MS Blood and Lymph Quiz

A patient with a history of congestive heart failure has an order to receive one unit of packed red blood cells (RBCs). If the nurse hangs the blood at 12:00 pm, by what time must the infusion be completed? a) 2:00 pm b) 3:00 pm c) 6:00 pm d) 4:00 pm

4:00 pm

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) Iron-deficiency anemia b) Agranulocytosis c) Aplastic anemia d) Pernicious anemia

Aplastic anemia

The nurse should be alert to which adverse assessment finding when transfusing a unit of packed red blood cells (PRBCs) too rapidly? a) Oral temperature of 97°F b) Crackles auscultated bilaterally c) Respiratory rate of 10 breaths/minute d) Pain and tenderness in calf area

Crackles auscultated bilaterally

An 82-year-old client has pernicious anemia and has been receiving treatment for several years. Which symptom may be confused with another condition in older adults? a) Dementia b) Ataxia c) Glossitis d) Stomatitis

Dementia

For a patient with iron-deficiency anzemia, the nurse should advise the patient to do which of the following to prevent staining the teeth? a) Take iron with or immediately after meals b) Do not combine iron with other prescribed or over-the-counter medications c) Avoid taking iron simultaneously with an antacid d) Dilute liquid preparations of iron with juice and drink with a straw

Dilute liquid preparations of iron with juice and drink with a straw

The nurse is reviewing a client's laboratory results and notes that her hemoglobin level is 15 g/dL. What action should the nurse take next? a) Document the finding as normal. b) Record the result and recommend a retest in 6 weeks. c) Notify the physician because the client requires further testing. d) Ask the client if she has had excessive menstruation or is lacking iron in her diet.

Document the finding as normal.

A client with anemia has been admitted to the medical-surgical unit. Which assessment findings are characteristic of iron deficiency anemia? a) Dyspnea, tachycardia, and pallor b) Nights sweats, weight loss, and diarrhea c) Itching, rash, and jaundice d) Nausea, vomiting, and anorexia

Dyspnea, tachycardia, and pallor

The client is a young, thin woman who is prescribed iron dextran intramuscularly. The nurse, when administering the medication, a) Rubs the site vigorously b) Uses a 23-gauge needle c) Injects into the deltoid muscle d) Employs the Z-track technique

Employs the Z-track technique

An adult patient has been diagnosed with iron-deficiency anemia. What nursing diagnosis is most likely to apply to this patient's health status? a) Acute pain related to uncontrolled hemolysis b) Risk for infection related to tissue hypoxia c) Fatigue related to decreased oxygen-carrying capacity d) Risk for deficient fluid volume related to impaired erythropoiesis

Fatigue related to decreased oxygen-carrying capacity

Which of the following is the percentage of blood volume consisting of erythrocytes? a) Hematocrit b) Differentiation c) Erythrocyte sedimentation rate (ESR) d) Hemoglobin

Hematocrit

A 36-year-old African-American client has a history of sickle-cell anemia with several sickle cell crises over the past 10 years. What blood component results in sickle cell anemia? a) Hemoglobin M b) Hemoglobin S c) Hemoglobin A d) Hemoglobin F

Hemoglobin S

Which of the following describes a red blood cell (RBC) that has pale or lighter cellular contents? a) Normocytic b) Hypochromic c) Hyperchromic d) Microcytic

Hypochromic

A patient with a diagnosis of immune thrombocytopenic purpura (ITP) is currently receiving IVIG for the treatment of her health condition. The nurse who is providing this patient's care is aware that ITP is a consequence of: a) Hemolysis of platelets in individuals who lack immunity to the Epstein-Barr virus b) Impaired liver function and the sequestering of platelets by hepatocytes c) Inappropriate platelet aggregation on the walls of the great vessels d) Platelet destruction and impaired platelet production resulting from an autoimmune process

Platelet destruction and impaired platelet production resulting from an autoimmune process

The nurse began transfusing the first unit of packed red blood cells (PRBCs) fifteen minutes ago. The client begins complaining of shortness of breath, nausea, and is restless. What is the nurse's priority action? a) Flush the blood tubing with normal saline. b) Discontinue the intravenous line. c) Stop the infusion. d) Notify the primary care provider.

Stop the infusion.

The nurse is observing the skin of a client who is taking medications that depress the hematopoietic system and notices multiple areas of ecchymosis on the arms; bleeding for a prolonged period after an IV was started; and reports of black, tarry stool. What does the nurse understand may be a side effect of this medication that the client displays? a) Leukopenia b) Thrombocytopenia c) Neutropenia d) Leukocytosis

Thrombocytopenia

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 if the client has had any blood transfusions b) To determine the varied sexual history of the client, if any c) To determine the potential exposure to infectious agents d) To determine if the client adopted any specific dietary habits

To determine the potential exposure to infectious agents

For a patient diagnosed with pernicious anaemia, the nurse emphasises the importance of lifelong administration of which of the following? a) Folic acid b) Vitamin B12 c) Vitamin A d) Vitamin C

Vitamin B12

After withdrawing the needle from blood donor's arm, the site begins to bleed excessively. What is the nurse's first action? a) Assist the client into an erect position. b) Apply a tourniquet above the antecubital fossa. c) Lower the arm below the level of the heart. d) Hold firm pressure on the venipuncture site.

Hold firm pressure on the venipuncture site.

The nursing instructor is talking with the students about the care of a patient with multiple myeloma who is experiencing bone destruction. What would the instructor tell the students the patient should be assessed for signs of? a) Elevated RBC count. b) Hyperproteinaemia. c) Hypercalcaemia. d) Elevated serum viscosity.

Hypercalcaemia.

Which of the following terms refers to a form of white blood cell involved in immune response? a) Granulocyte b) Lymphocyte c) Thrombocyte d) Spherocyte

Lymphocyte

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) B b) O c) AB d) ABO

O

A nurse is caring for a client admitted with pernicious anemia. Which set of findings should the nurse expect when assessing the client? a) Sore tongue, dyspnea, and weight gain b) Pallor, bradycardia, and reduced pulse pressure c) Pallor, tachycardia, and a sore tongue d) Angina pectoris, double vision, and anorexia

Pallor, tachycardia, and a sore tongue

Which of the following terms refers to an abnormal decrease in white blood cells, red blood cells, and platelets? a) Leukopenia b) Anemia c) Thrombocytopenia d) Pancytopenia

Pancytopenia

You are the nurse assessing a patient with multiple myeloma. What should you keep in mind that patients with multiple myeloma are at risk for? a) Acute heart failure. b) Chronic liver failure. c) Hypoxaemia. d) Pathologic bone fractures.

Pathologic bone fractures.

The nurse is caring for a client who is developing hypovolemic shock from a duodenal ulcer bleed. What is the first intervention the nurse can provide to facilitate blood flow to the brain? a) Administer a crystalloid solution. b) Place the client in a modified Trendelenburg position. c) Prepare the client for an endoscopy. d) Test the client for blood in the stool.

Place the client in a modified Trendelenburg position.

A nurse on a hematology/oncology floor is caring for a client with aplastic anemia. Which of the following would not be included in the client's discharge instructions? a) Plan for frequent periods of rest. b) Use a disposable razor when shaving. c) Avoid contact with family/friends who are sick. d) Encourage frequent handwashing.

Use a disposable razor when shaving.

A patient with a history of atrial fibrillation has contacted the clinic saying that she has accidentally overdosed on her prescribed warfarin (Coumadin). The nurse should recognize the possible need for what antidote? a) Factor VIII b) Vitamin K c) Factor X d) IVIG

Vitamin K

The nurse is discussing vitamin replacement with a client in the clinic. Which vitamin should the nurse discuss with the client in order to increase the absorption of folic acid and iron? a) Vitamin B6 b) Vitamin B12 c) Vitamin C d) Vitamin E

Vitamin C

The nurse is providing education to a patient with iron deficiency anemia who has been prescribed iron supplements. What statement should the nurse include in patient education? a) "Limit foods high in fiber due to the risk for diarrhea." b) "Iron will likely cause your stools to darken in color." c) "You should increase your intake of vitamin E while you're taking iron." d) "Take the iron with dairy products to enhance your body's absorption of it."

"Iron will likely cause your stools to darken in color."

Choice Multiple question - Select all answer choices that apply. A client is found to have a low hemoglobin and hematocrit when laboratory work was performed. What does the nurse understand the anemia may have resulted from? Select all that apply. a) Abnormal erythrocyte production b) Destruction of normally formed red blood cells c) Blood loss d) Infection e) Inadequate formed white blood cells

• Blood loss • Abnormal erythrocyte production • Destruction of normally formed red blood cells