Ch 25

Question 1

Common signs and symptoms of lymphoma include:

• an increased appetite.
• weight gain and nausea.
• night sweats and chills.
• irritability and a skin rash.

Answer 1

Night sweats and chills

Question 2

Most of the blood’s formed elements are:

• erythrocytes.
• leukocytes.
• platelets.
• electrolytes

Answer 2

Erythrocytes

Question 3

A 23-year-old woman with sickle cell disease presents with severe joint pain and a fever of 102.5 degrees Fahrenheit. She is conscious and alert, and tells you that her symptoms began yesterday and suddenly worsened today. Her blood pressure is 118/76 mm Hg, pulse rate is 120 beats/min and regular, and respirations are 24 breaths/min with adequate depth. After applying supplemental oxygen and initiating transport, you should:

• obtain a 12-lead ECG tracing, start a large-bore IV line, administer a 20-mL/kg normal saline bolus, and reassess her blood pressure.
• ensure that she is in a comfortable position, cover her with a blanket, start an IV line at a keep vein open rate, and monitor her throughout transport.
• monitor her oxygen saturation and cardiac rhythm, start an IV line with normal saline, administer 1 µg/kg of fentanyl, and reassess her vital signs.
• establish vascular access, administer 2 to 5 mg of midazolam, monitor her cardiac rhythm, and notify the receiving facility as soon as possible.

Answer 3

monitor her oxygen saturation and cardiac rhythm, start an IV line with normal saline, administer 1 µg/kg of fentanyl, and reassess her vital signs.

Question 4

You are dispatched to a residence for a 29-year-old woman with difficulty breathing. The patient was recently diagnosed with leukemia and has just completed her first round of chemotherapy. Upon arriving at the scene, you find the patient sitting in a recliner. Her level of consciousness is markedly diminished and her breathing is shallow. You should:

• move her to the floor and open her airway.
• administer high-flow oxygen via nonrebreathing mask.
• assess her carotid pulse for rate and regularity.
• assist her ventilations while she is in a sitting position.

Answer 4

Move her to the floor and open her airway

Question 5

The hematocrit is the:

• overall proportion of red blood cells in the blood.
• ratio of red blood cells to platelets.
• percentage of blood accounted for by the plasma.
• percentage of hemoglobin found within red blood cells.

Answer 5

Overall proportion of red blood cells in the blood

Question 6

In which of the following situations would a transfusion reaction most likely occur?

• A person with type O blood receives type AB blood
• A person with type B-positive blood receives type B-positive blood
• A person with type A-negative blood receives type O blood
• A person with type AB blood receives type O blood

Answer 6

A person with type O blood receives type AB blood

Question 7

Which of the following assessment findings is most suggestive of disseminated intravascular coagulation?

• Dyspnea
• Purpura
• Pruritis
• Tachycardia

Answer 7

Purpura

Question 8

Production of clotting factors is a function of the:

• spleen.
• kidney.
• liver.
• bone marrow.

Answer 8

Liver

Question 9

Which of the following statements regarding leukemia is correct?

• Leukemia is the result of abnormal white blood cell development.
• Most patients with leukemia have a normal white blood cell count.
• Leukemia may cause leukocytosis, a low white blood cell count.
• A hallmark of leukemia is an excess production of platelets.

Answer 9

Leukemia is the result of abnormal white blood cell development.

Question 10

You are transporting a 55-year-old woman to the hospital. The patient has lymphoma and complains of generalized, severe pain. She is receiving supplemental oxygen and has an IV line of normal saline established. Her blood pressure is 110/64 mm Hg, pulse rate is 104 beats/min and regular, and respirations are 22 breaths/min and adequate. You should:

• ensure that she is in a comfortable position and administer a 250-mL saline bolus.
• give her 2 to 5 mg of a benzodiazepine sedative and provide constant reassurance.
• provide emotional support, but refrain from analgesia as this may cause hypotension.
• administer narcotic analgesia as needed while closely monitoring her blood pressure.

Answer 10

administer narcotic analgesia as needed while closely monitoring her blood pressure.