Question 1

An older adult client is exhibiting many of the characteristic signs and symptoms of iron deficiency. In addition to a complete blood count, what diagnostic assessment should the nurse anticipate?

Accepted Answer

A)   Stool for occult blood
B)   Bone marrow biopsy
C)   Lumbar puncture
D)   Urinalysis A

Question 2

A patients diagnosis of atrial fibrillation has prompted the primary care provider to prescribe warfarin (Coumadin), an anticoagulant. When assessing the therapeutic response to this medication, what is the nurses most appropriate action?

Accepted Answer

A)   Assess for signs of myelosuppression.
B)   Review the patients platelet level.
C)   Assess the patients capillary refill time.
D)   Review the patients international normalized ratio (INR) . D

Question 3

The nurse is planning the care of a patient with a nutritional deficit and a diagnosis of megaloblastic anemia. The nurse should recognize that this patients health problem is due to what?

Accepted Answer

A)   Production of inadequate quantities of RBCs
B)   Premature release of immature RBCs
C)   Injury to the RBCs in circulation
D)   Abnormalities in the structure and function RBCs D

Question 4

A patient has been scheduled for a bone marrow biopsy and admits to the nurse that she is worried about the pain involved with the procedure. What patient education is most accurate?

Accepted Answer

A)   Youll be given painkillers before the test, so there wont likely be any pain?
B)   Youll feel some pain when the needle enters your skin, but none when the needle enters the bone because of the absence of nerves in bone.
C)   Most people feel some brief, sharp pain when the needle enters the bone.
D)   Ill be there with you, and Ill try to help you keep your mind off the pain.

Question 5

A patient is being treated for the effects of a longstanding vitamin $\mathrm{B}_{12}$ deficiency. What aspect of the patients health history would most likely predispose her to this deficiency?

Accepted Answer

A)   The patient has irregular menstrual periods.
B)   The patient is a vegan.
C)   The patient donated blood 60 days ago.
D)   The patient frequently smokes marijuana.

Question 6

An individual has accidentally cut his hand, immediately initiating the process of hemostasis. Following vasoconstriction, what event in the process of hemostasis will take place?

Accepted Answer

A)   Fibrin will be activated at the bleeding site.
B)   Platelets will aggregate at the injury site.
C)   Thromboplastin will form a clot.
D)   Prothrombin will be converted to thrombin.

Question 7

The nurse is providing care for an older adult who has a hematologic disorder. What age-related change in hematologic function should the nurse integrate into care planning?

Accepted Answer

A)   Bone marrow in older adults produces a smaller proportion of healthy, functional blood cells.
B)   Older adults are less able to increase blood cell production when demand suddenly increases.
C)   Stem cells in older adults eventually lose their ability to differentiate.
D)   The ratio of plasma to erythrocytes and lymphocytes increases with age.

Question 8

A clients health history reveals daily consumption of two to three bottles of wine. The nurse should plan assessments and interventions in light of the patients increased risk for what hematologic disorder?

Accepted Answer

A)   Leukemia
B)   Anemia
C)   Thrombocytopenia
D)   Lymphoma

Question 9

A patients wound has begun to heal and the blood clot which formed is no longer necessary. When a blood clot is no longer needed, the fibrinogen and fibrin will be digested by which of the following?

Accepted Answer

A)   Plasminogen
B)   Thrombin
C)   Prothrombin
D)   Plasmin

Question 10

An interdisciplinary team has been commissioned to create policies and procedures aimed at preventing acute hemolytic transfusion reactions. What action has the greatest potential to reduce the risk of this transfusion reaction?

Accepted Answer

A)   Ensure that blood components are never infused at a rate greater than  125 mL/hr125 \mathrm{~mL} / \mathrm{hr}125 mL/hr .
B)   Administer prophylactic antihistamines prior to all blood transfusions.
C)   Establish baseline vital signs for all patients receiving transfusions.
D)   Be vigilant in identifying the patient and the blood component.

Question 11

Two units of PRBCs have been ordered for a patient who has experienced a GI bleed. The patient is highly reluctant to receive a transfusion, stating, Im terrified of getting AIDS from a blood transfusion. How can the nurse best address the patients concerns?

Accepted Answer

A)   All the donated blood in the United States is treated with antiretroviral medications before it is used.
B)   That did happen in some high-profile cases in the twentieth century, but it is no longer a possibility.
C)   HIV was eradicated from the US blood supply in the early 2000s.
D)   The chances of contracting AIDS from a blood transfusion in the United States are exceedingly low.

Question 12

A patient is receiving a blood transfusion and complains of a new onset of slight dyspnea. The nurses rapid assessment reveals bilateral lung crackles and elevated BP. What is the nurses most appropriate action?

Accepted Answer

A)   Slow the infusion rate and monitor the patient closely.
B)   Discontinue the transfusion and begin resuscitation.
C)   Pause the transfusion and administer a  250 mL250 \mathrm{~mL}250 mL  bolus of normal saline.
D)   Discontinue the transfusion and administer a beta-blocker, as ordered.

Question 13

The nurse caring for a patient receiving a transfusion notes that 15 minutes after the infusion of packed red blood cells (PRBCs) has begun, the patient is having difficulty breathing and complains of severe chest tightness. What is the most appropriate initial action for the nurse to take?

Accepted Answer

A)   Notify the patients physician.
B)   Stop the transfusion immediately.
C)   Remove the patients IV access.
D)   Assess the patients chest sounds and vital signs.

Question 14

A patient has been diagnosed with a lymphoid stem cell defect. This patient has the potential for a problem involving which of the following?

Accepted Answer

A)   Plasma cells
B)   Neutrophils
C)   Red blood cells
D)   Platelets

Question 15

Which of the following circumstances would most clearly warrant autologous blood donation?

Accepted Answer

A)   The patient has type-O blood.
B)   The patient has sickle cell disease or a thalassemia.
C)   The patient has elective surgery pending.
D)   The patient has hepatitis  C\mathrm{C}C .

Question 16

A nurse at a blood donation clinic has completed the collection of blood from a woman. The woman states that she feels lightheaded and she appears visibly pale. What is the nurses most appropriate action?

Accepted Answer

A)   Help her into a sitting position with her head lowered below her knees.
B)   Administer supplementary oxygen by nasal prongs.
C)   Obtain a full set of vital signs.
D)   Inform a physician or other primary care provider.

Question 17

A patients electronic health record states that the patient receives regular transfusions of factor IX. The nurse would be justified in suspecting that this patient has what diagnosis?

Accepted Answer

A)   Leukemia
B)   Hemophilia
C)   Hypoproliferative anemia
D)   Hodgkins lymphoma

Question 18

A patient is scheduled for a splenectomy. During discharge education, what teaching point should the nurse prioritize?

Accepted Answer

A)   The importance of adhering to prescribed immunosuppressant therapy
B)   The need to report any signs or symptoms of infection promptly
C)   The need to ensure adequate folic acid, iron, and vitamin  B12\mathrm{B}_{12}B12​  intake
D)   The importance of limiting activity postoperatively to prevent hemorrhage

Question 19

The nurses review of a patients most recent blood work reveals a significant increase in the number of band cells. The nurses subsequent assessment should focus on which of the following?

Accepted Answer

A)   Respiratory function
B)   Evidence of decreased tissue perfusion
C)   Signs and symptoms of infection
D)   Recent changes in activity tolerance

Question 20

The nurse is describing the role of plasminogen in the clotting cascade. Where in the body is plasminogen present?

Accepted Answer

A)   Myocardial muscle tissue
B)   All body fluids
C)   Cerebral tissue
D)   Venous and arterial vessel walls

Exam 32: Assessment of Hematologic Function and Treatment Modalities

An older adult client is exhibiting many of the characteristic signs and symptoms of iron deficiency. In addition to a complete blood count, what diagnostic assessment should the nurse anticipate?

A patients diagnosis of atrial fibrillation has prompted the primary care provider to prescribe warfarin (Coumadin) , an anticoagulant. When assessing the therapeutic response to this medication, what is the nurses most appropriate action?

The nurse is planning the care of a patient with a nutritional deficit and a diagnosis of megaloblastic anemia. The nurse should recognize that this patients health problem is due to what?

A patient has been scheduled for a bone marrow biopsy and admits to the nurse that she is worried about the pain involved with the procedure. What patient education is most accurate?

A patient is being treated for the effects of a longstanding vitamin $\mathrm{B}_{12}$ deficiency. What aspect of the patients health history would most likely predispose her to this deficiency?

An individual has accidentally cut his hand, immediately initiating the process of hemostasis. Following vasoconstriction, what event in the process of hemostasis will take place?

The nurse is providing care for an older adult who has a hematologic disorder. What age-related change in hematologic function should the nurse integrate into care planning?

A clients health history reveals daily consumption of two to three bottles of wine. The nurse should plan assessments and interventions in light of the patients increased risk for what hematologic disorder?

A patients wound has begun to heal and the blood clot which formed is no longer necessary. When a blood clot is no longer needed, the fibrinogen and fibrin will be digested by which of the following?

An interdisciplinary team has been commissioned to create policies and procedures aimed at preventing acute hemolytic transfusion reactions. What action has the greatest potential to reduce the risk of this transfusion reaction?

Two units of PRBCs have been ordered for a patient who has experienced a GI bleed. The patient is highly reluctant to receive a transfusion, stating, Im terrified of getting AIDS from a blood transfusion. How can the nurse best address the patients concerns?

A patient is receiving a blood transfusion and complains of a new onset of slight dyspnea. The nurses rapid assessment reveals bilateral lung crackles and elevated BP. What is the nurses most appropriate action?

The nurse caring for a patient receiving a transfusion notes that 15 minutes after the infusion of packed red blood cells (PRBCs) has begun, the patient is having difficulty breathing and complains of severe chest tightness. What is the most appropriate initial action for the nurse to take?

A patient has been diagnosed with a lymphoid stem cell defect. This patient has the potential for a problem involving which of the following?

Which of the following circumstances would most clearly warrant autologous blood donation?

A nurse at a blood donation clinic has completed the collection of blood from a woman. The woman states that she feels lightheaded and she appears visibly pale. What is the nurses most appropriate action?

A patients electronic health record states that the patient receives regular transfusions of factor IX. The nurse would be justified in suspecting that this patient has what diagnosis?

A patient is scheduled for a splenectomy. During discharge education, what teaching point should the nurse prioritize?

The nurses review of a patients most recent blood work reveals a significant increase in the number of band cells. The nurses subsequent assessment should focus on which of the following?

The nurse is describing the role of plasminogen in the clotting cascade. Where in the body is plasminogen present?

Exam 32: Assessment of Hematologic Function and Treatment Modalities

An older adult client is exhibiting many of the characteristic signs and symptoms of iron deficiency. In addition to a complete blood count, what diagnostic assessment should the nurse anticipate?

A patients diagnosis of atrial fibrillation has prompted the primary care provider to prescribe warfarin (Coumadin) , an anticoagulant. When assessing the therapeutic response to this medication, what is the nurses most appropriate action?

The nurse is planning the care of a patient with a nutritional deficit and a diagnosis of megaloblastic anemia. The nurse should recognize that this patients health problem is due to what?

A patient has been scheduled for a bone marrow biopsy and admits to the nurse that she is worried about the pain involved with the procedure. What patient education is most accurate?

A patient is being treated for the effects of a longstanding vitamin B12\mathrm{B}_{12}B12​ deficiency. What aspect of the patients health history would most likely predispose her to this deficiency?

An individual has accidentally cut his hand, immediately initiating the process of hemostasis. Following vasoconstriction, what event in the process of hemostasis will take place?

The nurse is providing care for an older adult who has a hematologic disorder. What age-related change in hematologic function should the nurse integrate into care planning?

A clients health history reveals daily consumption of two to three bottles of wine. The nurse should plan assessments and interventions in light of the patients increased risk for what hematologic disorder?

A patients wound has begun to heal and the blood clot which formed is no longer necessary. When a blood clot is no longer needed, the fibrinogen and fibrin will be digested by which of the following?

An interdisciplinary team has been commissioned to create policies and procedures aimed at preventing acute hemolytic transfusion reactions. What action has the greatest potential to reduce the risk of this transfusion reaction?

Two units of PRBCs have been ordered for a patient who has experienced a GI bleed. The patient is highly reluctant to receive a transfusion, stating, Im terrified of getting AIDS from a blood transfusion. How can the nurse best address the patients concerns?

A patient is receiving a blood transfusion and complains of a new onset of slight dyspnea. The nurses rapid assessment reveals bilateral lung crackles and elevated BP. What is the nurses most appropriate action?

The nurse caring for a patient receiving a transfusion notes that 15 minutes after the infusion of packed red blood cells (PRBCs) has begun, the patient is having difficulty breathing and complains of severe chest tightness. What is the most appropriate initial action for the nurse to take?

A patient has been diagnosed with a lymphoid stem cell defect. This patient has the potential for a problem involving which of the following?

Which of the following circumstances would most clearly warrant autologous blood donation?

A nurse at a blood donation clinic has completed the collection of blood from a woman. The woman states that she feels lightheaded and she appears visibly pale. What is the nurses most appropriate action?

A patients electronic health record states that the patient receives regular transfusions of factor IX. The nurse would be justified in suspecting that this patient has what diagnosis?

A patient is scheduled for a splenectomy. During discharge education, what teaching point should the nurse prioritize?

The nurses review of a patients most recent blood work reveals a significant increase in the number of band cells. The nurses subsequent assessment should focus on which of the following?

The nurse is describing the role of plasminogen in the clotting cascade. Where in the body is plasminogen present?

A patient is being treated for the effects of a longstanding vitamin $\mathrm{B}_{12}$ deficiency. What aspect of the patients health history would most likely predispose her to this deficiency?