Med/Surg: Ch 30-32
The Pediatric Nurse Practitioner is doing a physical examination of a client with sickle cell anemia. Why would the nurse practitioner auscultate the lungs and heart? A. To detect the abnormal sounds suggestive of acute chest syndrome and heart failure B. To detect the evidence of infection such as fever and tachycardia C. To detect the evidence of dehydration that might have triggered a sickle cell crisis D. To detect the motor strength and stroke-related signs and symptoms
A
A client with a diagnosis of pernicious anemia comes to the clinic complaining of numbness and tingling in their arms and legs. What do these symptoms indicate? A. Loss of vibratory and position senses B. Neurologic involvement C. Severity of the disease D. Insufficient intake of dietary nutrients
B
The nurse is taking a health history on a new client with a suspected lymphatic or hematologic disorder. Why is it important for the nurse to inquire about any foreign travel this client may have done? A.To determine the varied sexual history of the client, if any. B.To determine the potential exposure to infectious agents. C. To determine if the client has had any blood transfusions D. To determine if the client adopted any specific dietary habits
B
The nursing instructor is talking with their clinical group about coagulopathies. How should the instructor define coagulopathies? A. Coagulopathies are bleeding disorders that are characterized by abnormalities in the numbers and types of red blood cells in the body. B. Coagulopathies are bleeding disorders that involve platelets or clotting factors. C. Coagulopathies are bleeding disorders that are characterized by a deficiency of globulins in the plasma. D. Coagulopathies are bleeding disorders that involve the destruction of stem cells in the bone marrow.
B
The physician has ordered a Schilling test for an 82-year-old client you are caring for. You know that in some older adults the Schilling test poses a problem. Why would this be true? A.Older adults cannot be subjected to radioactive substances. B.Older adults are prone to cognitive problems or urinary incontinence. C.Older adults pose a risk of adverse reactions from nonradioactive B12. D.Older adults have a decreased resistance to infection.
B
You are presenting an educational workshop for a local community group. You have been asked to speak about older adults and their health. What is the most important piece of information to include in this presentation? A. Older adults are more fragile than younger adults. B. Older adults get sicker than other people. C. Older adults take longer to heal than other people. D. Older adults are more susceptible to infections and malignancies.
D
Your client was admitted to the Emergency Department after an accident with a chain saw. The client is exhibiting signs and symptoms of acute hypovolemic anemia from severe blood loss. What signs and symptoms would you assess for? A. Malabsorption disorders B. Postural hypotension C. Fatigue D. Reduced urine output
D
Your client has just been prescribed oral iron. Why would you advise this client to avoid taking their medication with coffee, tea, eggs, or milk? A. Grand mal seizures may result. B. Untoward reactions may occur. C. Absorption of iron will decrease. D. Coffee, tea, eggs, and milk interact with oral iron.
C
You are caring for a 13-year-old diagnosed with sickle cell anemia. The client asks you what they can do to help prevent sickle cell crisis. What would be an appropriate answer to this client? A. Avoid any sports that tire you out. B. Drink at least 8 glasses of water every day. C. Avoid any activity that makes you short of breath. D.Stay on oxygen therapy 24/7.
C
Your client is taking medications that depress the hematopoietic system. What signs should you closely monitor in this client? Your client is taking medications that depress the hematopoietic system. What signs should you closely monitor in this client? A)Signs of leukocytosis B)Signs of painful joints and discomfort C)Signs of leukopenia and thrombocytopenia D)Signs of hemolysis
C
A client comes to the walk-in clinic complaining of weakness and fatigue. While assessing this client, you find evidence of petechiae and ecchymoses. You note that the spleen appears enlarged. What would you suspect is wrong with this client? A. Aplastic anemia B. Pernicious anemia C. Iron deficiency anemia D. Agranulocytosis
A
A client is admitted to the Emergency Department with significant blood loss. The physician orders 2 units of packed red blood cells to be transfused immediately. Which blood groups would be compatible with his O Rh-positive blood group? A. O Rh-positive or O Rh-negative B.Only O Rh-positive C. Only O Rh-negative D. AB Rh-positive or Rh-negative
A
The clinic nurse is preparing a client for diagnostic testing. What would the nurse include in the education of this client? A. Tasks are necessary to participate in the test. B. Anesthetic will be applied. C. Consent needs to be signed. D. They will need someone to drive them home.
A
The nurse caring for an older adult with a diagnosis of leukemia would encourage the client to use an electric razor. Why? A. Trauma and microabrasions may contribute to anemia. B. Fragile tissues and altered clotting mechanisms may result in hemorrhage. C. The client is at risk for spontaneous and uncontrolled bleeding. D. The client is at risk for infection from microorganisms.
A
The nursing instructor is discussing disorders of the hematopoietic system with the pre-nursing pathophysiology class. What disease would the instructor list with a primary characteristic of erythrocytosis? A. Polycythemia Vera B. Sickle Cell Disease C. Aplastic anemia D. Pernicious anemia
A
Which protein in plasma functions primarily as immunologic agents? A. Gamma globulins B. Albumin C. Fibrinogen D. Beta globulins
A
A student nurse, learning about the hematopoietic system would include what in their studies? Select all that apply. A. Bone marrow B. Blood C. Plasma D. Plasma granulocytes E. Protein inhibitors
ABC
You are studying the different forms of leukemia in your pathophysiology class. Which of the following would you be studying? Select all that apply. A. Chronic myelocytic B. Acute pernicious C. Chronic aplastic D. Acute lymphocytic E. Acute myelocytic
ADE
A client is admitted to the Emergency Department after a major motor vehicle accident. The client has lost a lot of blood and requires an emergency transfusion. What type of blood is compatible with all blood types? A. AB B.O C. ABO D. B
B
You are assessing vital signs on a hemophiliac who has come to the clinic complaining of an upper respiratory infection. What is the suggested method to check the temperature for a client with hemophilia? A. Taking the temperature orally B. Taking the temperature tympanically C. Taking the temperature rectally D. Taking the temperature on the forehead
B
An 81-year-old male with acute lymphoblastic leukemia is terminal. The family asks you why the prognosis is so poor for this client. What would be your best response? A. "Your family member is old and just can't fight any more." B. "This disease has been going on for a long time." C. "Leukemia is cancer of the blood and cancer is hard to beat." D. "Your family member doesn't have enough blood cells of all kinds."
D
The nurse is caring for a client who is taking medications that depress the hematopoietic system. What signs of leucopenia would the nurse assess this client for? A. Unusual or easy bleeding B. Oozing from injection sites C. Dark, tarry stoolS D. Fever and sore throat
D
You are caring for a client who has had prolonged treatment for osteoarthritis with Celecoxib. The client complains of fatigue, fever, chills, headache, and a vaginal infection. What would you suspect is wrong with this client? A. Multiple myeloma B. Agranulocytosis C. Leukopenia D. Leukemia
B
You are caring for a client with multiple myeloma. Why would it be important to assess this client for fractures? A. Osteopathic tumors destroy bone causing fractures. B. Osteoclasts break down bone cells so pathologic fractures occur. C. Osteolytic activating factor weakens bones producing fractures. D. Osteosarcomas form producing pathologic fractures.
B
You are caring for three clients who have the following blood count values: Client A has 24,500 white blood cells (WBCs), client B has 13.4 g/dL hemoglobin, and client C has a 250,000/mm3 platelet count. Which statement correctly describes the condition of each client? A.Client A has a normal WBC count, client B has a higher hemoglobin count than normal, and client C has a normal platelet count. B.Client A has a higher WBC count than normal, client B has a normal hemoglobin count, and client C has a normal platelet count. C.Client A has a higher WBC count than normal, client B has a normal hemoglobin count, and client C has a higher platelet count than normal. D.Client A has a normal WBC count than normal, client B has a normal hemoglobin count, and client C has a normal platelet count.
B
A client diagnosed with Polycythemia vera has come into the clinic because they have developed a night-time cough, fatigue, and shortness of breath. What complication would you suspect in this client? A. Stroke B. Tissue infarction C. Congestive heart failure D. Pulmonary embolus
C
A client with a diagnosis of thrombocytopenia has been admitted to your unit for IV corticosteroid treatment. As the nurse caring for this client, you would expect the physician's orders to include which of the following? A. A sleeping medication B. Small frequent meals throughout the day C. A tapering course of solumedrol at discharge D. An order for oxycodone for steroid induced headaches
C
Albumin is a protein in the plasma portion of the blood. Under normal conditions albumin cannot pass through the wall of a capillary. What significance is this for the vascular compartment? A. Helps push oxygen into the tissues of the body. B. Retains leukocytes in the vascular compartment. C. Helps retain fluid in the vascular compartment. D. Absorbs carbon dioxide from the tissues for transport to the lungs.
C
The clinic nurse is caring for a client diagnosed with leucopenia. What does the nurse know this client has? A. Too many erythrocytes B. A decrease in granulocytes C. A general reduction in all white blood cells D. A general reduction in neutrophils and basophils
C
The instructor in the anatomy and physiology class is discussing the components of the blood. What would the instructor cite as the most abundant protein in plasma? A. Platelets B. Fibrinogen C. Albumin D. Globulins
C
The nursing instructor is teaching their clinical group about laboratory blood tests. What is the major function of erythrocytes? A. Act as mediators for the immune system B. Destroy invading organisms C. Transportation of O2 to the tissues and removal of CO2 from the tissues D. Oxygenation of the brain
C
Undifferentiated cells that migrate to the thymus gland develop into which of the following? A. A lymphocytes B. D lymphocytes C. T lymphocytes D. S lymphocytes
C
When assessing for signs and symptoms related to hematopoietic and lymphatic systems, what details should the nurse ask about further? A. A client who does not eat at night. B. A female client, age 50, yet childless. C. A client undergoing cancer treatment. D. A female client who has melanin-related skin problem
C
You are assisting your client with multiple myeloma to ambulate. What is the most important nursing diagnosis to help prevent fractures in this client? A. Increased mobility B. Adequate hydration C. Safety D. Adequate nutrition
C
A client at the clinic has just been diagnosed with iron deficiency anemia. What would you recommend the client consume to promote the absorption of iron? A. Vitamin E B. Meat, egg yolks, oysters, and C. shellfish D. Rich sources of vitamin C Sources of vitamin B12
C
A nurse caring for a client who has hemophilia is getting ready to take the client's vital signs. What should the nurse do before taking a blood pressure? A. Ask if taking a blood pressure has ever produced bleeding under the skin or in the arm joints. B. Ask if taking a blood pressure has ever produced pain in the upper arm. C. Ask if taking a blood pressure has ever caused bruising in the hand and wrist. D. Ask if taking a blood pressure has ever produced the need for medication.
A
Erythrocytes, or red blood cells, carry oxygen throughout the body. The number of erythrocytes actually varies with age, gender, and altitude. What is the normal range for erythrocytes in the adult body? A. 3.6 and 5.4 million/mm3 B. 5.6 and 8.4 million/mm3 C. 7.2 and 9.3 million/mm3 D. 8.2 and 10.7 million/mm3
A
Macrophages attack and destroy foreign substances to the body. Where does this action occur? A. At the site of trauma B.In the lymph node C. In the vascular system D. In the thymus
B
The nurse is caring for a client with a lymphatic system disorder. What physical assessment is a priority for the nurse to perform? A. Examine the color and quantity of urine. B. Inspect the tonsils for size and appearance. C. Frequently examine and record blood pressure. D. Examine for any signs of physical injury.
B
Globulins are proteins contained in plasma. What is their primary function? A. Immunologic agents B. Destruction of invading organisms C. Precursors to clot formation D. Transport of oxygen to the tissues
A
What is hematopoiesis? A. The manufacture and development of blood cells B. The production of lymphatic fluid in the body C. The making of red blood cells and lymph D. The development of lymph in the bone marrow
A
You are caring for a client with thalassemia who is being transfused. What your role during a transfusion? A. To closely monitor the rate of administration B. To administer vitamin B12 injections C. To instruct the client to rest immediately if chest pain develops D. To assess for enlargement and tenderness over the liver and spleen
A
Both the liver and the spleen have a role in erythrocyte metabolism. How would this role best be described? A.The spleen helps in creating mature erythrocytes. B.The liver generates erythropoietin which regulates the rate of erythrocyte production. C.The spleen stores the iron component of hemoglobin from erythrocytes and returns it to the red marrow. D.The spleen removes erythrocytes after 120 days, and the liver removes severely damaged erythrocytes.
D
The Family Nurse Practitioner is conducting a physical assessment on a client with suspected Hodgkin's lymphoma. What could unilateral enlargement of an extremity indicate? A. Peripheral edematous involvement of the extremity B. An ineffective lymphatic system C. Splenic enlargement D. Obstruction of lymphatic circulation
D
The Oncology Advanced Practice Nurse (APN) is assessing a client with leukemia. How would the Oncology APN assess for enlargement and tenderness over the liver and spleen? A. By reviewing laboratory test results B. By calculating the absolute neutrophil count C. By looking for evidence of bruising D. By palpating the abdomen
D
The nurse, caring for a client in the emergency room with a severe nosebleed, becomes concerned when the client asks for a bedpan. The nurse documents the stool as loose, tarry, and black looking. The nurse suspects the client may have thrombocytopenia. What should be the nurse's priority action? A. Stop the nosebleed B. Put in an IV line C. Ask someone to clean the bedpan D. Notify the physician
D
What factor in plasma can be transformed from a liquid to a solid? A. Globulins B. Albumin C. Leukocytes D. Fibrinogen
D
What is the rationale for the classification of leukemia? A. Whether it attacks younger or older people B. Whether it is acute or chronic C. Which bone marrow it arises from, red, or yellow D. Which bone marrow stem cell line is dysfunctional
D
You are caring for a client who is undergoing bone marrow aspiration to determine their blood cell formation status. What nursing intervention should you provide to your client after the test? A. Administer oral radioactive vitamin B12 to the client. B. Administer a nonradioactive B12 injection. C. Collect urine for 24 to 48 hours after the client receives the nonradioactive B12. D. Support the client during a bone marrow aspiration and monitor the status.
D
You are caring for an 87-year-old female who has been admitted to your unit with anemia. What would you suspect? A. Excessive consumption of coffee or tea B. Elimination of iron by the body C. Decrease in the total body iron stores with age D. Blood loss from the gastrointestinal or genitourinary tract
D
