Deck 34: Coordinating Care for Patients With Hematological Disorders

Question 1

The home healthcare nurse is preparing a care plan for a patient with severe anemia. The patient currently lives alone and states, "I can't even walk to the kitchen without getting winded." What would be the priority nursing diagnosis for this patient?
1)Self Care Deficit
2)Activity Intolerance
3)Impaired Mobility
4)Anxiety

Answer 1

2

Question 2

The nurse is instructing a patient with iron deficiency anemia about appropriate menu choices. Which diet choice indicates that teaching has been effective?
1)Tofu with mixed vegetables in curry, milk, whole-wheat bun
2)Broiled fish, lettuce salad, grapefruit half, carrot sticks
3)Pork chop, mashed potatoes and gravy, cauliflower, tea
4)Roast beef, steamed spinach, tomato soup, orange juice

Answer 2

4

Question 3

The nurse prepares to administer the prescribed intramuscular injection (IM) iron to a patient. Which is the priority action for this task?
1)Using the Z-track method
2)Assessing for tachycardia
3)Applying pressure to the injection site
4)Monitoring the patient for cardiotoxic effects

Answer 3

1

Question 4

A nurse is planning care for a patient with sickle cell disease. The nurse should contact the provider about which prescribed intervention?
1)Administer ordered analgesic medications around the clock
2)Place patient in position of comfort
3)Use heat or cold packs as tolerated
4)Support the patient's joints and extremities with pillows

Question 5

A patient diagnosed with aplastic anemia is admitted to the hospital. In teaching the patient and family about this disease process, what information does the nurse include?
1)"Aplastic anemia causes a proliferation of white blood cells."
2)"Aplastic anemia is characterized by abnormally shaped red blood cells."
3)"Aplastic anemia is caused by the bone marrow producing inadequate cells."
4)"Aplastic anemia is a disorder that occurs after a viral illness."

Question 6

Which statement by a 65-year-old patient diagnosed with aplastic anemia secondary to chemotherapy indicates the need for further teaching?
1)"I am looking forward to getting a bone marrow transplant."
2)"I will be receiving medications that stimulate my bone marrow."
3)"I may need blood transfusions."
4)"I need to get my counts up to improve energy and decrease the risk of infection."

Question 7

Which is the priority teaching point for the nurse to include in the discharge instructions for the patient being discharged after treatment for sickle cell crisis?
1)Rapid weaning of pain medications
2)A diet high in protein
3)Adequate hydration
4)Restriction of activities

Question 8

A patient in sickle cell crisis reports taking a recent skiing trip that caused a respiratory infection from the cold weather. Which nursing diagnosis is a priority for this patient?
1)Fluid Volume Excess
2)Impaired Mobility
3)Knowledge Deficit
4)Acute Pain

Question 9

A nurse is providing discharge instructions to a patient with iron deficiency anemia who is experiencing glossitis. Which patient statement indicates the need for further education?
1)"I will monitor my lips and tongue daily."
2)"I will use an alcohol-based mouthwash twice per day."
3)"I will apply a petroleum-based lubricating ointment to my lips."
4)"I will use a soft toothbrush when brushing my teeth each day."

Question 10

The nurse is evaluating a patient's understanding of dietary needs to treat anemia. Which patient statement indicates a need for additional teaching?
1)"I will eat more fruits and vegetables, especially green leafy ones, to get more iron in my diet."
2)"I will need to include more protein foods in my diet such as meats, dried beans, and whole-grain breads."
3)"I will decrease foods high in vitamin C because they decrease the absorption of iron."
4)"I will take vitamins with extra iron in addition to eating a balanced diet with meat to correct my anemia."

Question 11

The nurse provides care for a patient who is diagnosed with a folic acid deficiency anemia. Which clinical manifestation requires healthcare provider notification?
1)Pallor
2)Eupnea
3)Confusion
4)Tachycardia

Question 12

A patient complaining of mouth soreness had gastric bypass surgery 1 year ago. During the assessment, the nurse notes the patient's tongue is beefy, red, and smooth and the patient's skin appears yellowish. The nurse correlates these findings to a decreased value of which diagnostic test?
1)Vitamin B₆ levels
2)Vitamin B₁₂ levels
3)Platelet count
4)Iron levels

Question 13

The nurse develops the nursing diagnosis "Risk for Bleeding related to lack of intrinsic factor" for the patient with which hematological disorder?
1)Iron deficiency anemia
2)Pernicious anemia
3)Folic acid deficiency anemia
4)Glucose-6-phosphate dehydrogenase (G6PD) deficiency

Question 14

A patient experiencing fatigue, pallor, and dyspnea on exertion has a complete blood count completed. The nurse correlates these clinical manifestations to which hematological disorder?
1)Polycythemia
2)Thrombocytopenia
3)Neutropenia
4)Anemia

Question 15

The nurse monitors for which diagnostic result in the patient with glucose-6-phosphate dehydrogenase (G6PD) deficiency?
1)Decreased reticulocyte count
2)Presence of Heinz bodies
3)White blood cells in the urine
4)Elevated platelets

Question 16

The nurse is providing discharge teaching for a patient with iron deficiency anemia. The patient has been prescribed ferrous sulfate and has been told to increase the intake of foods that are naturally high in iron. Which patient statement indicates the need for additional teaching?
1)"I will increase my intake of green leafy vegetables."
2)"I will increase my fluid intake while I am taking ferrous sulfate."
3)"I will take my ferrous sulfate tablet on an empty stomach."
4)"I will increase dried beans in my diet."

Question 17

An older adult patient with renal failure is diagnosed with anemia. Based on this data, which cause of anemia will the nurse include in the plan?
1)Loss of the kidney hormone erythropoietin
2)A loss of appetite related to elevated blood urea nitrogen (BUN) and creatinine levels
3)The renal dialysis used to treat the chronic renal failure
4)Loss of blood through the urine because the failing kidney does not function properly

Question 18

A patient is admitted to the emergency department in a sickle cell crisis. The nurse assesses the patient and documents the following clinical findings: temperature 102°F, O₂ saturation of 89%, and complaints of severe abdominal pain. Based on the assessment findings, which intervention is the greatest priority?
1)Apply oxygen per nasal cannula at 3 L/minute.
2)Assess and document peripheral pulses.
3)Administer morphine sulfate 10 mg IM.
4)Administer Tylenol 650 mg by mouth.

Question 19

The nurse provides care to a patient who is admitted for a sickle cell disease (SCD) crisis. Which is the priority prescription for the nurse to implement when providing patient care?
1)Administering oxygen
2)Administering antipyretics
3)Administering pain medication
4)Administering intravenous fluid

Question 20

The nurse conducts a teaching session for a patient who is diagnosed with iron deficiency anemia. Which patient statement indicates to the nurse a need for additional teaching?
1)"I will add beets to my salad."
2)"I will increase my intake of meats."
3)"I will eat an egg each day for breakfast."
4)"I will include dark-green vegetables in my diet."

Question 21

The nurse correlates appropriate secondary polycythemia to which of the following conditions?
1)Renal disease
2)Cancer
3)High altitudes
4)Cold temperatures

Question 22

The nurse is planning care for a patient with acute myeloid leukemia (AML). Which is the priority nursing diagnosis to minimize the risk of complications associated with this diagnosis?
1)Risk for Bleeding
2)Impaired Mobility
3)Imbalanced Nutrition
4)Fluid Volume Excess

Question 23

The nurse provides discharge instructions to a patient who is neutropenic. Which patient statements indicate the need for additional teaching? Select all that apply.
1)"My plants are being moved outside."
2)"I will avoid eating raspberries and blackberries."
3)"I will use a humidifier to moisten the air at night."
4)"I will wash all raw vegetables before eating them."
5)"My prescribed antibiotic can be stopped once I feel better."

Question 24

The nurse correlates which diagnostic results to the patient with pancytopenia? Select all that apply.
1)Decreased reticulocyte count
2)Increased immature neutrophils
3)Platelets 100,000 10³/mm^3-
4)RBC 3.2 million cells/mm³
5)WBC 12.0 10³/mm^3-

Question 25

The nurse monitors for which clinical manifestations in the patient diagnosed with malignant lymphoma? Select all that apply.
1)Night sweats
2)High fevers
3)Swollen lymph nodes
4)Painful lymph nodes
5)Weight loss

Question 26

A patient with a history of anemia has started a vegan diet. Which addition to meals should the nurse recommend to help ensure that this patient has adequate amounts of iron in the diet? Select all that apply.
1)Legumes
2)Orange juice
3)Brewer's yeast
4)Okra
5)Peas

Question 27

A patient diagnosed with polycythemia is prescribed radiation, and asks the rationale for this treatment. Which response by the nurse is accurate?
1)"It stimulates red blood cell production."
2)"It suppresses the bone marrow."
3)"It provides vitamin supplementation."
4)"It decreases the risk of transfusion reactions."

Question 28

The nurse correlates which diagnostic finding to a diagnosis of multiple myeloma?
1)Serum calcium 8.5 mg/dL
2)Serum creatinine 2.2 mg/dL
3)Hemoglobin 18 g/dL
4)Serum BUN 15 mg/dL

Question 29

A nurse educator is teaching a group of patients about prevention of sickle cell crises. What should the nurse instruct about the precipitating factors that could contribute to a sickle cell crisis? Select all that apply.
1)Increased fluid intake
2)Altitude
3)Fever
4)Vomiting
5)Regular exercise

Question 30

In providing care for a patient with malignant lymphoma, the nurse correlates which clinical manifestations to the development of superior vena cava syndrome?
1)Decreased peripheral pulses
2)Decreased reflexes
3)Tachycardia
4)Shortness of breath

Question 31

In administering cryoprecipitate to a patient diagnosed with idiopathic thrombocytopenia purpura, the nurse recognizes which of the following actions as the rationale for this treatment?
1)Increases plasma volume
2)Prevents platelet destruction
3)Provides clotting factors
4)Promotes platelet production