Deck 16: the Hematologic System

Question 1

The nurse is assessing an 82-year-old African American male with sickle cell anemia and notes the sclera of his eyes to be yellow.The nurse correctly interprets this finding as:

A)sickle cell crisis.
B)anemia.
C)jaundice.
D)a normal occurrence.

Answer 1

jaundice.

Question 2

The nurse explains that jaundice is present as a result of the release of excessive _____ into the bloodstream.

A)histamine
B)bilirubin
C)plasma
D)platelets

Answer 2

bilirubin

Question 3

When reviewing the hematologic system,the student nurse is correct when making which statement?

A)"African Americans have the highest incidence of sickle cell disease."
B)"Iatrogenic blood disorders are congenital in origin."
C)"Folic acid is directly related to synthesis of hemoglobin."
D)"Bruising in the elderly patient is of great concern."

Answer 3

"African Americans have the highest incidence of sickle cell disease."

Question 4

When the nurse observes melena,she is aware that a minimum of _____ to _____ mL of blood has been deposited into the GI tract.

A)25; 50
B)50; 75
C)75; 100
D)100; 120

Question 5

The nurse reading a complete blood count notes there is an abnormal amount of "bands," or immature granulocytes.From this assessment,the nurse suspects:

A)an ongoing bacterial infection.
B)an allergic reaction.
C)impending anemia.
D)an overwhelming viral infection.

Question 6

The nurse cautions that often confused and irritable older adults are thought to have dementia when the real underlying problem is a blood-related:

A)deficiency of WBCs resulting in infection.
B)excess of WBCs resulting in joint pain.
C)deficiency in RBCs resulting in hypoxia.
D)massive RBC destruction resulting in hyperbilirubinemia.

Question 7

The patient who is taking radiation treatments has a platelet count of 100,000/mm³.The nurse should be alert for:

A)significantly decreased blood pressure.
B)hematuria.
C)constipation.
D)confusion and disorientation.

Question 8

The elderly patient's daughter asks why her father seems to be catching so many colds.Which response by the nurse is the best?

A)"After the age of 60, the plasma volume decreases so there is less infection fighting ability."
B)"Bone marrow activity decreases by about 50% with aging, which lowers the immune response to infection."
C)"The elderly person's blood is more prone to clotting, so infection-fighting cells don't get to the source of infection quickly."
D)"His antibody response to vaccines is overactive."

Question 9

When the patient with pernicious anemia says,"I don't know why I am so tired," the nurse can clarify by saying that the fatigue is related to:

A)lack of oxygen being carried to cells of the body.
B)enlarged spleen, which makes breathing difficult.
C)proliferation of white cells.
D)excessive red cells that have decreased the blood pressure.

Question 10

The nurse explains that the function of blood includes: (Select all that apply.)

A)absorbing nutrients.
B)moving blood gases.
C)regulating pH by buffering.
D)regulating fluid distribution.
E)regulating body temperature.

Question 11

The nurse is reviewing a patient's assessment data upon admission to the acute care facility and observes signs of iron deficiency anemia that include:

A)RBCs 5.0 mil/mm3.
B)WBCs 5.0 mill/mm3.
C)hemoglobin 14.0 g/dL.
D)pale conjunctivae.

Question 12

The nurse notes a rise in the eosinophil count and suspects the patient has a(n):

A)bacterial infection.
B)allergy.
C)viral infection.
D)blood dyscrasia.

Question 13

Which nursing intervention is most appropriate following a bone marrow aspiration on the left posterior iliac crest from a patient with pernicious anemia?

A)Assist the patient to walk for 10 minutes to stimulate circulation.
B)Check the pulses in the leg and foot distal to the puncture.
C)Turn the patient on the back and remove the pillow.
D)Apply pressure to the site for 5 minutes with an ice pack.

Question 14

Red blood cells only live about _____ days.

A)30
B)90
C)100
D)120

Question 15

The nurse reminds the patient with a bleeding disorder that the life span of the platelet is the shortest of all blood cells,approximately _____ days.

A)10
B)14
C)30
D)45

Question 16

The stem cells in the marrow are stimulated to make blood cells by the erythropoietin- stimulating factor in the:

A)brain.
B)lung.
C)kidney.
D)liver.

Question 17

The nurse uses a visual aid to depict the several kinds of hemoglobin.The hemoglobin that changes the shape of the red blood cell (RBC)on which it resides is hemoglobin:

A)A.
B)A1c.
C)F.
D)S.

Question 18

The lymphatic system is composed of: (Select all that apply.)

A)thymus.
B)lymph glands.
C)lymph channels.
D)spleen.
E)tonsils.

Question 19

The nurse evaluates the lab reports for the patients on the unit,and recognizes the report requiring the most immediate attention is for the patient with RBCs,_____ mil/mm³;WBCs,_____ mil/mm³;and Hb,_____ g/dL.

A)4.2; 4500; 9.1
B)5.9; 4500; 12.7
C)6.0; 6000; 13.2
D)7.6; 8000; 18.0

Question 20

The nurse explains that,in the event of a massive hemorrhagic episode,the _____ contracts and adds blood to the circulating volume.

A)spleen
B)liver
C)pancreas
D)bone marrow

Question 21

Matching
The student nurse is drawing a diagram of the phases of the monocyte cell to present to the nursing class.The student correctly diagrams the phases in which order of occurrence?

Step: 2

A)Becomes a phagocyte
B)Becomes a macrophage
C)Engulfs bacteria
D)Migrates into tissues
E)Becomes a monocyte
F)Becomes a leukocyte

Question 22

In making an assessment of a patient with a bleeding disorder who has a dark complexion,the nurse should check the palms of the hands and the soles of the feet for _____________.

Question 23

To assure accuracy of a daily measurement of abdominal girth in a patient with ascites,the nurse will: (Select all that apply.)

A)place marks on the lateral sides of the abdomen where the tape is placed.
B)use the same tape every day.
C)measure girth with the tape placed 1 inch above the umbilicus.
D)measure the same area every day.
E)measure girth at the same time every day.

Question 24

The nurse explains that age-related changes that occur in the hematologic system include: (Select all that apply.)

A)decrease in blood volume.
B)decrease in bone marrow production.
C)decreased rate of blood cell production.
D)increased immune response.
E)increased clotting time.

Question 25

A female patient being seen in an outpatient clinic states she is having excessive menstruation and reports saturating four peri-pads per day.The nurse estimates the blood loss for this patient as ______ mL per day.

Question 26

Matching
The student nurse is drawing a diagram of the phases of the monocyte cell to present to the nursing class.The student correctly diagrams the phases in which order of occurrence?

Step: 3

A)Becomes a phagocyte
B)Becomes a macrophage
C)Engulfs bacteria
D)Migrates into tissues
E)Becomes a monocyte
F)Becomes a leukocyte

Question 27

To assess cyanosis in a patient with a dark complexion,the nurse should inspect the: (Select all that apply.)

A)conjunctiva.
B)gums.
C)roof of the mouth.
D)nail beds.
E)palms of the hands.

Question 28

To help conserve energy for the severely anemic patient,the nurse will: (Select all that apply.)

A)manage care so that the patient can have frequent rest periods.
B)assist with activities of daily living.
C)place personal care items close at hand.
D)arrange for small meals with between-meal snacks.
E)ensure that exercise sessions are planned during the morning.

Question 29

Matching
The student nurse is drawing a diagram of the phases of the monocyte cell to present to the nursing class.The student correctly diagrams the phases in which order of occurrence?

Step: 6

A)Becomes a phagocyte
B)Becomes a macrophage
C)Engulfs bacteria
D)Migrates into tissues
E)Becomes a monocyte
F)Becomes a leukocyte

Question 30

Matching
The student nurse is drawing a diagram of the phases of the monocyte cell to present to the nursing class.The student correctly diagrams the phases in which order of occurrence?

Step: 4

A)Becomes a phagocyte
B)Becomes a macrophage
C)Engulfs bacteria
D)Migrates into tissues
E)Becomes a monocyte
F)Becomes a leukocyte

Question 31

The normal range of hemoglobin is from _____ g/dL to _____ g/dL.

Question 32

Matching
The student nurse is drawing a diagram of the phases of the monocyte cell to present to the nursing class.The student correctly diagrams the phases in which order of occurrence?

Step: 1

A)Becomes a phagocyte
B)Becomes a macrophage
C)Engulfs bacteria
D)Migrates into tissues
E)Becomes a monocyte
F)Becomes a leukocyte

Question 33

Matching
The student nurse is drawing a diagram of the phases of the monocyte cell to present to the nursing class.The student correctly diagrams the phases in which order of occurrence?

Step: 5

A)Becomes a phagocyte
B)Becomes a macrophage
C)Engulfs bacteria
D)Migrates into tissues
E)Becomes a monocyte
F)Becomes a leukocyte