ATI Week 7: The Hematologic System

Question 1

A client is about to start taking liquid ferrous sulfate to treat iron deficiency anemia. Which of the following instructions should you include when talking with the client about taking this drug?

Answer 1

1. Drink it through a straw
2. Dilute it first with water
3. Take it with food

Question 2

A client is about to start taking cyanocobalamin, a vitamin B12 preparation. You understand that this drug treats which of the following types of anemia?

Answer 2

Pernicious

Question 3

Therapeutic effect of: Factor VIII (8)

Answer 3

Hemophilia A

Question 4

Therapeutic effect of: Folic Acid

Answer 4

Megaloblastic anemia

Question 5

Therapeutic effect of: Heparin

Answer 5

Deep vein thrombosis

Question 6

Therapeutic effect of: Filgrastim

Answer 6

Chronic neutropenia

Question 7

Before administering IV folic acid, you should explain to the client that this drug can cause which of the following A/E?

Answer 7

Rash

Question 8

You are reviewing the history of a client who is about to start therapy with Factor VIII to treat hemophilia A. Which of the following drugs the client takes should alert you to take further action?

Answer 8

Aspirin

Question 9

A client is about to start taking warfarin to prevent venous thrombosis. You should explain to the client that taking this drug initially requires daily blood samples to monitor the results of which of the following lab tests?

Answer 9

PT / NR

Question 10

You are caring for a client who is receiving alteplase to dissolve a thrombus. Which of the following should you include in your care plan for this client?

Answer 10

1. Monitor temperature
2. Limit venipunctures
3. Assess neurologic status
4. Apply pressure to oozing sites

Question 11

Pharmacologic action of: Alteplase

Answer 11

Dissolves blood clots

Question 12

Pharmacologic action of: Filgrastim

Answer 12

Stimulates leukocyte production

Question 13

Pharmacologic action of: Epoetin alfa

Answer 13

Stimulates RBC production

Question 14

Pharmacologic action of: Clopidogrel

Answer 14

Inhibits platelet aggregation

Question 15

A client is about to start taking clopidogrel to prevent transient ischemic attacks. You should instruct the client to watch and report for which of the following adverse effects of this drug?

Answer 15

1. Petechiae
2. Weakness
3. Vision changes

Question 16

A client is about to start taking oprelvekin for thrombocytopenia. To assess for A/E of this drug, you should monitor for which of the following carefully during drug therapy?

Answer 16

ECG

Question 17

A nurse should identify that clopidogrel is contraindicated for clients who have which of the following conditions?

Answer 17

Peptic ulcer disease

Question 18

A nurse is monitoring a client who is undergoing anticoagulant therapy with heparin. Which of the following findings should the nurse identify as a possible indication of a hemorrhage?

Answer 18

Rapid pulse

Question 19

A nurse is caring for a client who is about to begin taking epoetin. An increase in which of the following lab values should indicate to the nurse that the therapy is effective?

Answer 19

Hgb

Question 20

A nurse is caring for a client who is taking clopidogrel to prevent stent restenosis. The nurse should monitor the client for which of the following A/E reactions?

Answer 20

Thrombocytopenia

Question 21

A nurse is caring for a client who has hemophilia A and is about to begin taking desmopressin to prevent bleeding. The nurse should monitor the client for which of the following A/E?

Answer 21

Edema

Question 22

A nurse is caring for a client who is about to begin alteplase therapy to treat pulmonary embolism. Which of the following drugs should the nurse have available in the event of a severe adverse reaction?

Answer 22

Aminocaproic acid

Question 23

A nurse is caring for a client who is scheduled for an outpatient surgical procedure and reports taking aspirin 81 mg daily, including this morning. The nurse should identify that this places the client at risk for which of the following complications?

Answer 23

Uncontrolled bleeding

Question 24

A nurse is caring for a client who recently started alteplase therapy. The nurse should monitor the client for which of the following A/E?

Answer 24

Headache

Question 25

A nurse is caring for a client who has renal failure and is receiving epoetin. The nurse should monitor the client for which of the following A/E?

Answer 25

Hypertension

Question 26

A nurse is teaching a client about taking ferrous sulfate to treat iron-deficiency anemia. Which of the following instructions should the nurse include?

Answer 26

1. Eat iron-enriched food 2. Spread the dosage across each day 3. Take the drug on an empty stomach 4. Increase dietary fiber intake

Question 27

A nurse is caring for a client who is taking ferrous sulfate to treat iron-deficiency anemia and develops iron toxicity. Which of the the following drugs should the nurse expect to use to treat this complication?

Answer 27

Deferoxamine

Question 28

A nurse is caring for a client who is taking filgrastim to treat neutropenia. The nurse should assess the client for which of the following A/E?

Answer 28

Enlarged spleen

Question 29

A nurse is caring for a client who has chronic stable angina. The nurse should identify that which of the following drugs inhibit the action of adenosine diphosphate receptors (ADP) on platelets and can be prescribed to reduce the clients risk for myocardial infarction?

Answer 29

Clopidogrel

Question 30

A nurse is an emergency department is assessing a client who is been taking warfarin and is experiencing rectal bleeding. Which of the following drugs should the nurse expect to administer to the client?

Answer 30

Vitamin K

Question 31

A nurse is caring for a client who is about to begin taking aspirin to reduce the risk of a cardiovascular event. The nurse should identify that the drug inhibits platelet aggregation by which of the following mechanisms.

Answer 31

Inhibiting cyclooxygenase action in platelets

Question 32

A nurse is monitoring a client following ferrous sulfate administration. The nurse should monitor the client for which of the following A/E?

Answer 32

Constipation

Question 33

A nurse is teaching a client who is starting treatment with warfarin. The nurse should plan to include information on which of the following topics to promote the effectiveness of the drug?

Answer 33

Dietary modifications

Question 34

A nurse is reviewing the medication record of a client who is receiving alteplase following an acute myocardial infarction (MI). Which of the following medications should the nurse expect the client to be taking in addition to the alteplase?

Answer 34

Heparin

Question 35

A nurse is caring for a client who is about to begin factor VIII therapy to treat hemophilia A. When administering factor VIII, which of the following actions should the nurse take?

Answer 35

Have emergency equipment ready

Question 36

A nurse is caring for a client who is experiencing an acute ischemic cerebrovascular event due to a thrombus in a cerebral vessel. Which of the following drugs should the nurse expect to administer?

Answer 36

Alteplase

Question 37

A nurse is preparing to administer a prescribed dose of desmopressin to a client who has hemophilia A. The clients laboratory results indicate that the client has a sodium level of 130 mEq/ L. Which of the following actions should the nurse take?

Answer 37

Clarify the prescription with the provider

Question 38

A nurse is caring for a client who is about to begin taking folic acid to treat megaloblastic anemia. The nurse should monitor which of the following lab values to determine therapeutic effectiveness?

Answer 38

Reticulocyte count

Question 39

A nurse is caring for a client who is about to begin therapy with recombinant factor IX to treat hemophilia B. The client asks the nurse about the risk of disease transmission with recombinant factor IX as compared with plasma-derived factor IX. The nurse should explain that recombinant factor IX practically eliminates risk for which of the following?

Answer 39

Creutzfeldt-Jakob disease

Question 40

A nurse is administering epoetin IV to a client who has renal failure. Which of the following actions should the nurse take?

Answer 40

Administer via IV bolus over 1 - 3 minutes

Question 41

A nurse should assess a client who has megaloblastic anemia for indications of which of the following vitamin deficiencies?

Answer 41

Vitamin B12