Question 1

``` H-1) ​Dead, diseased, or injured white blood cells are removed from the body via​ the: A. bone marrow. B. spleen and the liver. C. gastrointestinal system. D. pulmonary system. ```

Accepted Answer

B. spleen and the liver Red blood​ cells, white blood​ cells, and platelets survive in the circulation for only a finite period of time and are then removed from the circulation by means of the filtration by the spleen or liver.

Question 2

``` H-2) Specialized molecules called hemoglobin bind to oxygen and deliver it to the body cells​ via: A. plasma. B. white blood cells. C. red blood cells. D. platelets. ```

Accepted Answer

C. red blood cells. Red blood cells contain specialized molecules called hemoglobin that bind to oxygen and are responsible for oxygen delivery to the cells.

Question 3

H-3) Which of the following statements about patients with chronic anemia is​ true? A. Patients with chronic anemia experience rapid onset of​ symptoms, usually due to trauma. B. Patients with chronic anemia appear paler than​ normal, and are easily fatigued with exertion. C. Patients with chronic anemia rapidly exhibit signs and symptoms of shock. D. Patients with chronic anemia have a rapid pulse​ rate; cool, clammy​ skin; and hypotension.

Accepted Answer

B. Patients with chronic anemia appear paler than​ normal, and are easily fatigued with exertion. Chronic anemia occurs over​ time, and can be caused by conditions such as recurrent heavy menstrual​ periods, slow GI blood​ loss, or diseases of the bone marrow or structure of the hemoglobin molecule. Patients with chronic anemia often appear more pale than normal and often complain of fatigue and shortness of breath with exertion. Only after a prolonged period of time will patients with chronic anemia exhibit signs and symptoms of shock.

Question 4

``` H-4) Examining the color of the conjunctiva of a​ patient's lower eyelid is an appropriate assessment for which of the following​ conditions? A. Acute anemia B. Chronic anemia C. Sickle cell anemia D. Atrial fibrillation ```

Accepted Answer

B. Chronic anemia (Page 768) One of the best ways to assess for chronic anemia is to examine the color of the​ patient's conjunctiva on the lower eyelid. Anemic patients will have very pale​ conjunctiva, as opposed to the​ red/pink color seen in normal patients.

Question 5

H-5) You arrive at the home of a​ 47-year-old female who reportedly lost her balance on her front​ porch, fell​ backward, and struck her head. She is awake and alert but complains of a headache. The only medications that she takes are Plavix and aspirin. What concerns should you have for this​ patient? A. The medications that she is taking will mask the pain that she could be having from her head injury. B. These​ drugs, by preventing platelet​ aggregation, could cause a serious bleed in her head. C. The combination of these two medications may cause seizures that may have led to her fall in the first place. D. The combination of these two medications is probably why she lost her balance in the first place.

Accepted Answer

B. These​ drugs, by preventing platelet​ aggregation, could cause a serious bleed in her head. These​ drugs, by preventing platelet​ aggregation, could cause a serious bleed in her​ head, which could be​ life-threatening.

Question 6

``` H-6) You arrive on scene to a​ 54-year-old male with chest pain and shortness of breath. Based on his signs and symptoms as well as his​ history, you suspect​ he's having a myocardial infarction. What medication can you administer to inhibit the aggregation of platelets at the site of coronary​ occlusion? A. Oxygen B. Nitroglycerin C. Morphine D. Aspirin ```

Accepted Answer

D. Aspirin Aspirin is used to inhibit platelet aggregation in suspected MI patients.

Question 7

H-7) You arrive on scene where an elderly patient has suffered a​ ground-level fall. He has a large hematoma on his forehead. After you perform your primary​ assessment, his wife tells you that he just had surgery and now takes Lovenox injections. What concerns do you have about this​ finding? A. On the basis of your​ assessment, there is no cause for immediate concern. B. Lovenox may cause kidney failure. C. Lovenox could cause the​ patient's blood pressure to rise to dangerous levels. D. Lovenox is a blood thinner that could exacerbate hemorrhage.

Accepted Answer

D. Lovenox is a blood thinner that could exacerbate hemorrhage. Lovenox is a prescribed blood thinner that could cause massive hemorrhage in seemingly benign situations. In this​ scenario, the patient should be evaluated and transported because of the possibility of increased internal bleeding.

Question 8

H-8) Why do patients with sickle cell disease sometimes develop​ jaundice? A. Most patients with sickle cell disease also have hepatitis because of repeated blood transfusions. B. The sickled red blood cells tend to leak the hemoglobin into the blood plasma. C. The jaundice is a product of the powerful medications that are necessary to treat sickle cell disease. D. The liver becomes overwhelmed by the breakdown in red blood cells.

Accepted Answer

D. The liver becomes overwhelmed by the breakdown in red blood cells The liver becomes overwhelmed by the breakdown in red blood cells. The red blood cells that are sickled do not survive​ long, and tend to accumulate in the​ liver, awaiting destruction. This accumulation overwhelms the liver​ function, and bilirubin accumulates in the​ blood, resulting in yellowish pigmentation of body tissues.

Question 9

H-9) Which of the following is the best explanation for the increased risk of stroke in sickle cell anemia​ patients? A. Sludging red blood cells block the capillaries that supply the brain. B. The sickled cells do not carry​ oxygen; therefore, some brain tissue will become ischemic. C. The sickled cells are irregular in​ shape, and will likely damage the vascular walls. D. Sickle cell anemia tends to develop mostly in elderly individuals.

Accepted Answer

A. Sludging red blood cells block the capillaries that supply the brain.

Question 10

H-10) Monitor a patient with a history of sickle cell anemia for signs of hypoperfusion​ if: A. the patient has hypertension. B. the patient has a high fever. C. the patient shows a temporary increase in pulse oximetry readings. D. the patient has inadequate respirations.

Accepted Answer

B. the patient has a high fever Monitor patients with high fever for signs of​ hypo-perfusion, and treat for shock as necessary.

Question 11

``` H-11) Patients with acute chest syndrome commonly​ have: A. priapism. B. inadequate respirations. C. jaundice. D. strokes. ```

Accepted Answer

B. inadequate respirations. Monitor patients with acute chest syndrome for signs of inadequate​ respiration, and provide​ bag-valve-mask ventilation as necessary.

Question 12

H-12) When an individual becomes​ dehydrated, how do the kidneys compensate for this​ state? A. Only one kidney will continue​ filtration, whereas the other goes dormant. B. The kidneys help the body retain needed fluid. C. The kidneys temporarily shut down to prevent additional fluid loss. D. The kidneys reduce the amount of blood that is initially filtered.

Accepted Answer

B. The kidneys help the body retain needed fluid. (Page 771) In addition to filtering​ blood, the kidneys can adjust the concentration of urine by adding water to or taking away water from urine. In patients who are​ dehydrated, this helps the body retain needed fluid.

Question 13

H-13) Which of the following functions do the kidneys normally​ perform? A. Fluid regulation by removal of excess fluid B. Production of hormones such as adrenaline C. Filtration of the blood for removal of excess red blood cells D. Maintaining a balance of the thermoregulatory hormones

Accepted Answer

A. Fluid regulation by removal of excess fluid (page 771) Removal of excess fluid is a key function of the kidneys.

Question 14

H-14) Patients who suffer acute renal​ failure: A. are unlikely to develop chronic renal failure. B. may recover normal kidney function if the cause is rapidly discovered and treated. C. likely have an inherited disease such as polycystic kidney disease. D. never recover normal kidney function.

Accepted Answer

B. may recover normal kidney function if the cause is rapidly discovered and treated. Some patients who experience acute renal failure can recover normal kidney function if the underlying cause of the insult to the kidneys is rapidly identified and corrected.

Question 15

H-15) For a patient with acute renal failure from severe​ dehydration, what would need to occur for recovery of normal renal​ function? A. Hemodialysis B. Aggressive treatment with intravenous fluids C. Coagulopathy D. Peritoneal dialysis

Accepted Answer

B. Aggressive treatment with intravenous fluids Some patients who experience acute renal failure can recover normal kidney function if the underlying cause of the insult to the kidneys is rapidly identified and corrected. An example of this would be severe dehydration in a patient trapped in a building collapse for several​ days; with aggressive treatment with intravenous​ fluids, the patient can recover normal renal function over time.

Question 16

``` H-16) What is one​ short-term complication resulting from ingestion of toxic​ substances? A. Peritoneal dialysis B. ​Long-term hemodialysis C. ​End-stage renal failure D. Acute renal failure ```

Accepted Answer

D. Acute renal failure (Page 771) Patients with acute intoxication from toxic substances suffer from acute renal​ failure, and may have their renal function​ restored, if properly managed.

Question 17

``` H-17) ​Hemodialysis: A. is typically performed at home. B. involves two large catheters. C. uses gravity to perform dialysis. D. is the least common form of dialysis. ```

Accepted Answer

B. involves two large catheters (Page 773) In​ hemodialysis, a patient is connected to a dialysis machine by two large catheters. The machine filters the blood pumped through the catheters.

Question 18

H-18) Which of the following is true of​ hemodialysis? A. Most patients receive hemodialysis at home. B. Hemodialysis is temporary for most patients. C. There are few complications from hemodialysis. D. It is the most common type of renal dialysis in the United States.

Accepted Answer

D. It is the most common type of renal dialysis in the United States. The majority of​ end-stage renal disease patients in the United States receive hemodialysis at outpatient centers. Hemodialysis presents with many​ complications, and is often a​ long-term management procedure for patients with ESRD.

Question 19

``` H-19) Dialysis is the process by which toxins and excess fluid are removed from the body by a medical system independent of​ the: A. spleen. B. liver. C. kidneys. D. heart. ```

Accepted Answer

C. kidneys. Dialysis is the process by which toxins and excess fluid are removed from the body by a medical system independent of the kidneys.

Question 20

``` H-20) You are caring for a hemodialysis patient when you sense an odd vibration in the​ patient's lower arm. This condition is​ termed: A. a thrill. B. an oscillation. C. a crepitus. D. an excitement. ```

Accepted Answer

A. a thrill. (Page 775) A vibration felt on gentle​ palpation, such as the palpable sensation of blood flowing through an arteriovenous​ fistula, is known as a thrill.

Question 21

``` H-21) Patients receiving peritoneal dialysis who experience abdominal​ pain, fever, and cloudy dialysis fluid are possibly suffering​ from: A. peritonitis. B. completion of dialysis treatment. C. AV fistula malfunction. D. electrolyte imbalance. ```

Accepted Answer

A. peritonitis (Page 777) Abdominal​ pain, fever, and cloudy dialysis fluid are all signs and symptoms associated with peritonitis.

Question 22

H-22) You are seeing a​ 49-year-old hemodialysis patient for complaints of headache and arm pain. You examine her arm and find an AV fistula that is hard to the​ touch, not​ vibrating, and warm. What is the most likely​ explanation? A. The lack of vibration suggests that the AV fistula is occluded by a clot. B. The firmness from palpation and absence of a vibration are​ normal; being warm to touch suggests an infection. C. Vibration is not a condition to be expected in an AV​ fistula, and the​ hard, warm condition is a result of repeated use for hemodialysis. D. These conditions clearly indicate that electrolytes are beginning to accumulate.

Accepted Answer

A. The lack of vibration suggests that the AV fistula is occluded by a clot. (Page 777 - Complications of Dialysis - Bullet 2) The most likely explanation is an occluded fistula.​ Normally, you should feel a thrill while lightly palpating the fistula.

Question 23

H-23) After you assess the ABCs of an ESRD patient with complications of​ dialysis, you should​ immediately: A. control any serious bleeding from the site of the AV fistula. B. treat for shock. C. transport the patient. D. administer supplemental oxygen.

Accepted Answer

A. control any serious bleeding from the site of the AV fistula.

Question 24

H-24) For an ESRD patient who has missed dialysis and become unresponsive and​ pulseless, you​ should: A. place the patient in a position of comfort. B. be prepared to attach and use the AED. C. monitor vital signs. D. administer supplemental oxygen.

Accepted Answer

B. be prepared to attach and use the AED. For an ESRD patient who has missed dialysis and become unresponsive and​ pulseless, you should be prepared to attach and use the AED. Be aware that ESRD patients who suffer cardiac arrest may not respond to defibrillation. Paramedics carry certain drugs that can be administered in the field to help stabilize​ ESRD-induced dysrhythmias. Consider ALS​ backup, but do not delay transport to the hospital.

Question 25

``` H-25) Recipients of kidney transplants are much more prone​ to: A. abnormal weight loss. B. infections. C. heart failure. D. high blood pressure. ```

Accepted Answer

B. infections. Infections are a significant risk for kidney transplant​ recipients, particularly because their immune systems are​ suppressed, to avoid rejection of the transplant.

Question 26

H-26) A patient with a kidney​ transplant: A. must take drugs to prevent organ rejection. B. needs sustained oxygen therapy. C. needs constant dialysis. D. cannot resist infection.

Accepted Answer

A. must take drugs to prevent organ rejection Patients with kidney transplants spend the rest of their lives on a special class of drugs that prevent organ rejection by suppressing the​ body's immune system.

Question 27

PT-1) Why do some patients prefer peritoneal dialysis​ (PD) over hemodialysis​ (HD)? A. Peritoneal dialysis allows patients to be treated at home. B. Peritoneal dialysis requires fewer treatments per day than hemodialysis. C. Peritoneal dialysis is quicker than hemodialysis. D. Peritoneal dialysis enables full freedom of movement during treatments.

Accepted Answer

A. Peritoneal dialysis allows patients to be treated at home. (Page 775)

Question 28

``` PT-2) Sickled red blood cells are believed to block blood that is trying to exit the corpus​ spongiosum, which for men​ causes: A. strokes. B. ​vaso-occlusive crises. C. joint pain. D. priapism. ```

Accepted Answer

D. priapism.

Question 29

PT-3) In a patient who has recently undergone peritoneal dialysis​ (PD), which of the following findings is the most suggestive of​ peritonitis? A. The patient is sitting upright with some breathing difficulty. B. The patient has back pain and is pacing about. C. The patient reports a gradual onset of bloody stools for more than 5 days. D. The patient develops abdominal pain and fever.

Accepted Answer

D. The patient develops abdominal pain and fever. Page 777

Question 30

PT-4) Patients who have had a successful kidney​ transplant: A. will be on medicines to suppress immune function. B. will still need dialysis. C. will be on medications to stimulate the immune system. D. will have two kidneys from different donors.

Accepted Answer

A. will be on medicines to suppress immune function. Page 779

Question 31

PT-5) You arrive at the home of a​ 65-year-old male patient with chest pain. His wife gives you a list of medications that he is taking because of previous heart attacks. One of the daily medications is aspirin. Why does the patient take daily doses of​ aspirin? A. Aspirin helps to inhibit clot formation by inhibiting platelet aggregation. B. Aspirin counteracts the side effects of​ nitroglycerin, which include headache. C. He is probably taking aspirin for his arthritis. D. Aspirin helps to reduce the pain of angina or heart attacks.

Accepted Answer

A. Aspirin helps to inhibit clot formation by inhibiting platelet aggregation.

Question 32

PT-6) Which of the following statements about administering oxygen to patients with sickle cell anemia​ (SCA) is​ true? A. Only give supplemental oxygen to patients with SCA if you have been instructed to do so by medical direction. B. Patients with SCA experiencing high fever and hypoperfusion should receive supplemental oxygen. C. All patients with SCA should always be given supplemental oxygen. D. Patients with SCA experiencing shortness of​ breath, chest​ pain, or oxygen saturation below​ 95% should receive supplemental oxygen.

Accepted Answer

D. Patients with SCA experiencing shortness of​ breath, chest​ pain, or oxygen saturation below​ 95% should receive supplemental oxygen. Page 770

Question 33

``` PT-7) You are on scene with a​ 64-year-old female who appears to have a dialysis shunt on her arm. Based on this​ finding, you know that the patient​ has: A. acute renal insufficiency. B. polycystic kidney disease. C. ​end-stage renal disease. D. diabetes. ```

Accepted Answer

C. ​end-stage renal disease

Question 34

``` PT-8) A drainage tube placed into the urinary system to allow the flow of urine out of the body is​ a: A. dialyzer. B. peritoneal catheter C. urinary catheter. D. surgically created fistula. ```

Accepted Answer

C. urinary catheter Page 771

Question 35

PT-9) Sickle cell anemia differs physically from general anemia in what​ way? A. In sickle cell​ anemia, the cells lack a normal​ structure, and tend to be easily compressible. B. In sickle cell​ anemia, the red blood cells lack a nucleus. C. In sickle cell​ anemia, the red blood cells have a sickle shape. D. In sickle cell​ anemia, the white blood cells have a sickle shape.

Accepted Answer

C. In sickle cell​ anemia, the red blood cells have a sickle shape.

Question 36

``` PT-10) You are gathering a medical history on a​ 74-year-old female with chest pain. She states she has a history of atrial fibrillation and is on a​ "blood thinner." Based on this​ information, which medication would you expect her to be​ on? A. Lisinopril B. Lebatolol C. Nexium D. Lovenox ```

Accepted Answer

D. Lovenox

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CH 28 Hematologic and Renal Emergencies Flashcards

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