Deck 16: Care of Patients with Hematologic Disorders

Question 1

Which descriptions accurately characterize the appearance of red blood cells (RBCs)in iron deficiency anemia?

A) Normochromic and normocytic
B) Hypochromic and microcytic
C) Hyperchromic and macrocytic
D) Normochromic and microcytic

Answer 1

Hypochromic and microcytic

Question 2

Blood infusions must be started within how many minutes of its arrival on the unit?

A) 10 minutes
B) 15 minutes
C) 30 minutes
D) 60 minutes

Answer 2

30 minutes

Question 3

The nurse is caring for a 79-year-old male who underwent a gastrectomy 1 month ago.The nurse recognizes that this patient is at the greatest risk for which type of anemia?

A) Aplastic anemia
B) Pernicious anemia
C) Iron deficiency anemia
D) Nutritional anemia

Answer 3

Pernicious anemia

Question 4

When caring for a patient with advanced multiple myeloma,the nursing staff must exercise extreme care to prevent which complication?

A) Pain
B) Hematomas
C) Muscle spasms
D) Pathologic fractures

Question 5

The nurse is caring for a patient with sickle cell anemia.Which intervention may best help prevent sickle cell crisis?

A) Taking iron supplements daily
B) Maintaining adequate fluid intake
C) Engaging in daily exercise
D) Eating leafy green vegetables

Question 6

The home health nurse is caring for a patient with polycythemia vera.Which focus is most important for the nurse to emphasize?

A) Maintenance of high fluid intake
B) Daily exercise to reduce weight
C) Daily dose of anticoagulants
D) Adequate intake of vitamin C

Question 7

The home health nurse is caring for a patient who is taking ferrous sulfate (Feosol).Which statement indicates that the patient requires additional teaching about this medication?

A) "It tastes better when I take my medicine with milk."
B) "My wife says I should take my medicine with orange juice."
C) "I am always careful not to break open the capsule."
D) "I usually take my iron with my whole-grain toast during breakfast."

Question 8

Iron deficiency anemia impacts adequate production of which component?

A) Plasma
B) White blood cells (WBCs)
C) Hemoglobin
D) Antibodies

Question 9

Which statement accurately describes induction therapy for acute lymphocytic leukemia (ALL)?

A) Induction therapy is an intensive protocol of chemotherapy in high doses to achieve remission.
B) Induction therapy is a long-term protocol with smaller doses of chemotherapy to achieve a cure.
C) Induction therapy is a 2- to 5-year low-dose chemotherapy regimen to reduce painful symptoms.
D) Induction therapy is a combination of chemotherapy and radiation to achieve remission.

Question 10

A patient with a nutritional anemia may lack which nutrients?

A) Proteins
B) Vitamin B₁
C) Folic acid
D) Zinc
E) Iron

Question 11

The nurse is caring for a patient with sickle cell anemia.Which statement indicates that the patient requires further instruction?

A) "I should not drink iced drinks."
B) "I miss drinking beer in the afternoon."
C) "I walk every day rather than doing other strenuous exercise."
D) "I am planning a trip to Colorado next month."

Question 12

The nurse is caring for a patient with aplastic anemia.Which actions are most important for the nurse to take?

A) Alternate activity with periods of rest and provide magazines.
B) Provide a soft toothbrush and decrease clutter in the room.
C) Request an order for telemetry and limit intake of potassium-rich foods.
D) Encourage the patient to reposition regularly and float heels on pillows.

Question 13

The nurse is caring for a patient with anemia who has a past medical history of diabetes,hypertension,chronic kidney disease,and acid reflux.The nurse is aware the patient's anemia is likely related to which condition?

A) Diabetes
B) Hypertension
C) Chronic kidney disease
D) Acid reflux

Question 14

The nurse is caring for a 20-year-old female patient with sickle cell trait.Which statement accurately reflects this patient's condition?

A) The condition will evolve into sickle cell anemia as she ages.
B) All of her children will have sickle cell anemia.
C) The trait will be transmitted to male children only.
D) The trait can be passed on to all children.

Question 15

The nurse is assessing a patient with polycythemia vera.Which finding is consistent with this disorder?

A) Pallor
B) Blood pressure (BP) of 100/60
C) Hemoglobin of 17 mg/dL
D) Agitation

Question 16

The patient with acute myelogenous leukemia (AML)asks why he is making more WBCs when he already has so many.Which statement clarifies the underlying pathophysiology related to the patient's white blood cells (WBCs)?

A) "The large number of leukemic white cells that you already have are not as effective as normal white cells."
B) "The large number of leukemic white cells that you already have protect against infection."
C) "The large number of leukemic white cells that you already have attempt to take over the functions of RBCs.
D) "The large number of leukemic white cells that you already have are produced by the lymphatic system."

Question 17

The nurse is caring for a patient with sickle cell anemia.Based on the underlying pathophysiology of this disorder,the nurse should carefully perform which detailed assessment?

A) Examination for skin breakdown
B) Auscultation of lungs
C) Abdominal girth measurement
D) Palpation of radial pulses

Question 18

The student nurse is preparing to administer an iron preparation via the intramuscular (IM)route.Which action indicates the need for further instruction?

A) The student changes needles after drawing up the medication.
B) The student administers 3 mL at the ventrogluteal site.
C) The student chooses a 20-gauge needle.
D) The student uses the Z-track technique when administering the injection.

Question 19

How often should a patient with polycythemia vera have phlebotomy to thin the blood?

A) Every 2 to 3 weeks
B) Monthly
C) Every 2 to 3 months
D) Semiannually

Question 20

The nurse makes a visual aid differentiating between mild,moderate,and severe anemia.Which signs and symptoms are manifestations of mild anemia?

A) Hemoglobin of 14.4 g/dL
B) Palpitations
C) Dyspnea on exertion
D) Pallor
E) Fatigue

Question 21

The patient with AML has a platelet count of 95,000.What interventions should the nurse include in the patient's care plan?

A) Observe for melena and hematuria.
B) Instruct the patient to brush and floss at least twice daily.
C) Measure abdominal girth daily.
D) Apply ice and pressure to puncture sites.
E) Instruct the patient to use an electric razor.

Question 22

The nurse is monitoring a patient who is receiving a blood transfusion.Which finding(s)would lead the nurse to stop the infusion?

A) Report of chills
B) Headache
C) Back pain
D) Report of a rash
E) Fever

Question 23

The patient with acute myelogenous leukemia (AML)has a volume of blood extracted by machine,white cells are extracted in the machine,and the blood is then returned to the patient.This process is called ____________________.

Question 24

The nurse is caring for patient with iron deficiency anemia.The nurse should encourage intake of which food(s)?

A) Liver
B) Lima beans
C) Prune juice
D) Cabbage
E) Dried apricots

Question 25

The nurse explains to a person who has undergone bone marrow transplantation (BMT)that engraftment takes up to ____________________ weeks.

Question 26

When assessing a complete blood count (CBC)of a patient with acute lymphocytic leukemia (ALL),the nurse would anticipate large numbers of immature white cells,called ____________________.

Question 27

Which medication(s)may cause aplastic anemia?

A) Antimetabolite cancer drugs
B) Phenylbutazone (Butazolidin)
C) Oral contraception drugs
D) Chloramphenicol (Chloromycetin)
E) Sulfonamides

Question 28

Which factor(s)may be causative for leukemia?

A) Radiation exposure
B) Pesticides exposure
C) Benzene exposure
D) Frequent bacterial infections
E) Virulent viral infections

Question 29

The nurse is aware that bone marrow transplantation (BMT)is a treatment alternative for aplastic anemia for people under the age of ____________________.