.
D. The spleen is the primary site for platelet destruction.
