Chapter 82: Blood and Lymph Disorders Flashcards
The nurse would monitor for which laboratory result as indicating an adverse reaction in the client who is receiving chemotherapy?
- Hemoglobin 12.5g/dL
- Platelet count 20,000mm3
- Blood urea nitrogen (BUN) 20mg/dL
- White blood cell count (WBC) 7000mm3
- Platelet count 20,000mm3.
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.
- Provide a diet high in protein.
- Monitor electrolyte levels daily.
- Monitor white blood cell counts
daily. - Ensure meticulous hand washing before caring for the client.
- Ask visitors with respiratory infection symptoms to not visit the client.
- Monitor white blood cell counts
daily. - Ensure meticulous hand washing before caring for the client.
- Ask visitors with respiratory infection symptoms to not visit the client.
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?
0.2mL.
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?
- Iron
- Folic acid
- Thiamine
- Vitamin B12
- Vitamin B12.
Which food sources would the nurse include in the discharge teaching plan of a client with vitamin B12 deficiency anemia? Select all that apply.
- Eggs
- Liver
- Ice cream
- Red meats
- Citrus fruits
- Eggs
- Liver
- Red meats
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?
- Intense thirst
- Slow bounding pulse
- Dry mucous membranes
- Postural blood pressure changes
- Postural blood pressure changes
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?
- Increased calcium level
- Increased white blood cells
- Decreased blood urea nitrogen (BUN) level
- Decreased number of plasma cells in the bone marrow
- Increased calcium level
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?
- A child of Mexican descent
- A child of Mediterranean descent
- A child whose intake of iron is extremely poor
- A child breast-fed by a mother with chronic anemia
- A child of Mediterranean descent
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.
- Chills
- Itching
- Back pain
- Dry cough
- Distended neck veins
- Dry cough
- Distended neck veins
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.
- Pain
- Nausea
- Fatigue
- Infection
- Petechiae
- Shortness of breath
- Fatigue
- Infection
- Petechiae
- Shortness of breath
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?
- Hematocrit 37%
- Glucose 86 mg/dL
- Hemoglobin 9.1 g/dL
- White blood cell count 12,400/mm3
- Hemoglobin 9.1 g/dL
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?
- “Are you tiring easily?”
- “Do you have any weakness?”
- “Have you gained any weight?”
- “Have you noticed any swollen lymph nodes?”
- “Have you noticed any swollen lymph nodes?”
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?
- Flat on bed rest
- On bed rest in a semi-Fowler’s position
- In lateral position on the unaffected side
- In the lateral position on the affected side
- On bed rest in a semi-Fowler’s position
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?
- Dehydration
- Inability to perform activities
- Verbalizing fear about delivery
- Expressing concern about appearance
- Dehydration
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?
- The family brings a bouquet of plastic flowers to brighten the client’s room.
- The family member with a cold wears a mask while visiting for a short period of time.
- The client orders lunch of soup, salad with tomatoes and cucumbers, and an apples.
- The client wears a mask while being transported to the interventional radiology department.
- The client orders lunch of soup, salad with tomatoes and cucumbers, and an apples.
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
- Exertion
- Infection
- Hypoxemia
- Dehydration
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.
- Craving to eat ice
- Muscle weakness
- Dry and brittle hair
- Difficulty in walking
- Numbness in hands
- Muscle weakness
- Difficulty in walking
- Numbness in hands
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.
- Milk
- Fish
- Eggs
- Liver
- Cheese
- Eggs
- Liver
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?
- Heparin
- Warfarin
- Dabigatran
- Dipyridamole
- Warfarin (Coumadin)
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.
- Hematocrit (Hct) 30%
- Hemoglobin (Hgb) 8.8 g/dL
- Platelet count 300,000 mm3
- White blood count (WBC) 7500 mm3
- Decreased mean corpuscular volume (MCV) 66 fL
- Hematocrit (Hct) 30%
- Hemoglobin (Hgb) 8.8 g/dL
- Decreased mean corpuscular volume (MCV) 66 fL
The client with acute myelocytic leukemia is being treated with busulfan. Which laboratory value would the nurse specifically monitor during treatment with this medication?
- Clotting time
- Uric acid level
- Potassium level
- Blood glucose level
- Uric acid level
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?
- Tea
- Milk
- Water
- Tomato juice
- Tomato juice
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?
- Stimulate the labor process.
- Prevent dehydration and hypoxemia.
- Avoid the necessity of a cesarean delivery.
- Eliminate the need for analgesic administration.
- Prevent dehydration and hypoxemia.
A client arrives in the emergency department with a bloody nose. Which is the initial nursing action?
- Place the client in a supine position.
- Apply an ice collar around the client’s neck.
- Assist the client to a sitting position with the head tilted slightly forward.
- Instruct the client to swallow the blood until the bleeding can be controlled.
- Assist the client to a sitting position with the head tilted slightly forward.
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?
- Fever
- Diarrhea
- Complaints of nausea and vomiting
- Crackles on auscultation of the lungs
- Crackles on auscultation of the lungs
A client is diagnosed with disseminated intravascular coagulopathy (DIC). The nurse would become concerned with which laboratory values? Select all that apply.
- Increased D-dimer
- Decreased hemoglobin
- Increased platelet count
- Decreased fibrinogen level
- Decreased prothrombin level
- Increased D-dimer
- Decreased hemoglobin
- Decreased fibrinogen level
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?
- Ask a friend or family member to donate blood ahead of time.
- Arrange an autologous blood donation before the planned surgery.
- Take iron supplements before surgery to boost hemoglobin levels.
- Request that any donated blood be screened twice by the blood bank.
- Arrange an autologous blood donation before the planned surgery.
A client who has had a radical neck dissection begins to hemorrhage at the incision site. Which action by the nurse would be contraindicated?
- Monitoring the client’s airway
- Applying manual pressure over the site
- Lowering the head of the bed to a flat position
- Calling the primary health care provider immediately
- Lowering the head of the bed to a flat position
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?
- A clotting time of 10 minutes
- A hemoglobin of 11 g/dL (110 mmol/L)
- A platelet count of 40,000 mm3 (40 × 109/L)
- A white blood cell (WBC) count of 3,000 mm3 (3 × 109/L)
- A platelet count of 40,000 mm3 (40 × 109/L)
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?
- Force fluid intake for the next 3 days.
- Take the client’s temperature daily for a week.
- Do not administer acetaminophen for discomfort.
- Watch the puncture site for bleeding for the next several days.
- Watch the puncture site for bleeding for the next several days.
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?
Sore Throat.
A client is having problems with blood clotting. Which food item would the nurse encourage the client to eat?
Green, leafy vegetables.
A client diagnosed with acute lymphocytic leukemia has been prescribed asparaginase. Which finding represents possible medication toxicity?
Prolonged blood clotting times.
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?
Drawing a sample for prothrombin time (PT) and international normalized ratio (INR).
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.
-Clams and mussels.
-Lean beef and chicken liver.
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?
Signifying leukopenia.
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?
Complete blood count.
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?
Provide emotional support.
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.
-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.
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.
-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.
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.
-Protamine sulfate
-Intravenous tubing
-Intravenous infusion controller
-Intravenous insertion equipment
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?
Vital signs.
A client has been diagnosed with disseminated intravascular coagulation (DIC). Which laboratory tests would the nurse anticipate being prescribed? Select all that apply.
D-dimer
Hemoglobin
Prothrombin time
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?
Increased uric acid level
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?
Hyperuricemia
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?
2 months after therapy
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?
Iron deficiency anemia
