Deck 32: Hematologic Disorders

Question 1

When the nurse prepares to give ferrous sulfate (Feosol)to a home health care patient,the nurse will:

A) Mix the drug with a high-protein milkshake.
B) Give undiluted with a small snack.
C) Mix with coffee or cola to disguise the bitter taste.
D) Dilute and offer through a straw and a few crackers.

Answer 1

Dilute and offer through a straw and a few crackers.

Question 2

A major focus in a teaching plan for a teenager with sickle cell anemia would be:

A) Limit tobacco use to no more than two cigarettes a day.
B) Eat foods high in iron and vitamin B.
C) Maintain environmental temperature at 65° to 68° F.
D) Maintain adequate hydration.

Answer 2

Maintain adequate hydration.

Question 3

At the end of a shift,a nurse documents the effectiveness of parent teaching concerning the transmission of hemophilia.Which of the following statements by the mother would best indicate an accurate parental perception?

A) "Hemophilia is a genetic disorder and I am a carrier, although I do not have the disease."
B) "My son developed hemophilia because I had measles while I was pregnant."
C) "Since my husband isn't affected by the disease, our daughter will not be a carrier."
D) "I know it is not necessary to have my two daughters tested for the disease."

Answer 3

"Hemophilia is a genetic disorder and I am a carrier, although I do not have the disease."

Question 4

A 3-year-old African-American child is diagnosed with sickle cell anemia.The parents know that sickle cell anemia is hereditary but do not understand why their child has the disease,because neither of them has it.The nurse explains that:

A) At least one of the parents has to have the disease.
B) Only one parent has to have the disease or the trait.
C) Someone in previous generations had the disease.
D) Both parents were carriers of the sickle cell trait.

Question 5

A nurse is completing an initial assessment on a new patient being seen in the hospital clinic.The presentation of this female patient includes vague symptoms of tiredness and large areas of ecchymosis.The question that would be most important to ask is:

A) "Are you allergic to anything?"
B) "Do your gums easily bleed?"
C) "How many hours do you sleep?"
D) "How frequent are your periods?"

Question 6

The nurse caring for a patient who is having radiation treatment for cancer is alert to the threat of thrombocytopenia ______ days after the start of radiation.

A) 2
B) 5
C) 9
D) 12

Question 7

The patient receiving Epogen asks how soon an increase in his red blood cell count will occur.The nurse's best reply is that the initial increase in red blood cells should be seen in:

A) 2 days
B) 1 week
C) 10 days
D) 2 weeks

Question 8

A newborn infant has developed significant jaundice and has a positive Coombs test result from high levels of bilirubin.The nurse has assessed the symptoms as being indicative of:

A) Aplastic anemia
B) Hemophilia
C) Hemolytic anemia
D) Sickle cell anemia

Question 9

The rationale for administering injections of vitamin B12 to patients with pernicious anemia is that:

A) The patient's body does not normally manufacture enough vitamin B12.
B) The patient may lack the intrinsic factor necessary for vitamin B12 absorption.
C) Vitamin B₁₂ is found in very small quantities in the patient's body.
D) Vitamin B₁₂ is a mineral necessary to aid in the formation of strong bones.

Question 10

A 52-year-old man has a diagnosis of aplastic anemia.The information that the nurse recognizes as being pertinent to this diagnosis is that the man:

A) Has a long family history of cancer.
B) Is a regular blood donor.
C) Is a 25-year employee in a chemical plant.
D) Has gained 5 pounds in the last 2 years.

Question 11

The nurse explains that a normal hematocrit value is approximately:

A) Three times the hemoglobin value
B) The same as the hemoglobin value
C) Four times lower than the red blood cell count
D) Same as the red blood cell count

Question 12

The nurse taking the history of a patient who has come in for evaluation of the large areas of purpura on her limbs is alarmed when the patient confesses that she uses an alternative therapy of __________ for her menopausal symptoms.

A) Black cohosh
B) Valerian
C) Lavender
D) Rosemary

Question 13

A child with sickle cell anemia is placed prescribed the drug hydroxyurea.The nurse explains that this drug will:

A) Increase energy
B) Decrease cardiomegaly
C) Clean out obstructed vessels
D) Produce a hemoglobin that resists sickling

Question 14

The foods that the nurse would include in a nutrition teaching plan for a patient with iron-deficiency anemia are:

A) Beans and dried fruit
B) Apples and white rice
C) Yogurt and cooked carrots
D) Yellow squash and tortillas

Question 15

The nurse caring for a patient receiving a transfusion assesses that the patient is wheezing and is complaining of back pain.After the nurse stops the transfusion,the nurse should:

A) Discontinue the intravenous (IV) transfusion.
B) Notify the charge nurse.
C) Administer heparin.
D) Raise the patient's head.

Question 16

A 35-year-old man is examined in an urgent care clinic.His presenting symptoms suggest polycythemia vera.The laboratory value that would confirm this possible diagnosis is an extremely:

A) High hemoglobin level
B) Low white cell count
C) Low platelet count
D) High iron level

Question 17

Based on the nursing assessment,an appropriate nursing diagnosis for a patient with hemophilia would be:

A) Acute pain, related to bleeding in closed spaces.
B) Impaired gas exchange, related to decreased oxygen to the cells.
C) Excess fluid volume, related to increased fluid within the cells.
D) Hypothermia, related to inability to produce heat.

Question 18

When the patient with a platelet count of 20,000/mm³ receives 1 unit of platelets,the platelet count should rise to:

A) 25,000 to 30,000/mm₃
B) 35,000 to 40,000/mm₃
C) 45,000 to 50,000/mm₃
D) 55,000 to 100,000/mm₃

Question 19

The nurse explains that sickle cell crisis occurs when the sickle-shaped red blood cells:

A) Rupture
B) Produce hemoglobin S
C) Interfere with blood production
D) Obstruct major arteries

Question 20

In preparing discharge plans for a patient recently diagnosed with pernicious anemia,the nurse must include information regarding:

A) Adding daily high-fat, low-fiber supplements.
B) Adding a rigorous daily workout.
C) Avoiding prolonged exposure to direct sunlight.
D) Providing sufficient rest periods throughout the day.

Question 21

At 10:00 AM,the nurse receives 2 units of blood for a patient to be transfused.The nurse should:

A) Set up 1 unit for the infusion to start at 10:30 AM, and send the other unit back until the first one has run.
B) Set up both units to run at the same time for an infusion at 11:00 AM.
C) Set up one unit for infusion, and place the other in the refrigerator for the later infusion.
D) Send both units back and ask for a reissue of 1 unit only.

Question 22

When assessing the patient with thrombocytopenia,the nurse observes for:

A) Distended neck veins and skin discoloration
B) Discoloration of the nails and sclera
C) Petechiae on the skin and bleeding gums
D) Enlarged thyroid gland and excitability

Question 23

The nurse giving iron dextran intramuscularly (IM)will use the Z-track method because this method: (Select all that apply.)

A) Makes the injection less painful.
B) Prevents staining of the skin.
C) Prevents postinjection pain.
D) Allows another injection to be given at the same location.
E) Cleans the needle on withdrawal.

Question 24

The nurse caring for a patient with crushing injuries from an automobile accident is horrified to find the patient bleeding profusely from the nose,mouth,and rectum,as well as from the injuries.The nurse assesses this emergency situation as:

A) Hemophilia
B) Disseminated intravascular coagulation (DIC)
C) Leukemia
D) Thrombocytopenia

Question 25

The nurse plans the interventions to prepare a patient for a bone marrow aspiration: (Place the options in the correct sequence.)

A) Assist the patient to lie on his or her abdomen, and drape the hip and lower limbs.
B) Confirm the presence of laboratory personnel to stain the specimen.
C) Apply a pressure dressing, and help the patient lie on his or her back.
D) Obtain a signed permission form.
E) Explain that the procedure will take about 30 minutes.

Question 26

The nurse notes the medical history information that is significant to potential bleeding problems as: (Select all that apply.)

A) Drinks two glasses of wine a day.
B) Eats red meat three times a week.
C) Takes nonsteroidal antiinflammatory drugs (NSAIDs) for the relief of arthritic pain four times a day.
D) Has hepatitis B.
E) Had a cardiac valve replaced 6 months earlier.

Question 27

The nurse assessing a patient 20 minutes after a bone marrow biopsy is concerned when the patient says:

A) "There is fresh blood on my dressing."
B) "I am thirsty."
C) "My hip feels bruised where they stuck the needle."
D) "I had a sharp pain in my leg when they pulled the needle out."

Question 28

The nurse explains that the major difference between fresh frozen plasma (FFP)and cryoprecipitate (CPP)is that FFP: (Select all that apply.)

A) Contains more albumin.
B) Has a longer infusion time.
C) Contains no platelets.
D) Has a very high probability of causing an allergic reaction.
E) Can cause dangerous blood pressure elevation.

Question 29

In helping prepare a nursing care plan for a 90-pound,82-year-old woman with iron-deficiency anemia with a hemoglobin of 5.2,the nurse agrees that the most appropriate nursing diagnosis would be:

A) Impaired tissue integrity, related to immobility.
B) Disturbed body image, related to weight loss
C) Anxiety, related to unfamiliar hospital environment
D) Activity intolerance, related to fatigue.