PrepU Adult 2 Assignment 7
After receiving chemotherapy for lung cancer, a client's platelet count falls to 98,000/mm3. What term should the nurse use to describe this low platelet count?
Thrombocytopenia
A client with pernicious anemia is receiving parenteral vitamin B12 therapy. Which client statement indicates effective teaching about this therapy?
"I will receive parenteral vitamin B12 therapy for the rest of my life."
Which of the following nursing interventions should be incorporated into the plan of care to manage the delayed clotting process in a patient with leukemia?
Apply prolonged pressure to needle sites or other sources of external bleeding.
When teaching a client with iron deficiency anemia about appropriate food choices, the nurse encourages the client to increase the dietary intake of which foods?
Beans, dried fruits, and leafy, green vegetables
Which is a symptom of hemochromatosis?
Bronzing of the skin
Which of the following vitamins enhance the absorption of iron?
C
A client reports feeling tired, cold, and short of breath at times. Assessment reveals tachycardia and reduced energy. What would the nurse expect the physician to order?
CBC
A client reports feeling tired, cold, and short of breath at times. Your assessment reveals tachycardia and reduced energy. What would you expect the physician to order?
CBC
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?
Dementia
A client with sickle cell anemia has a
low hematocrit.
Vitamin B and folic acid deficiencies are characterized by production of abnormally large erythrocytes called
megaloblasts.
Which initial intervention should a nurse perform for a client with external bleeding?
Direct pressure
When assessing a client with a disorder of the hematopoietic or the lymphatic system, which assessment is most essential?
Health history, such as bleeding, fatigue, or fainting
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?
Hemoglobin S
A 63-year-old woman has been diagnosed with polycythemia vera (PV) after undergoing a series of diagnostic tests. When the woman's nurse is providing health education, what subject should the nurse prioritize?
Lifestyle modifications and techniques for preventing thromboembolism
The nurse is assessing a patient who is a strict vegetarian. What type of anemia is the nurse aware that this patient is at risk for?
Megaloblastic anemia
A pregnant woman is hospitalized as the result of sickle-cell crisis. A finding that indicates the outcome has been achieved for this client is that the client
Reports joint pain less than 3 on a scale of 0 to 10
A 71-year-old woman with a history of rheumatoid arthritis and chronic heart failure has been admitted to the hospital for the treatment of a suspected upper gastrointestinal bleed. When performing an assessment of this patient, which of the following questions most directly addresses a likely cause of the woman's bleeding disorder?
"Do you ever take aspirin to treat the pain of your arthritis?"
An 82-year-old client has pernicious anemia and has been receiving treatment for several years. What is she lacking that results in pernicious anemia?
Intrinsic factor
The nurse observes a co-worker who always seems to be eating a cup of ice. The nurse encourages the co-worker to have an examination and diagnostic workup with the physician. What type of anemia is the nurse concerned the co-worker may have?
Iron deficiency anemia
A patient with sickle cell anemia is to begin treatment for the disease with hydroxyurea (Hydrea). What does the nurse inform the patient will be the benefits of treatment with this medication? (Select all that apply.)
-Fewer painful episodes of sickle cell crisis -Lower incidence of acute chest syndrome -Decreased need for blood transfusions
A client is prescribed 325 mg/day of oral ferrous sulfate. The nurse includes in client teaching, "Take your iron pill
1 hour before breakfast"
Richard Brooks, a 36-year-old male who is African-American is a client at the primary care group where you practice nursing. Mr. Brooks has a history of sickle cell anemia with several sickle cell crises over the past ten years. While it is a genetic disorder, it is found primarily in African Americans. How many African Americans does it affect in the United States?
1 in 600
A patient with end-stage kidney disease (ESKD) has developed anemia. What laboratory finding does the nurse understand to be significant in this stage of anemia?
Creatinine level of 6 mg/100 mL
The nurse is performing an assessment for a client with anemia admitted to the hospital to have blood transfusions administered. Why would the nurse need to include a nutritional assessment for this patient?
It may indicate deficiencies in essential nutrients.
Which of the following describes a red blood cell (RBC) that has pale or lighter cellular contents?
Hypochromic
A client is receiving chemotherapy for cancer. The nurse reviews the client's laboratory report and notes that he has thrombocytopenia. To which nursing diagnosis should the nurse give the highest priority?
Ineffective tissue perfusion: Cerebral, cardiopulmonary, GI
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:
Platelet destruction and impaired platelet production resulting from an autoimmune process
When evaluating a patient's symptoms that are consistent with a diagnosis of leukemia, the nurse is aware that a common feature of all leukemias is which of the following?
Unregulated accumulation of white cells in the bone marrow, which replace normal marrow elements
A nurse on a hematology/oncology floor is caring for a client with aplastic anemia. Which would not be included in the client's discharge instructions?
Use a disposable razor when shaving.
The nurse should advise a client with iron deficiency anemia to take which action in order to prevent staining of the teeth?
Use a straw or place a spoon at the back of the mouth to take the liquid supplement.
A 79-year-old client has been diagnosed with pernicious anemia. In your client education, as his nurse, you emphasize the importance of lifelong intramuscular administration of which of the following?
Vitamin B
For a client diagnosed with pernicious anemia, the nurse emphasizes the importance of lifelong administration of
Vitamin B12
A young male client is diagnosed with a mild form of hemophilia. He is experiencing bleeding in the joints with pain. In preparing the client for discharge, the nurse educates the client to
Wear a medical identification bracelet.
The most common cause of iron deficiency anemia in men and postmenopausal women is
bleeding.
A client has been diagnosed with Cooley's anemia, a severe form of beta-thalassemia. Which is a symptom of Cooley's anemia?
bronzing of the skin
A 50-year-old woman was recently diagnosed with non-Hodgkin's lymphoma (NHL) and has begun a treatment regimen that includes simultaneous radiation therapy and chemotherapy. The combination of severe symptoms and aggressive therapy has necessitated admission to the hospital. When providing care for this patient, which of the following actions should the nurse implement?
Applying standard precautions conscientiously to reduce the patient's risk of infection
Ralph Meander, an 80-year-old retired chemist, has been diagnosed with Cooley's anemia, a severe form of beta-thalassemia. Which of the following is a symptom of Cooley's anemia?
Bronzing of the skin
A nursing instructor is evaluating a student caring for a neutropenic client. The instructor concludes that the nursing student demonstrates accurate knowledge of neutropenia based on which intervention?
Monitoring the client's temperature and reviewing the client's complete blood count (CBC) with differential
A client diagnosed with systemic lupus erythematosus comes to the emergency department with severe back pain. She reports that she first felt pain after manually opening her garage door and that she is taking prednisone daily. What adverse effect of long-term corticosteroid therapy is most likely responsible for the pain?
Osteoporosis
A patient had gastric bypass surgery 3 years ago and now, experiencing fatigue, visits the clinic to determine the cause. The patient takes pantoprazole (Protonix) for the treatment of frequent heartburn. What type of anemia is this patient at risk for?
Pernicious anemia
After teaching a client about taking daily oral iron preparations for a moderate iron deficiency anemia, which statement by the client indicates to the nurse that additional instruction is needed?
"I will call the doctor if my stools turn black."
A young mother with a 2 year old and a 6 month old is experiencing fatigue related to anemia. The client states that she is having difficulty performing the activities needed for her job, family, and home. The nurse assists the client to
Prioritize and balance activities and rest.
The nurse is providing palliative care for a 69-year-old patient who has a diagnosis of multiple myeloma. The patient states that she enjoyed good health for most of her life and rarely had to visit her family health care provider until she experienced the first signs and symptoms of her current illness. Which of the following complaints most likely prompted the patient to initially seek care?
Bone pain
Your cousin from Denver, who has been visiting for several months, seeks treatment due to her increased fatigue, pruritis, and dizziness. Most disturbingly, her face and lips have taken on a reddish-purple tone. What could have contributed to her condition?
Where she lives
The nurse is educating a patient with iron deficiency anemia about food sources high in iron and how to enhance the absorption of iron when eating these foods. What can the nurse inform the client would enhance the absorption?
Eating calf's liver with a glass of orange juice
The nurse is currently planning the care of a patient with multiple myeloma who is experiencing bone destruction. When reviewing the patient's most recent blood work, what value would the nurse pay particular attention to?
Hypercalcemia
The nurse should advise a client with iron deficiency anema to take which action in order to prevent staining of the teeth?
Dilute liquid preparations of iron with juice and drink with a straw
Hemophilia A is the most common of the three types of hemophilia. What is diminished in the less serious form of hemophilia A, known as von Willebrand's disease?
amount and quality of factor VIII
An otherwise healthy 33-year-old woman experienced debilitating and persistent fatigue over a period of several weeks and was subsequently diagnosed with acute myeloid leukemia (AML). The woman has been admitted to the hospital for treatment. The nurse who is providing care for this patient should prioritize which of the following assessments?
Assessing the woman for signs and symptoms of infection
The nurse is assessing a client who lives in a community that is at a very high altitude. When reviewing the client's most recent laboratory values, the nurse notes that the client has elevated red blood cell levels. The client denies having any unwanted symptoms. What is the nurse's best response?
Document the assessment finding.
A client with anemia has been admitted to the medical-surgical unit. Which assessment findings are characteristic of iron deficiency anemia?
Dyspnea, tachycardia, and pallor
The nurse is preparing the patient for a test to determine the cause of vitamin B12 deficiency. The patient will receive a small oral dose of radioactive vitamin B12 followed by a large parenteral dose of nonradioactive vitamin B12. What test is the patient being prepared for?
Schilling test
A 12-year-old girl on the oncology unit at children's hospital tells the nurse that she has discovered that there are several different kinds of leukemia. The child asks the nurse to explain what makes them all "leukemia." What should the nurse reply?
The different leukemias all have unregulated proliferation of white blood cells.
