Deck 39: Assessment of the Hematologic System

Question 1

The health care provider tells the nurse that a client is to be started on a platelet inhibitor.About what drug does the nurse plan to teach the client?

A) Clopidogrel (Plavix)
B) Enoxaparin (Lovenox)
C) Reteplase (Retavase)
D) Warfarin (Coumadin)

Answer 1

Clopidogrel (Plavix)

Question 2

An older client asks the nurse why "people my age" have weaker immune systems than younger people.What responses by the nurse are best? (Select all that apply.)

A) "Bone marrow produces fewer blood cells."
B) "You may have decreased levels of circulating platelets."
C) "You have lower levels of plasma proteins in the blood."
D) "Lymphocytes become more reactive to antigens."
E) "Spleen function declines after age 60."

Answer 2

"Bone marrow produces fewer blood cells."
"You have lower levels of plasma proteins in the blood."

Question 3

A nurse is assessing a dark-skinned client for pallor.What action is best?

A) Assess the conjunctiva of the eye.
B) Have the client open the hand widely.
C) Look at the roof of the client's mouth.
D) Palpate for areas of mild swelling.

Answer 3

Assess the conjunctiva of the eye.

Question 4

A client is receiving rivaroxaban (Xarelto)and asks the nurse to explain how it works.What response by the nurse is best?

A) "It inhibits thrombin."
B) "It inhibits fibrinogen."
C) "It thins your blood."
D) "It works against vitamin K."

Question 5

A nursing student learns that many drugs can impair the immune system.Which drugs does this include? (Select all that apply.)

A) Acetaminophen (Tylenol)
B) Amphotericin B (Fungizone)
C) Ibuprofen (Motrin)
D) Metformin (Glucophage)
E) Nitrofurantoin (Macrobid)

Question 6

A hospitalized client has a platelet count of 58,000/mm³.What action by the nurse is best?

A) Encourage high-protein foods.
B) Institute neutropenic precautions.
C) Limit visitors to healthy adults.
D) Place the client on safety precautions.

Question 7

A client is having a radioisotopic imaging scan.What action by the nurse is most important?

A) Assess the client for shellfish allergies.
B) Place the client on radiation precautions.
C) Sedate the client before the scan.
D) Teach the client about the procedure.

Question 8

A nurse is caring for four clients.After reviewing today's laboratory results,which client should the nurse see first?

A) Client with an international normalized ratio of 2.8
B) Client with a platelet count of 128,000/mm³
C) Client with a prothrombin time (PT) of 28 seconds
D) Client with a red blood cell count of 5.1 million/µL

Question 9

A nurse works in a gerontology clinic.What age-related changes cause the nurse to alter standard assessment techniques from those used for younger adults? (Select all that apply.)

A) Dentition deteriorates with more cavities.
B) Nail beds may be thickened or discolored.
C) Progressive loss of hair occurs with age.
D) Sclerae begin to turn yellow or pale.
E) Skin becomes dry as the client ages.

Question 10

A client is having a bone marrow biopsy today.What action by the nurse takes priority?

A) Administer pain medication first.
B) Ensure valid consent is on the chart.
C) Have the client shower in the morning.
D) Premedicate the client with sedatives.

Question 11

A nursing student wants to know why clients with chronic obstructive pulmonary disease tend to be polycythemic.What response by the nurse instructor is best?

A) It is due to side effects of medications for bronchodilation.
B) It is from overactive bone marrow in response to chronic disease.
C) It combats the anemia caused by an increased metabolic rate.
D) It compensates for tissue hypoxia caused by lung disease.

Question 12

A client is having a bone marrow biopsy and is extremely anxious.What action by the nurse is best?

A) Assess client fears and coping mechanisms.
B) Reassure the client this is a common test.
C) Sedate the client prior to the procedure.
D) Tell the client he or she will be asleep.

Question 13

A student nurse learns that the spleen has several functions.What functions do they include? (Select all that apply.)

A) Breaks down hemoglobin
B) Destroys old or defective red blood cells (RBCs)
C) Forms vitamin K for clotting
D) Stores extra iron in ferritin
E) Stores platelets not circulating