Deck 34: Coordinating Care for Patients With Hematological Disorders

Question 1

A child diagnosed with aplastic anemia is admitted to the hospital.The parents ask the nurse what aplastic anemia is.Which response by the nurse is accurate?

A) "Aplastic anemia causes a proliferation of white blood cells."
B) "Aplastic anemia is characterized by abnormally shaped red blood cells."
C) "Aplastic anemia is caused by the bone marrow producing inadequate cells."
D) "Aplastic anemia is a disorder that occurs after a viral illness."

Answer 1

"Aplastic anemia is caused by the bone marrow producing inadequate cells."

Question 2

The home healthcare nurse is preparing a care plan for a patient with severe anemia.The patient currently lives alone and states,"I can't even walk to the kitchen without getting winded." What would be the priority nursing diagnosis for this patient?

A) Hopelessness
B) Activity Intolerance
C) Altered Nutrition,Less than Body Requirements
D) Anxiety

Answer 2

Activity Intolerance

Question 3

A pediatric nurse is caring for a child with acute lymphoblastic leukemia (ALL).When providing education to the child's parents regarding this disease,which topic should the nurse include?

A) ALL is characterized by abnormal proliferation of all bone marrow elements.
B) This form of leukemia is the most common type among children and adolescents.
C) This form of leukemia is very rarely seen in children.
D) The onset of ALL is usually gradual.

Answer 3

This form of leukemia is the most common type among children and adolescents.

Question 4

The health-care provider prescribes laboratory tests following the initiation of treatment for a child who is diagnosed with iron-deficiency anemia.Which laboratory result should the nurse share with the child's family as an indication of improvement?

A) Low hemoglobin
B) Normal platelet count
C) High reticulocyte count
D) Low hematocrit

Question 5

Which is the priority nursing diagnosis for the child diagnosed with idiopathic thrombocytopenic purpura (ITP)?

A) Ineffective Breathing Pattern
B) Nausea
C) Fluid Volume Deficit
D) Risk for Injury

Question 6

A nurse is planning care for a patient with sickle cell disease and chooses Acute Pain as the nursing diagnosis.Which intervention is inappropriate for the nurse to include in this plan of care?

A) Administer ordered analgesic medications around the clock
B) Place patient in position of comfort
C) Use heat or cold packs as tolerated
D) Support the patient's joints and extremities with pillows

Question 7

The nurse is evaluating a patient's understanding of dietary needs to treat anemia.Which patient statement indicates a need for additional teaching?

A) "I will eat more fruits and vegetables,especially green leafy ones,to get more iron in my diet."
B) "I will need to include more protein foods in my diet such as meats,dried beans,and whole-grain breads."
C) "I will decrease foods high in vitamin C,as they decrease my absorption of iron."
D) "I will take vitamins with extra iron in addition to eating a balanced diet with meat to correct my anemia."

Question 8

The nurse is instructing a patient with iron-deficiency anemia about appropriate menu choices.Which diet choice indicates that teaching has been effective?

A) Tofu with mixed vegetables in curry,milk,whole-wheat bun
B) Broiled fish,lettuce salad,grapefruit half,carrot sticks
C) Pork chop,mashed potatoes and gravy,cauliflower,tea
D) Roast beef,steamed spinach,tomato soup,orange juice

Question 9

An emergency department nurse is caring for a child in a sickle cell crisis.The nurse suspects the etiology of the crisis as being thrombotic in nature due to which clinical manifestations?

A) The patient has profound pallor and fatigue.
B) The patient is in extreme pain.
C) The patient has profound hypotension and shock.
D) The patient's chest CT reveals a pulmonary infarct.

Question 10

Which is the priority teaching point for the nurse to include in the discharge instructions for the parents of a child who was admitted to the hospital in a sickle cell crisis?

A) Rapid weaning of pain medications
B) A diet high in protein
C) Adequate hydration
D) Restriction of activities

Question 11

A patient is admitted to the emergency department in a sickle cell crisis.The nurse assesses the patient and documents the following clinical findings: temperature 102°F,O₂ saturation of 89%,and complaints of severe abdominal pain.Based on the assessment findings,which intervention is the greatest priority?

A) Apply oxygen per nasal cannula at 3 L/minute.
B) Assess and document peripheral pulses.
C) Administer morphine sulfate 10 mg IM.
D) Administer Tylenol 650 mg by mouth.

Question 12

The nurse is planning care for a patient with acute myeloid leukemia (AML).Which is the priority nursing diagnosis to minimize the risk of complications associated with AML?

A) Risk for Bleeding
B) Ineffective Thermoregulation
C) Imbalanced Nutrition
D) Fluid Volume Excess

Question 13

A child who has polycythemia is prescribed radiation.The child's parents ask why this is necessary since the child does not have cancer.Which response by the nurse is accurate?

A) "It stimulates red blood cell production."
B) "It suppresses the bone marrow."
C) "It provides vitamin supplementation."
D) "It decreases the risk of transfusion reactions."

Question 14

A nurse is providing discharge instructions to a patient with iron-deficiency anemia who is experiencing glossitis.Which patient statement indicates the need for further education?

A) "I will monitor my lips and tongue daily."
B) "I will use an alcohol-based mouthwash twice per day."
C) "I will apply a petroleum-based lubricating ointment to my lips."
D) "I will use a soft toothbrush when brushing my teeth each day."

Question 15

The nurse is caring for a patient who was admitted to a medical-surgical unit in a sickle cell crisis.Which medication should the nurse expect to administer to this patient?

A) Acetaminophen
B) Ibuprofen
C) Meperidine
D) Hydroxyurea

Question 16

A nurse is providing discharge teaching for a patient with iron-deficiency anemia.The patient has been prescribed ferrous sulfate and has been told to increase the intake of foods that are naturally high in iron.Which patient statement indicates correct understanding?

A) "I will decrease my intake of green leafy vegetables while taking my ferrous sulfate tablet."
B) "I will increase my fluid intake while I am taking my ferrous sulfate."
C) "I will take my ferrous sulfate tablet on an empty stomach."
D) "I will decrease milk intake while taking my ferrous sulfate tablet."

Question 17

The nurse is providing care to a patient who is receiving treatment for sickle cell disease.The patient is at risk for infection.Which medication does the nurse expect to administer to this patient?

A) Acetaminophen
B) Penicillin
C) Morphine sulfate
D) Tamoxifen

Question 18

A pediatric patient being treated for acute lymphocytic leukemia (ALL)has a white blood cell count of 1,000/mm3.Which nursing diagnosis would be a priority for this patient?

A) Readiness for Enhanced Immunization Status
B) Impaired Gas Exchange
C) Risk for Infection
D) Activity Intolerance

Question 19

A nurse is planning care for a patient with leukemia.The nurse chooses Risk for Bleeding as the nursing diagnosis.Which intervention supports this nursing diagnosis?

A) Educate patient in use of soft toothbrush for oral care
B) Limit parenteral injections
C) Apply pressure to arterial puncture sites for five minutes
D) Encourage patient to deep breathe and huff cough

Question 20

A patient in sickle cell crisis reports taking a recent skiing trip that caused a respiratory infection from the cold weather.Which nursing diagnosis is a priority for this patient?

A) Fluid Volume Excess
B) Risk for Self-Mutilation
C) Knowledge Deficit
D) Acute Pain

Question 21

A patient experiencing fatigue,pallor,and dyspnea on exertion has a complete blood count drawn.Which red blood cell disorder should the nurse anticipate the patient is experiencing?

A) Polycythemia
B) Erythropoiesis
C) Herpes simplex
D) Anemia

Question 22

Parents of a newborn infant are concerned that their baby may have sickle cell disease.The nurse reviews the medical record and finds that both parents have the sickle cell trait.Which is the best response for the nurse to give the parents?

A) "Since neither of you actually has sickle cell disease,your baby is not at risk."
B) "Your baby has the disease,as you both carry the trait."
C) "As you both have the sickle cell trait,your baby will be tested for the disease."
D) "Have you talked to a genetic counselor about your concerns?"

Question 23

A nurse is educating a patient with anemia about the pathophysiological mechanisms of anemia.Which should be excluded in the nurse's teaching plan for this patient?

A) Altered hemoglobin synthesis
B) Altered DNA synthesis
C) Decreased hemolysis
D) Bone marrow failure

Question 24

A patient complaining of mouth soreness had gastric bypass surgery one year ago.During the assessment,the nurse notes the patient's tongue is beefy,red,and smooth and the patient's skin appears yellowish.Which additional information is most likely needed before diagnosing this patient?

A) Vitamin B₆ levels
B) Vitamin B₁₂ levels
C) Potassium levels
D) Iron levels

Question 25

An older adult patient with renal failure is diagnosed with anemia.Based on this data,which cause of anemia will the nurse plan for when providing care?

A) Loss of the kidney hormone erythropoietin
B) A loss of appetite related to elevated blood urea nitrogen (BUN)and creatinine levels
C) The renal dialysis used to treat the chronic renal failure
D) Loss of blood through the urine because the failing kidney does not function properly