Deck 17: Care of Patients With Hematologic Disorders

Question 1

The nurse is aware that the patient with a nutritional anemia is lacking the nutrients: (Select all that apply.)

A)proteins.
B)vitamin B12.
C)folic acid.
D)zinc.
E)iron.

Answer 1

proteins.
folic acid.
iron.

Question 2

The patient with acute myelogenous leukemia (AML)asks why he is making more WBCs when he already has so many.The nurse clarifies that the large number of leukemic white cells he already has:

A)are not as effective as normal white cells would be.
B)protect against infection.
C)attempt to take over the functions of RBCs.
D)are produced by the lymphatic system.

Answer 2

are not as effective as normal white cells would be.

Question 3

Because of a deficiency of iron,the person with iron deficiency anemia is unable to make sufficient:

A)plasma.
B)WBCs.
C)hemoglobin.
D)antibodies.

Answer 3

hemoglobin.

Question 4

The nurse stresses to the patient with sickle cell anemia that one of the most elementary home interventions to help prevent sickle cell crisis is to:

A)take iron supplements daily.
B)maintain adequate fluid intake.
C)engage in daily exercise.
D)eat leafy green vegetables.

Question 5

The nurse takes into consideration that the patient with polycythemia vera will have a phlebotomy to thin the blood:

A)every 2 to 3 weeks.
B)monthly.
C)every 2 to 3 months.
D)semiannually.

Question 6

The nurse assessing a patient with polycythemia vera would anticipate:

A)pale complexion.
B)low blood pressure.
C)high hemoglobin.
D)normal energy level.

Question 7

The nurse is aware that a common cause of reduced amounts of erythropoietin is:

A)renal failure.
B)liver cancer.
C)emphysema.
D)diabetes.

Question 8

The nurse makes a visual aid differentiating between mild,moderate,and severe anemia.The signs and symptoms of mild anemia include: (Select all that apply.)

A)hemoglobin of 14.4 g/dL.
B)palpitations.
C)dyspnea on exertion.
D)pallor.
E)fatigue.

Question 9

The nurse anticipates that the patient with iron deficiency anemia will have red cells that are:

A)normochromic and normocytic.
B)hypochromic and microcytic.
C)hyperchromic and macrocytic.
D)normochromic and microcytic.

Question 10

The nurse cautions the 79-year-old male who had a gastrectomy a month ago that he is at risk for _____ anemia.

A)aplastic
B)pernicious
C)iron deficiency
D)nutritional

Question 11

Change question stem,answer options,rationale,and cognitive level as follows: The student nurse is preparing to administer an iron preparation via the intramuscular (IM)route.Which action by the student indicates the need for further instruction?

A)The student changes needles after drawing up the medication.
B)The student chooses a 1 1/2 inch needle.
C)The student chooses a 20-gauge needle.
D)The student uses the Z-track technique when administering the injection.

Question 12

The nurse evaluates a need for further instruction to the patient with sickle cell anemia when he says:

A)"I know I'm not supposed to drink iced drinks."
B)"I surely do miss my three beers in the afternoon."
C)"I walk every day rather than doing other strenuous exercise."
D)"I am looking forward to my annual ski trip to Colorado."

Question 13

Extreme care is used by the nursing staff when repositioning or transporting a patient with advanced multiple myeloma to prevent:

A)pain to the patient.
B)bruising and hematomas.
C)muscle spasms.
D)pathologic fractures.

Question 14

Blood must be started within _____ minutes of its arrival on the unit.

A)10
B)15
C)30
D)60

Question 15

The nurse explains that induction therapy for acute lymphocytic leukemia (ALL)is a(n):

A)intensive protocol of chemotherapy in high doses to achieve remission.
B)long-term protocol with smaller doses of chemotherapy to achieve a cure.
C)2- to 5-year low-dose chemotherapy regimen to reduce painful symptoms.
D)combination of chemotherapy and radiation to achieve remission.

Question 16

The nurse is conscientious in the care of the feet and legs of a patient with sickle cell anemia because:

A)stasis ulcers are a constant threat.
B)bleeding may occur on the soles of the feet.
C)edema of the feet increases activity intolerance.
D)toenails must be kept short to avoid ingrown nails.

Question 17

The nurse instructs the 20-year-old female patient with sickle cell trait that:

A)the condition will evolve into sickle cell anemia as she ages.
B)all of her children will have sickle cell anemia.
C)the trait will be transmitted to male children only.
D)the trait can be passed on to all children.

Question 18

The home health nurse assesses the patient taking ferrous sulfate (Feosol).Which patient statement alerts the nurse that teaching is necessary regarding this medication?

A)"It tastes better when I take my medicine with milk."
B)"My wife says I should take my medicine with orange juice."
C)"I am always careful not to break open the capsule."
D)"I usually take my iron with my whole-grain toast during breakfast."

Question 19

The home health nurse caring for the patient with polycythemia vera will focus care on:

A)maintenance of high fluid intake.
B)daily exercise to reduce weight.
C)daily dose of anticoagulants.
D)adequate intake of vitamin C.

Question 20

The nurse frequently assesses for signs of infection on the patient with aplastic anemia because the patient will not be able to produce an inflammatory response related to the low level of:

A)leukocytes.
B)erythrocytes.
C)histamine.
D)hemopoietin.

Question 21

The nurse is aware that bone marrow transplantation (BMT)is a treatment alternative for aplastic anemia for people under the age of ____________________.

Question 22

The patient with acute myelogenous leukemia (AML)has a volume of blood extracted by machine,white cells are extracted in the machine,and the blood is then returned to the patient.This process is called ____________________.

Question 23

The nurse recommends to a patient with iron deficiency anemia to include foods high in iron,such as: (Select all that apply.)

A)liver.
B)lima beans.
C)prune juice.
D)cabbage.
E)dried apricots.

Question 24

The nurse explains to a person who has undergone bone marrow transplantation (BMT)that engraftment takes up to ____________________ weeks.

Question 25

Some of the causes of leukemia are thought to be: (Select all that apply.)

A)exposure to radiation.
B)exposure to pesticides.
C)exposure to benzene.
D)frequent bacterial infections.
E)virulent viral infections.

Question 26

The nurse monitoring a patient who is receiving a transfusion will stop the transfusion in the event of the patient complaining of: (Select all that apply.)

A)feeling cold.
B)a headache.
C)back pain.
D)a rash.
E)urticaria.

Question 27

The patient with AML has a platelet count of 95,000.What interventions should be included in the plan of care for this patient? (Select all that apply.)

A)Observe for melena and hematuria.
B)Brush and floss at least twice daily.
C)Measure abdominal girth daily.
D)Apply ice and pressure to puncture sites.
E)Use electric razor.

Question 28

Aplastic anemia has its etiology in a variety of drugs,such as: (Select all that apply.)

A)antimetabolite cancer drugs.
B)phenylbutazone (Butazolidin).
C)oral contraception drugs.
D)chloramphenicol (Chloromycetin).
E)sulfonamides.

Question 29

When assessing a complete blood count (CBC)of a patient with acute lymphocytic leukemia (ALL),the nurse would anticipate large numbers of immature white cells,called ____________________.