Chapter 82: Blood and Lymph Disorders

Question 1

The nurse would monitor for which laboratory result as indicating an adverse reaction in the client who is receiving chemotherapy?

1. Hemoglobin 12.5g/dL
2. Platelet count 20,000mm3
3. Blood urea nitrogen (BUN) 20mg/dL
4. White blood cell count (WBC) 7000mm3

Answer 1

2. Platelet count 20,000mm3.

Question 2

The nurse is assisting in planning care for a client with Hodgkin’s disease who is neutropenic as a result of radiation and chemotherapy. Which actions would be included in the client’s plan of care? Select all that apply.

1. Provide a diet high in protein.
2. Monitor electrolyte levels daily.
3. Monitor white blood cell counts
   daily.
4. Ensure meticulous hand washing before caring for the client.
5. Ask visitors with respiratory infection symptoms to not visit the client.

Answer 2

3. Monitor white blood cell counts
   daily.
4. Ensure meticulous hand washing before caring for the client.
5. Ask visitors with respiratory infection symptoms to not visit the client.

Question 3

A client with sickle cell anemia is being treated for sickle cell crisis. The primary health care provider prescribes morphine sulfate 2 mg. The concentration of the vial is 10 mg/mL of solution. How many milliliters of solution would the nurse administer?

Answer 3

0.2mL.

Question 4

A client has been diagnosed with pernicious anemia. In planning care for the client, the nurse anticipates that the client will be treated with which vitamin or mineral?

1. Iron
2. Folic acid
3. Thiamine
4. Vitamin B12

Answer 4

4. Vitamin B12.

Question 5

Which food sources would the nurse include in the discharge teaching plan of a client with vitamin B12 deficiency anemia? Select all that apply.

1. Eggs
2. Liver
3. Ice cream
4. Red meats
5. Citrus fruits

Answer 5

1. Eggs
2. Liver
3. Red meats

Question 6

The nurse is caring for a client with leukemia and notes that the client has poor skin turgor and flat neck and hand veins. The nurse suspects hyponatremia. Which additional sign/symptom would the nurse expect to note in this client if hyponatremia is present?

1. Intense thirst
2. Slow bounding pulse
3. Dry mucous membranes
4. Postural blood pressure changes

Answer 6

4. Postural blood pressure changes

Question 7

The nurse is reviewing the laboratory results of a client who has been diagnosed with multiple myeloma. Which finding would the nurse expect to note with this diagnosis?

1. Increased calcium level
2. Increased white blood cells
3. Decreased blood urea nitrogen (BUN) level
4. Decreased number of plasma cells in the bone marrow

Answer 7

1. Increased calcium level

Question 8

The nursing student is presenting a clinical conference and discusses the causative factors related to beta-thalassemia. Which group is at greatest risk of developing this disorder?

1. A child of Mexican descent
2. A child of Mediterranean descent
3. A child whose intake of iron is extremely poor
4. A child breast-fed by a mother with chronic anemia

Answer 8

2. A child of Mediterranean descent

Question 9

The licensed practical nurse is assisting the registered nurse (RN) in the care of a child who is receiving a blood transfusion and notifies the RN if the child displays which signs/symptoms of fluid overload? Select all that apply.

1. Chills
2. Itching
3. Back pain
4. Dry cough
5. Distended neck veins

Answer 9

4. Dry cough
5. Distended neck veins

Question 10

The nurse is caring for a client with a diagnosis of aplastic anemia. Which are the most likely signs/symptoms associated with aplastic anemia? Select all that apply.

1. Pain
2. Nausea
3. Fatigue
4. Infection
5. Petechiae
6. Shortness of breath

Answer 10

3. Fatigue
4. Infection
5. Petechiae
6. Shortness of breath

Question 11

A pregnant client tells the nurse that she has been craving “unusual foods.” On further data collection, the nurse discovers that the client has been ingesting daily amounts of white clay dirt from her backyard. Which laboratory result indicates a physiological consequence of a result of this practice?

1. Hematocrit 37%
2. Glucose 86 mg/dL
3. Hemoglobin 9.1 g/dL
4. White blood cell count 12,400/mm3

Answer 11

3. Hemoglobin 9.1 g/dL

Question 12

The nurse is collecting data from a client who is admitted to the hospital for diagnostic studies to rule out the presence of Hodgkin’s disease. Which question would the nurse ask the client to elicit information specifically related to this disease?

1. “Are you tiring easily?”
2. “Do you have any weakness?”
3. “Have you gained any weight?”
4. “Have you noticed any swollen lymph nodes?”

Answer 12

4. “Have you noticed any swollen lymph nodes?”

Question 13

A client arrives in the emergency department after an automobile crash. The client’s forehead hit the steering wheel, and a hyphema has been diagnosed. Which position would the nurse prepare to position the client?

1. Flat on bed rest
2. On bed rest in a semi-Fowler’s position
3. In lateral position on the unaffected side
4. In the lateral position on the affected side

Answer 13

2. On bed rest in a semi-Fowler’s position

Question 14

The nurse is assigned to care for a pregnant client with a diagnosis of sickle cell anemia. The nurse plans care, knowing that which problem would receive highest priority?

1. Dehydration
2. Inability to perform activities
3. Verbalizing fear about delivery
4. Expressing concern about appearance

Answer 14

1. Dehydration

Question 15

The nurse is caring for a client with a diagnosis of cancer who is immunosuppressed. Neutropenic precautions have been implemented. Which activity would the nurse question if observed while caring for this client?

1. The family brings a bouquet of plastic flowers to brighten the client’s room.
2. The family member with a cold wears a mask while visiting for a short period of time.
3. The client orders lunch of soup, salad with tomatoes and cucumbers, and an apples.
4. The client wears a mask while being transported to the interventional radiology department.

Answer 15

3. The client orders lunch of soup, salad with tomatoes and cucumbers, and an apples.

Question 16

During the intrapartum period, the nurse is caring for a laboring client diagnosed with sickle cell disease. The nurse recognizes that which conditions are most likely to lead to a sickling crisis? Select all that apply.
1. Exertion
2. Infection
3. Hypoxemia
4. Dehydration
5. Analgesic administration

Answer 16

1. Exertion
2. Infection
3. Hypoxemia
4. Dehydration

Question 17

A client is admitted to the hospital with vitamin B12 deficiency. When taking the client’s history, which symptoms would the nurse expect the client to report? Select all that apply.

1. Craving to eat ice
2. Muscle weakness
3. Dry and brittle hair
4. Difficulty in walking
5. Numbness in hands

Answer 17

2. Muscle weakness
3. Difficulty in walking
4. Numbness in hands

Question 18

The nurse is reinforcing instructions to a client with iron deficiency anemia about eating a diet with iron-rich foods. Which food sources would the nurse include in the discharge teaching plan of a client with iron deficiency anemia? Select all that apply.

1. Milk
2. Fish
3. Eggs
4. Liver
5. Cheese

Answer 18

3. Eggs
4. Liver

Question 19

The nurse is reviewing laboratory results and notes that the client’s international normalized ratio (INR) is 2.2. The nurse would realize this test is performed to monitor the effectiveness of which medication?

1. Heparin
2. Warfarin
3. Dabigatran
4. Dipyridamole

Answer 19

2. Warfarin (Coumadin)

Question 20

The nurse is reviewing the complete blood count (CBC) laboratory results of a female adult client suspected of having iron deficiency anemia. The nurse reviews the results and determines that which results are consistent with this diagnosis? Select all that apply.

1. Hematocrit (Hct) 30%
2. Hemoglobin (Hgb) 8.8 g/dL
3. Platelet count 300,000 mm3
4. White blood count (WBC) 7500 mm3
5. Decreased mean corpuscular volume (MCV) 66 fL

Answer 20

1. Hematocrit (Hct) 30%
2. Hemoglobin (Hgb) 8.8 g/dL
3. Decreased mean corpuscular volume (MCV) 66 fL

Question 21

The client with acute myelocytic leukemia is being treated with busulfan. Which laboratory value would the nurse specifically monitor during treatment with this medication?

1. Clotting time
2. Uric acid level
3. Potassium level
4. Blood glucose level

Answer 21

2. Uric acid level

Question 22

The nurse reinforces instructions to a pregnant client regarding the administration of iron. The nurse determines that the teaching is effective if the client states that she will take the iron with which food items?

1. Tea
2. Milk
3. Water
4. Tomato juice

Answer 22

4. Tomato juice

Question 23

The nurse is caring for a client with sickle cell disease who is in labor. The nurse ensures that the client receives appropriate intravenous (IV) fluid intake and oxygen consumption to primarily accomplish which goal?

1. Stimulate the labor process.
2. Prevent dehydration and hypoxemia.
3. Avoid the necessity of a cesarean delivery.
4. Eliminate the need for analgesic administration.

Answer 23

2. Prevent dehydration and hypoxemia.

Question 24

A client arrives in the emergency department with a bloody nose. Which is the initial nursing action?

1. Place the client in a supine position.
2. Apply an ice collar around the client’s neck.
3. Assist the client to a sitting position with the head tilted slightly forward.
4. Instruct the client to swallow the blood until the bleeding can be controlled.

Answer 24

3. Assist the client to a sitting position with the head tilted slightly forward.

Question 25

A client with non-Hodgkin's lymphoma is receiving daunorubicin. Which sign/symptom would indicate to the nurse that the client is experiencing a toxic effect related to the medication? 1. Fever 2. Diarrhea 3. Complaints of nausea and vomiting 4. Crackles on auscultation of the lungs

Answer 25

4. Crackles on auscultation of the lungs

Question 26

A client is diagnosed with disseminated intravascular coagulopathy (DIC). The nurse would become concerned with which laboratory values? Select all that apply. 1. Increased D-dimer 2. Decreased hemoglobin 3. Increased platelet count 4. Decreased fibrinogen level 5. Decreased prothrombin level

Answer 26

1. Increased D-dimer 2. Decreased hemoglobin 4. Decreased fibrinogen level

Question 27

A client requiring upcoming surgery is extremely anxious about the need for a possible blood transfusion and is concerned about the risk of infection from contaminated blood. The nurse suggests that the client consider which as an effective method to minimize this risk? 1. Ask a friend or family member to donate blood ahead of time. 2. Arrange an autologous blood donation before the planned surgery. 3. Take iron supplements before surgery to boost hemoglobin levels. 4. Request that any donated blood be screened twice by the blood bank.

Answer 27

2. Arrange an autologous blood donation before the planned surgery.

Question 28

A client who has had a radical neck dissection begins to hemorrhage at the incision site. Which action by the nurse would be contraindicated? 1. Monitoring the client's airway 2. Applying manual pressure over the site 3. Lowering the head of the bed to a flat position 4. Calling the primary health care provider immediately

Answer 28

3. Lowering the head of the bed to a flat position

Question 29

The nurse is monitoring the laboratory results of a female client receiving an antineoplastic medication by the intravenous (IV) route. The nurse plans to initiate bleeding precautions if which laboratory result is noted? 1. A clotting time of 10 minutes 2. A hemoglobin of 11 g/dL (110 mmol/L) 3. A platelet count of 40,000 mm3 (40 × 109/L) 4. A white blood cell (WBC) count of 3,000 mm3 (3 × 109/L)

Answer 29

3. A platelet count of 40,000 mm3 (40 × 109/L)

Question 30

A client with leukemia who had a bone marrow aspiration is thrombocytopenic. The nurse gives which instruction to the family as the client is discharged to home? 1. Force fluid intake for the next 3 days. 2. Take the client's temperature daily for a week. 3. Do not administer acetaminophen for discomfort. 4. Watch the puncture site for bleeding for the next several days.

Answer 30

4. Watch the puncture site for bleeding for the next several days.

Question 31

A client with acute nonlymphocytic anemia receives treatment with cytarabine. The nurse reinforces medication instructions to the client and tells the client that it is important to report which adverse effect to the primary health care provider?

Answer 31

Sore Throat.

Question 32

A client is having problems with blood clotting. Which food item would the nurse encourage the client to eat?

Answer 32

Green, leafy vegetables.

Question 33

A client diagnosed with acute lymphocytic leukemia has been prescribed asparaginase. Which finding represents possible medication toxicity?

Answer 33

Prolonged blood clotting times.

Question 34

A client brought to the emergency department states that he has accidentally been taking two times his prescribed dose of warfarin for the past week. After noting that the client has no evidence of obvious bleeding, the nurse plans to assist the registered nurse with which action?

Answer 34

Drawing a sample for prothrombin time (PT) and international normalized ratio (INR).

Question 35

The nurse is caring for a client following a total hip replacement. The client has been diagnosed with iron deficiency anemia. The nurse instructs the client to increase intake of which foods? Select all that apply.

Answer 35

-Clams and mussels. -Lean beef and chicken liver.

Question 36

The nurse reviews the laboratory results for a client diagnosed with leukemia who is receiving chemotherapy. The nurse notes that the white blood cell (WBC) count is 2000 mm3. The nurse identifies the finding as indicative of which?

Answer 36

Signifying leukopenia.

Question 37

A client is receiving supplemental therapy with folic acid. The nurse evaluates the effectiveness of this therapy by monitoring the results of which laboratory study?

Answer 37

Complete blood count.

Question 38

The nurse is planning interventions for counseling a maternity client newly diagnosed with sickle cell anemia. The nurse understands that the important psychosocial intervention at this time is which action?

Answer 38

Provide emotional support.

Question 39

The nurse is reviewing the laboratory results of a client who is receiving chemotherapy and notes that the platelet count is 10,000 mm3 (10 × 109/L). On the basis of this laboratory value, the nurse would perform which interventions? Select all that apply.

Answer 39

-Monitor stools for occult blood. -Instruct the client not to bend over at the waist or lift. -Instruct the client to blow nose very gently without blocking either nostril.

Question 40

A client with sickle cell disease has been admitted to the hospital complaining of a sudden onset of severe pain in the extremities, abdomen, back, and chest. Which interventions would the nurse expect to be included in the care of the client? Select all that apply.

Answer 40

-Administer oxygen per nasal cannula. -Administer the prescribed opioid analgesic. -Encourage the client to keep extremities extended. -Hydrate the client with 0.9% normal saline 125 mL/hr intravenously.

Question 41

The nurse is asked to assist in preparing a heparin sodium infusion for a client with a diagnosis of thrombophlebitis. Which items would the nurse have available for this procedure? Select all that apply.

Answer 41

-Protamine sulfate -Intravenous tubing -Intravenous infusion controller -Intravenous insertion equipment

Question 42

The nurse is assisting with caring for a client who will receive a unit of blood. Just before the infusion, it is most important for the nurse to check which item?

Answer 42

Vital signs.

Question 43

A client has been diagnosed with disseminated intravascular coagulation (DIC). Which laboratory tests would the nurse anticipate being prescribed? Select all that apply.

Answer 43

D-dimer Hemoglobin Prothrombin time

Question 44

The nurse is reviewing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory finding is indicative of the massive cell destruction that occurs with chemotherapy?

Answer 44

Increased uric acid level

Question 45

The nurse tells a client with leukemia that allopurinol has been added to the medication list. The client is currently receiving busulfan. When the client asks the purpose of the new medication, the nurse responds that allopurinol is intended to prevent which complication?

Answer 45

Hyperuricemia

Question 46

The nurse is reviewing the laboratory studies of a client receiving epoetin alfa. When would the nurse expect to note a therapeutic effect of this medication on the hemoglobin and hematocrit?

Answer 46

2 months after therapy

Question 47

An adult female client has a hemoglobin level of 10.8 g/dL (108 g/L). The nurse interprets that this result is most likely caused by which condition noted in the client's history?

Answer 47

Iron deficiency anemia

Question 48

During an initial prenatal visit, the nurse notes that the primary health care provider documents that the client is experiencing iron deficiency anemia. Which client data support this finding? Select all that apply.

Answer 48

Reports of fatigue Pink mucous membranes

Question 49

A client in labor has an underlying diagnosis of sickle cell anemia. During labor the client is at high risk for sickling crisis. The nurse would take which action to assist in preventing a crisis from occurring during labor?

Answer 49

Administer oxygen as prescribed.

Question 50

The nurse is assisting in the care of a client diagnosed with multiple myeloma who has been prescribed an intravenous solution of 0.9% normal saline at 125 mL per hour. Which finding would indicate a positive response to this treatment?

Answer 50

Creatinine of 1 mg/dL

Question 51

Which test would the nurse expect to have done for a client suspected of having pernicious anemia?

Answer 51

Schilling test

Question 52

A client who has been diagnosed with multiple myeloma asks the nurse about the diagnosis. The nurse bases the response on which characteristic of the disorder?

Answer 52

Malignant proliferation of plasma cells and tumors within the bone

Question 53

A client has experienced several episodes of sickle cell crisis. Which reinforced instructions would be included in the client's teaching plan to prevent recurrence? Select all that apply.

Answer 53

Wear shoes and socks when walking outside to prevent damage to the feet. Recognize early symptoms of infection and contact the primary health care provider (PHCP).

Question 54

The primary health care provider prescribes one unit of packed red blood cells to infuse over 4 hours. One unit of blood contains 250 mL, and the drop factor is 10 gtts/1 mL. Although an infusion pump will be used, the registered nurse asks the licensed practical nurse (LPN) to assist with monitoring the flow rate during the infusion. The LPN monitors the flow rate, knowing that how many gtt/min would infuse? Fill in the blank and round answer to the nearest whole number.

Answer 54

10gtts/min

Question 55

A nursing instructor asks a nursing student about the characteristics of Hodgkin's disease. The instructor determines that the student needs additional study if the student states that which is an associated characteristic?

Answer 55

Occurs most often in older adults

Question 56

A bone marrow aspiration is scheduled for a client suspected of having leukemia. What intervention does the nurse anticipate will be done to protect the aspiration site and client from becoming infected?

Answer 56

The site will be cleansed thoroughly with an antiseptic and allowed to air dry before the procedure.

Question 57

The nurse is admitting a client to the hospital who has been scheduled for gastrointestinal (GI) surgery later in the day. When asking the client whether the client has taken any scheduled or over-the-counter medications in the past 24 hours, which statements would concern the nurse? Select all that apply.

Answer 57

"Yes, I take a full-strength aspirin every day." "I have taken my medication for my blood pressure this morning."

Question 58

The nurse is assisting in caring for a client immediately following an abdominal surgical procedure who lost a significant amount of blood during surgery. Which findings would indicate a sign of a potential complication? Select all that apply.

Answer 58

Increasing restlessness A pulse rate of 108 beats per minute A blood pressure (BP) of 88/58 mm Hg Increasing pain unrelieved by analgesics

Question 59

The nurse is doing discharge teaching with a client who has sickle cell disease. The nurse reinforces instructions to the client to avoid which factors that could precipitate a sickle cell crisis? Select all that apply.

Answer 59

Infection Emotional stress

Question 60

The nurse is caring for a client with thrombocytopenia. Which data would the nurse monitor for related to this condition? Select all that apply.

Answer 60

Purpura Ecchymoses Platelet count less than 150,000 mm3

Question 61

The nurse is caring for a client receiving chemotherapy and determines that the client has developed myelosuppression. Which laboratory value would support the client's diagnosis of myelosuppression?

Answer 61

Hemoglobin 9.4 g/dL, hematocrit 26%

Question 62

A pregnant anemic client is concerned about her baby's condition following delivery. Which nursing response best supports the client?

Answer 62

"The effects of anemia on your baby are difficult to predict, but let's review your plan of care to ensure you are providing the best nutrition and growth potential."

Question 63

The nurse who is assisting in caring for a client with a tracheostomy tube notes heavy bleeding from the stoma. The nurse also notes that the tracheostomy tube pulsates with the client's heartbeat. The nurse immediately performs which action?

Answer 63

Applies pressure to the artery at the stoma site

Question 64

The nurse is assisting in performing an arterial blood gas (ABG) analysis on a client. The nurse initially implements which intervention after the blood gas is drawn to minimize the risk for uncontrolled bleeding?

Answer 64

Applying direct pressure to the site

Question 65

The client is admitted to the hospital with a diagnosis of suspected Hodgkin's disease. Which signs and symptoms of the client are associated with Hodgkin's disease? Select all that apply.

Answer 65

Fatigue Weakness Night sweats Enlarged lymph nodes

Question 66

The nurse is assisting with caring for a client who has received a transfusion of platelets. The nurse determines that the client is benefiting most from this therapy if the client exhibits which finding?

Answer 66

A decrease in oozing from puncture sites and gums

Question 67

During the intrapartum period, the nurse assists the health care team to ensure appropriate intravenous (IV) fluid intake and oxygen consumption for the laboring client with sickle cell disease. Which rationale would the nurse provide to the client for these interventions?

Answer 67

"Administering adequate IV fluids and oxygen during your labor will assist in preventing dehydration and hypoxemia, which can lead to sickling."

Question 68

A client is seen in the clinic for a physical examination. Laboratory studies are performed and reveal that the hemoglobin and hematocrit are low, indicating the need for further diagnostic studies and possibly a blood transfusion. The client is a Jehovah's Witness and states he will never have a blood transfusion. Which would be an appropriate action by the clinic nurse?

Answer 68

Support the client's decision not to receive a blood transfusion.

Question 69

The nurse has conducted dietary teaching with the client diagnosed with iron deficiency anemia. The nurse determines that the client understands the information if the client states the intention to increase intake of which foods? Select all that apply.

Answer 69

Oysters Spinach Kidney beans

Question 70

The nurse is assisting with developing a plan of care for the client with multiple myeloma. Which nursing intervention would be included to prevent renal failure for this client? Select all that apply.

Answer 70

Encouraging fluids Monitoring serum calcium and uric acid levels

Question 71

The nurse is caring for a client with a suspected diagnosis of aplastic anemia. Which test would the nurse anticipate to be performed to confirm the diagnosis?

Answer 71

Bone marrow aspiration

Question 72

The nurse collects data from a pregnant client diagnosed with iron deficiency anemia during her third trimester for additional risk factors associated with the anemia. Which statement made by the client would the nurse question to receive more information?

Answer 72

"I have had mild vaginal spotting twice since my last prenatal visit."

Question 73

Iron dextran is prescribed to be administered intramuscularly to a client. The nurse prepares the medication and determines that the appropriate method of administration is which?

Answer 73

Using the Z-track technique

Question 74

A client with cancer is receiving chemotherapy and develops thrombocytopenia. Which intervention is a priority in the nursing plan of care?

Answer 74

Monitor the client for bleeding.

Question 75

The nurse is reviewing the laboratory results of a client receiving chemotherapy. The nurse prepares to initiate neutropenic precautions when the nurse notes which laboratory result?

Answer 75

A white blood cell (WBC) count of 2000 mm3

Question 76

The nurse is reviewing the laboratory results of a client scheduled for surgery. Which laboratory result would indicate to the nurse that the surgery might be postponed?

Answer 76

Hemoglobin, 8.4 g/dL

Question 77

A client who is receiving a blood transfusion pushes the call light for the nurse. When entering the room, the nurse notes that the client is flushed, dyspneic, and complaining of generalized itching. How would the nurse correctly interpret these findings?

Answer 77

Transfusion reaction

Question 78

A registered nurse has just hung a 250-mL bag of packed red blood cells (PRBCs) on a client. The licensed practical nurse assisting in caring for the client plans to remain with the client for at least how many minutes following the start of the infusion?

Answer 78

15 minutes

Question 79

The nurse monitors a client’s white blood cell count and observes an increase from 7,500/mm3 to 18,000/mm3. What does this increase indicate for the client?

Answer 79

An infection

Question 80

A client taking warfarin sodium (Coumadin) for anticoagulation therapy has an increased INR with bleeding and hemorrhage. Which medication should the nurse anticipate administering?

Answer 80

IM Vitamin K

Question 81

The nurse is caring for a client with primary polycythemia. Which data obtained by the nurse should be immediately reported to the primary care provider?

Answer 81

Pain in the calf

Question 82

The nurse is reinforcing discharge instructions for parents of a child with hemophilia. Which statements made by the parents demonstrate understanding of the care? Select all that apply.

Answer 82

"I will make sure he wears a helmet and protective gear when riding a bike." "I will administer factor VIII at home if needed for bleeding." "Swimming would be an appropriate activity for my child."

Question 83

A client diagnosed with iron deficiency anemia is to begin iron supplementation. Which information would the nurse provide the client regarding therapy? Select all that apply.

Answer 83

Eat food with increased fiber content. Stools may be black and tarry. Take iron with citrus food or fluid.

Question 84

The nurse is preparing a transfusion for a client with type AB blood. Which blood type is considered the universal donor?

Answer 84

Type O.

Question 85

In which disease would the D antigen be particularly important?

Answer 85

Erythroblastosis fetalis.

Question 86

The nurse Is caring for a client who has leukemia. Which blood test result for white blood cells is useful in diagnosing and monitoring the response to treatment for this condition?

Answer 86

Lymphocytosis.

Question 87

A blood culture is ordered for a client with pneumonia to discover the presence of bacteria in the blood and to choose an antibiotic which is a key nursing intervention when this test is ordered?

Answer 87

Notify the laboratory when the client's temperature elevates.

Question 88

The nurse is preparing to administer a blood transfusion to a client who experienced postoperative hemorrhaging. Which guidelines should be followed for this procedure?

Answer 88

Two licensed personnel must identify the unit of blood.

Question 89

The nurse explains to a client receiving packed RBCS that the blood product is produced by centrifuging whole blood, which forces the army seats to the bottom of the container. For which client would packed RBCs be the best choice?

Answer 89

A client who has anemia.

Question 90

A client diagnosed with leukemia is receiving high-dose chemotherapy to kill cancerous cells and promote sites for new noncancerous cells to grow before a bone marrow transplant. For what complication of chemotherapy is this client at risk?

Answer 90

Infections.

Question 91

Why should the nurse encourage the client prescribed an iron supplement to eat a high-fiber diet?

Answer 91

Decrease the side effects of iron supplements.

Question 92

The nurse is caring for a five-year-old male African American client who reports severe pain in his arms and legs, and stomach. The nurse knows the client has jaundice, fever, dyspnea, and swelling of the hands and feet. What blood disorder would the nurse suspect?

Answer 92

Sickle cell disease.

Question 93

A nurse is educating a client being treated for lymphoma about the side effects of antineoplastic drugs used for the treatment, which is a common side effect of anti-neoplastic drug therapy?

Answer 93

Neutropenia.

Question 94

The nurse is caring for a client following a total hip replacement. The client has been diagnosed with iron deficiency anemia. The nurse instructs the client to increase intake of which foods? Select all that apply.

Answer 94

Lean beef and chicken liver Clams and mussels

Question 95

A client brought to the emergency department state that he has accidentally been taking two times his prescribed doors of warfarin for the past week. After noting that the client has no evidence of obvious bleeding, the nurse plans to assist the registered nurse with which action?

Answer 95

Drawing a sample for prothrombin time (PT) and international normalized ration (INR).

Question 96

The nurse is assisting with caring for a client who will receive a unit of blood. Just before the infusion, it is most important for the nurse to check which item.

Answer 96

Vital signs.

Question 97

The nurse is assisting with caring for a client who has received a transfusion of platelets. The nurse determines that the client is benefiting most from this therapy if the client exhibits which finding?

Answer 97

A decrease in oozing from puncture site and gums.

Question 98

A client is seen in the clinic for a physical examination. Laboratory studies are performed and revealed that the hemoglobin and hematocrit are low, indicating the need for further diagnostic studies and possibly a blood transfusion. The client is a Jehovah's Witness and states he will never have a blood transfusion. Which would be an appropriate action by the clinic nurse?

Answer 98

Support the client's decision not to receive a blood transfusion.

Question 99

Function of Diagnostic Test: Hematocrit

Answer 99

To identify the percentage of RBCs in the blood.

Question 100

Function of Diagnostic Test: Indirect Coombs test

Answer 100

To screen for circulating Rh antibodies.

Question 101

Function of Diagnostic Test: Partial Thromboplastin Time

Answer 101

To monitor the clot formation pathway.

Question 102

Function of Diagnostic Test: Direct Coombs Test

Answer 102

To detect antibodies already attached to RBCs.

Question 103

List the correct sequence of the various stages of Hodgkin's Disease.

Answer 103

1. The disease is limited to a single extraymphatic site. 2. The disease is present on one side of the diaphragm and involves more than one lymph node. 3. The disease is present both above and below the diaphragm. 4. The disease is spread to one or more extraymphatic organs or tissues.

Question 104

The ____________ sedimentation rate measures the speed at which RBCs settle in 1 hour at the bottom of a tube of unclotted blood.

Answer 104

Erythrocyte.

Question 105

Hemolytic anemia is characterized by the presence of immature RBCs called ________.

Answer 105

Reticulocytes.

Question 106

Removal of blood and simultaneous infusion of other solutions to maintain intravascular volume is known as acute normovolemic _________.

Answer 106

Hemodilution.

Question 107

If the donor in bone marrow transplantation is the recipient's identical twin, it is known as ___________ bone marrow transplantation.

Answer 107

Syngeneic.

Question 108

Pernicious anemia is caused by a lack of _________ factor.

Answer 108

Intrinsic.

Question 109

What should the nurse assess for in a client with multiple myeloma?

Answer 109

Increase in body temperature.

Question 110

A client is diagnosed with granulocytopenia. Decrease in which blood component is the nurse likely to notice in the client's hematology report?

Answer 110

Neutrophils.

Question 111

A nurse is caring for a client who is receiving a blood transfusion. The nurse notices a transfusion reaction in the client. Which of the following measures should the nurse take to manage the transfusion reaction? Select all that apply.

Answer 111

-Collect blood and urine samples and send to the laboratory. -Stop the blood transfusion procedure. -Report the reaction to the transfusion service.

Question 112

A nurse is caring for a client with non-Hodgkin lymphoma. When assessing the client, what sign and symptom should the nurse look for?

Answer 112

Enlargement of the liver.

Question 113

Which nursing care measure should be employed when caring for a client with relative polycythemia?

Answer 113

Encourage the client to drink plenty of fluids, especially water.

Question 114

A nurse is caring for a client with secondary polycythemia. Which would show an increase in the laboratory report for this client?

Answer 114

Erythropoietin.

Question 115

A female client has chronic myeloid leukemia. What signs and symptoms should the nurse monitor in such a client? Select all that apply.

Answer 115

-Night sweats. -Weight gain. -Enlarged spleen.

Question 116

A client is admitted to a healthcare facility in a stage of hemorrhagic shock. What should be the primary concern of the nurse?

Answer 116

Sustain the blood pressure by providing fluids.

Question 117

Which of the following should the nurse keep in mind when caring for the client who is receiving warfarin therapy? Select all that apply.

Answer 117

-Monitor the PT twice a week after stabilization of the blood anticoagulant level. -Avoid the administration of intramuscular injections. -Avoid monitoring the rectal temperature of the client.

Question 118

A nurse is caring for a client with peptic ulcer. The client shows symptoms of anemia. Which term should the nurse use to describe the anemic condition of the client?

Answer 118

Chronic hemorrhagic anemia.