Deck 27: Hematopoietic and Lymphatic System Function, Assessment, and Therapeutic Measures

Question 1

A nurse is preparing to assist with a bone marrow biopsy. Which anatomical site should the nurse anticipate will be used to obtain the specimen?

A)Posterior iliac crest
B)Long bones in the legs
C)Ribs
D)Humerus

Answer 1

Posterior iliac crest

Question 2

What term should a nurse use to document a large area of discoloration from hemorrhage under the skin?

A)Petechiae
B)Pallor
C)Rubor
D)Ecchymosis

Answer 2

Ecchymosis

Question 3

What is the maximum time that blood can hang during infusion before it begins to deteriorate?

A)1 hour
B)2 hours
C)3 hours
D)4 hours

Answer 3

4 hours

Question 4

The nurse is caring for a patient who is to have a blood transfusion. Which needle size should the nurse insert?

A)12-gauge
B)18-gauge
C)22-gauge
D)26-gauge

Question 5

Which organ removes old red blood cells from circulation?

A)Kidney
B)Spleen
C)Lung
D)Pancreas

Question 6

Which term describes hemoglobin that has given up its oxygen to the body's cells?

A)Reduced
B)Detached
C)Oxyhemoglobin
D)Hypoxyhemoglobin

Question 7

A patient receiving blood complains of dyspnea. The nurse auscultates the patient's lungs and finds crackles that were not present before the start of the transfusion. Which type of reaction should the nurse suspect?

A)Hemolytic
B)Anaphylactic
C)Urticarial
D)Circulatory overload

Question 8

How long does the average red blood cell live in the body?

A)30 days
B)60 days
C)90 days
D)120 days

Question 9

The nurse is caring for a patient who undergoes a bone marrow biopsy. What nursing action is most important following the biopsy?

A)Observe for bleeding.
B)Administer an analgesic for pain.
C)Monitor the puncture site for infection.
D)Encourage oral fluids.

Question 10

What nursing assessment measure is most important before and during a blood product infusion to detect a reaction?

A)Vital signs
B)Bowel sounds
C)Pupil reactivity
D)Skin turgor

Question 11

Where are neutrophils, eosinophils, and basophils produced?

A)Thymus
B)Spleen
C)Red bone marrow
D)Lymph nodes

Question 12

A patient who is taking warfarin (Coumadin) 5 mg daily has an international normalized ratio (INR) of 2.5. It is time to administer the next dose of Coumadin. What should the nurse do?

A)Hold the dose of Coumadin.
B)Notify the physician STAT.
C)Administer the daily Coumadin as ordered.
D)Prepare to administer vitamin K.

Question 13

A patient receiving blood begins complaining of severe chest pain and a feeling of warmth. What should the nurse do first?

A)Call the physician.
B)Assess vital signs and cardiovascular status.
C)Discontinue the blood transfusion.
D)Administer diuretics as ordered.

Question 14

The nurse is assessing a patient with chronic lung disease. Which of the following findings indicates long-term hypoxia?

A)Pulmonary crackles
B)Clubbed fingertips
C)Dyspnea
D)Pallor

Question 15

A patient has a bone marrow aspiration from the posterior iliac crest. Before the procedure, the patient's vital signs were as follows: blood pressure 132/82 mm Hg and pulse 88 beats/min. One hour after the procedure, the blood pressure is 108/70 mm Hg and pulse is 96 beats/min. Which assessment is least important at this time?

A)Observe the puncture site.
B)Determine if the patient had any medications before the procedure.
C)Ask the patient about feelings of lightheadedness or dizziness.
D)Check the patient's most recent complete blood count report.

Question 16

Which of the following is a waste product of red blood cell (RBC) destruction?

A)Thrombin
B)Iron
C)Bilirubin
D)Intrinsic factor

Question 17

T cells and B cells are groups of which cell type?

A)Red blood cells
B)Lymphocytes
C)Platelets
D)Eosinophils

Question 18

Which of the following individuals is at highest risk for blood clotting dysfunction?

A)A 54-year-old whose K+ = 3.8 mEq/L
B)A 41-year-old whose Na+ = 140 mmol/L
C)A 39-year-old whose Ca+ = 3.5 mg/dL
D)A 47-year-old whose Cl- = 105 mEq/L

Question 19

What is the best way the LPN can assist the health team to prevent a transfusion reaction?

A)Warm blood to 98.6°F (37°C) before infusion.
B)Assist the RN to identify correctly the patient and the blood product.
C)Administer diphenhydramine (Benadryl) before the infusion.
D)Monitor vital signs every 15 minutes.

Question 20

What is the stimulus for the formation of a blood clot or a platelet plug?

A)A rough surface
B)A smooth surface
C)An intact vessel
D)The endothelial lining of a vessel

Question 21

A patient who underwent lymphangiography the day before asks the LPN, "Why does my urine look blue?" What would be an appropriate response by the LPN?

A)"I will notify the RN and physician immediately."
B)"This indicates that the procedure found abnormal results."
C)"The dye used in the procedure may cause bluish skin and urine for 2 days."
D)"It is nothing to be concerned about."

Question 22

Which of the following values would be considered within normal limits? (Select all that apply.?

A)An adult male with Hgb = 12.8 g/100 mL
B)An adult female with RBC = 5 million/mm³
C)An adult male with RBC = 4 million/mm³
D)An adult female with Hct = 40%
E)An adult male with Hct = 35%
F)An adult female with Hgb = 11.5 g/100 mL

Question 23

Which of the following are functions of the spleen in a healthy adult? (Select all that apply.?

A)Storage of platelets
B)Production of red blood cells
C)Phagocytosis of worn blood cells and platelets
D)Formation of bilirubin
E)Production of lymphocytes and monocytes
F)Production of neutrophils and eosinophils

Question 24

A patient reports severe abdominal cramping and diarrhea. Assessment reveals a temperature of 102°F (38.8°C) and pulse of 82 beats/min. Results of a complete blood count reveal lower than normal segmented and banded neutrophils and higher than normal lymphocytes. Which type of infection is this patient most likely experiencing?

A)Bacterial
B)Parasitic
C)Viral
D)Fungal
Multiple Response
Identify one or more choices that best complete the statement or answer the question.

Question 25

The nurse should stay with a patient for the first ________________minutes after a blood transfusion is started, and then check the patient periodically according to agency guidelines.

Question 26

What is the rationale for the use of washed packed red blood cells for transfusion?

A)To reduce the risk of a febrile reaction
B)To reduce the risk of hypothermia
C)To remove potential harmful particles from the blood
D)To clean the blood cells of impurities

Question 27

The nurse is caring for a patient who has a white blood cell (WBC) count of 8,000/mm³. What concern does the nurse have about this finding?

A)The patient has an infection.
B)The patient is at risk for infection.
C)The patient has a hematological disorder.
D)There is no concern; this is a normal finding.

Question 28

What is the pH of the blood under normal circumstances?

A)Slightly acidic
B)Neutral
C)Slightly alkaline

Question 29

Which of the following are proteins in the plasma? (Select all that apply.?

A)Electrolytes
B)Albumin
C)Globulin
D)Fibrinogen
E)Hemoglobin
F)Iron

Question 30

An older adult patient is receiving a transfusion of packed red blood cells after being injured in a car accident. On assessment, the nurse notes a new finding of bounding pulse, crackles, and increasing dyspnea. What should the nurse do first, after stopping the transfusion?

A)Administer prn diphenhydramine (Benadryl) as ordered.
B)Raise the head of the bed.
C)Assess vital signs.
D)Encourage the patient to deep breathe and cough.

Question 31

Which of the following play a role in preventing excessive clotting in the vascular system? (Select all that apply.?

A)The very smooth endothelial lining of the blood vessels
B)The conversion of fibrinogen to fibrin
C)The production of heparin
D)The synthesis of antithrombin
E)The formation of prothrombinase

Question 32

A patient with type O+ blood can receive which of the following transfusions? (Select all that apply.?

A)Type A+
B)Type AB-
C)Type O+
D)Type O-
E)Type B-
F)Type A-
Completion
Complete each statement.