chapter 47

Question 1

Which is the process by which certain cells engulf and digest microorganisms and cellular
debris?
a. Erythrocytosis
b. Hematocrit
c. Phagocytosis
d. Hemostasis

Answer 1

c. Phagocytosis

Question 2

The nurse explains that because it is a reliable and predictable indicator of the body’s level
of infection or recovery, which is a common diagnostic tool?
a. hemoglobin
b. hematocrit
c. mean cell volume (MCV)
d. differential

Answer 2

d. differential

Question 3

The nurse assessing a differential sees an increase in immature neutrophils (bands) and is
aware that this indicates which concern?
a. a significant hemorrhage.
b. aplastic anemia.
c. an infection or stsress.
d. beginning recovery from an infection.

Answer 3

c. an infection or stsress.

Question 4

B cells and T cells fit under which classification?
a. Erythrocytes
b. Basophils
c. Lymphocytes
d. Monocytes

Answer 4

c. Lymphocytes

Question 5

The nurse is reading the results of a white blood cell count differential. Which abnormal
reading indicates a severe allergic reaction?
a. Increased basophil count
b. Increased lymphocyte count
c. Increased monocyte count
d. Increased neutrophil count

Answer 5

a. Increased basophil count

Question 6

The presence of excess bands in the peripheral blood that indicate severe infection is
indicated in which manner?
a. shift to the left.
b. shift to the right.
c. bone marrow aspiration.
d. thrombocytosis.

Answer 6

a. shift to the left.

Question 7

A patient has been diagnosed with pernicious anemia. When reinforcing instructions, the
nurse explains this disorder results from which process?
a. Poor nutritional intake of iron
b. Lack of the intrinsic factor
c. Blood loss due to hemorrhage
d. Excess production of red blood cells

Answer 7

b. Lack of the intrinsic factor

Question 8

Erythropoiesis is the term referring to which process?
a. Destruction of older red blood cells
b. Lack of folic acid to create new red blood cells
c. Releasing white blood cells in response to infection
d. Production of new red blood cells in the bone marrow

Answer 8

d. Production of new red blood cells in the bone marrow

Question 9

Which does the elevation in the eosinophil count to 10% indicate?
a. Anemia
b. Allergy
c. Infection
d. Hypoxia

Answer 9

b. Allergy

Question 10

Which would a nurse reinforce in a teaching plan for a home health patient with a
hemoglobin of 8.4 mg?
a. Exercising for periods of 30 minutes daily
b. Limiting fluid intake
c. Alternating activity with rest periods
d. Avoiding the use of oxygen

Answer 10

c. Alternating activity with rest periods

Question 11

Approximately how much blood is stored in the spleen that can be released in a
hypovolemic emergency?
a. 100 mL
b. 300 mL
c. 500 mL
d. 1000 mL

Answer 11

c. 500 mL

Question 12

The nurse caring for a patient with pernicious anemia should make provisions for which
intervention?
a. frequent iced drinks.
b. lightweight blanket.
c. a fan to circulate the air.
d. reverse isolation.

Answer 12

b. lightweight blanket.

Question 13

When reinforcing instructions for the patient taking an oral liquid iron preparation, which
should the nurse include?
a. Information relative to taking the iron with milk
b. Information relative to the bowel movement color changing to dark red
c. Information relative to taking preparation through a straw to prevent staining of teeth
d. Information relative to taking a drug with meals or a snack

Answer 13

c. Information relative to taking preparation through a straw to prevent staining of teeth

Question 14

When the 14-year-old patient comes into the emergency room in sickle cell crisis, which
should be the primary focus of care?
a. Genetic counseling
b. Applying ice packs
c. Pain relief measures
d. Providing iron replacements

Answer 14

c. Pain relief measures

Question 15

The nurse expects the plan of care for a patient with leukemia to focus on which aspect of care?
a. Prevention of abnormal clotting
b. Promotion of mobility activities
c. Frequent transfusions of plasma
d. Prevention of infectious diseases

Answer 15

d. Prevention of infectious diseases

Question 16

Which must a patient undergo before a bone marrow transplant?
a. A thorough nutritional plan to support new marrow
b. Chemotherapy to eradicate malignant bone marrow cells
c. A physical therapy program to strengthen the body
d. Inhalation therapy to reduce possible pathogens in the lungs

Answer 16

b. Chemotherapy to eradicate malignant bone marrow cells

Question 17

The 9-year-old child with leukemia who is on palliative care has drawn a picture of a boy
under a huge black cloud that has lightning coming out of it. Which would be an appropriate
intervention for the nurse?
a. “What is this picture about?”
b. “Are you afraid of lightning?”
c. “I bet this is a picture of you, isn’t it?”
d. “Is it about to rain in your picture?”

Answer 17

a. “What is this picture about?”

Question 18

The home health nurse recommends to the mother of a 12-year-old child with leukemia that
the child should have which vaccine?
a. the series for prevention of hepatitis
b. an annual influenza vaccine.
c. an annual pneumococcal vaccine.
d. vitamin B12 shots.

Answer 18

b. an annual influenza vaccine.

Question 19

Which patient statement from a 15-year-old girl with thrombocytopenia would require more
assessment to report to the charge nurse?
a. “I think these red spots on my skin are going away.”
b. “I am so bored lying in bed I could scream.”
c. “I can’t tell if the corticosteroids are helping.”
d. “I started my menstrual period this morning.”.”

Answer 19

d. “I started my menstrual period this morning.”.”

Question 20

20. A 23-year-old male patient with hemophilia A says, “How can I keep my children from
    having hemophilia A?” Which is the most informative response?
    a. “You need to select a very dependable mode of birth control.”
    b. “You can only pass hemophilia B to your sons.”
    c. “Your daughter may be a carrier and her children may have hemophilia A.
    d. “Your sons should have coagulation studies.”

Answer 20

c. “Your daughter may be a carrier and her children may have hemophilia A.

Question 21

A child with hemophilia is hospitalized with hemarthrosis. Which should the nurse caring
for that child expect to implement when following the plan of care?
a. Use analgesia sparingly.
b. Apply warm compresses to reduce hemorrhages in the joint.
c. Encourage vigorous joint movement exercises to keep the joints flexible.
d. Reinforce instructions to receive factor VIII infusions prophylactically

Answer 21

d. Reinforce instructions to receive factor VIII infusions prophylactically

Question 22

In caring for a patient with multiple myeloma, which should the prioritize from the plan of
care?
a. Limit fluid intake to less than 1000 mL/day
b. Closely supervise and assistwhen ambulating
c. Strain all urine for kidney crystals
d. Limit the use of an analgesic

Answer 22

b. Closely supervise and assistwhen ambulating

Question 23

The nurse is aware that a person with Hodgkin disease, who has two or more abnormal
lymph nodes on the same side of the diaphragm and cancer extending locally from one
lymph node area into a nearby organ, would be in which stage?
a. stage I.
b. stage II.
c. stage III.
d. stage IV.

Answer 23

b. stage II.

Question 24

The nurse explains to a patient with Non-Hodgkin’s lymphoma that a positron emission
tomography (PET) has been ordered for which reason?
a. assess bone marrow depression.
b. measure bone density.
c. radiate and destroy diseased lymph nodes.
d. determine the extent of possible metastasis.

Answer 24

d. determine the extent of possible metastasis.

Question 25

Which food would the nurse recommend to a person with iron-deficiency anemia as an
excellent meat source for erythropoiesis?
a. Dark meat of chicken
b. Cured ham
c. Pork chops
d. Processed meat

Answer 25

a. Dark meat of chicken

Question 26

The peripheral smear is a diagnostic test performed for which reason?
a. assesses the level of hemoglobin.
b. measures antibody production.
c. examines the shape and structure of cells
d. identifies possible sources of infection

Answer 26

c. examines the shape and structure of cells

Question 27

The typical medical treatment of polycythemia vera involves repeated phlebotomies for
which intended benefit?
a. stimulate bone marrow.
b. Reduce blood viscosity
c. increase hemoglobin.
d. reduce symptoms of gout.

Answer 27

b. Reduce blood viscosity

Question 28

Which would the nurse explain as a type of leukemia that affects noticeably more children
and teens than adults?
a. Chronic lymphocytic leukemia (CLL)
b. Acute myeloid leukemia (AML)
c. Acute lymphocytic leukemia (ALL)
d. Chronic myeloid leukemia (CML)

Answer 28

c. Acute lymphocytic leukemia (ALL)

Question 29

The nurse is aware that some persons of the Jehovah’s Witness faith accept which types of
blood transfusions?
a. No type of blood transfusion
b. Blood that has been blessed by their religious leader
c. Transfusions only for persons who have not yet been baptized
d. Autologous blood transfusions

Answer 29

d. Autologous blood transfusions

Question 30

Which mandatory practice is the most effective and significant nursing practice to prevent
the spread of infection for a patient with agranulocytosis?
a. Strict and frequent hand washing by all people having contact with the patient
b. Placement of patients in private rooms with high-efficiency particulate air (HEPA)
filtration
c. Administration of combinations of prophylactic antibiotics
d. Creation of a “sterile” environment for the patient with the use of laminar airflow
rooms

Answer 30

a. Strict and frequent hand washing by all people having contact with the patient

Question 31

Which is the average lifespan of an erythrocyte?
a. 7 days
b. 60 days
c. 120 days
d. Up to several years

Answer 31

c. 120 days

Question 32

Because older adults suffer from conditions such as colonic diverticula, hiatal hernia, and
ulcerations that can cause occult bleeding, the nurse should assess for symptoms of which
blood disorder?
a. leukemia.
b. iron-deficiency anemia.
c. sickle cell anemia.
d. polycythemia.

Answer 32

b. iron-deficiency anemia.

Question 33

The nurse explains that the treatment of hemophilia has been revolutionized with the advent
of the use of which medical intervention?
a. corticosteroids.
b. large doses of testosterone.
c. Prophylactic use of factors VIII and IX.
d. transfusion with packed red cells.

Answer 33

c. Prophylactic use of factors VIII and IX.

Question 34

The nurse will prepare the adult patient who will be undergoing bone marrow sampling by
explaining the sample will be obtained from which site?
a. Sternum
b. Posterior superior iliac crest
c. Posterior iliac crest
d. Femur

Answer 34

c. Posterior iliac crest

Question 35

Which is the first step in the process of hemostasis?
a. Prothrombin converts to thrombin
b. Formation of thrombin
c. Formation of fibrin
d. Trapping of RBC and platelets
e. Clot
f. Release of thromboplastin from platelets

Answer 35

f. Release of thromboplastin from platelets

Question 36

Which event causes the kidney to produce erythropoetin?
a. Decreased erythrocytes
b. Decreased oxygen levels
c. Extensive systemic infection
d. Excessive circulating clotting factor

Answer 36

b. Decreased oxygen levels

Question 37

?? are leukocytes that destroy and remove cellular waste, bacteria, and solid particles.

Answer 37

Neutrophils

Question 38

The nurse clarifies that ? ferrous replaces iron stores to treat iron
deficiency anemia.

Answer 38

sulfate