Question 1

A patient's laboratory values indicate a "shift to the left." The nurse would anticipate further testing for which possible conditions?. Select all that apply.

Accepted Answer

A,B,D,E

Question 2

The nurse is developing a series of presentations for a group of high school students interested in a career in health care. Which topics would the nurse consider for inclusion in a discussion of hematologic function?. Select all that apply.

Accepted Answer

A,B,C,D

Question 3

A patient's laboratory values indicate a "shift to the left." The nurse would expect changes in which cell count?

Accepted Answer

"Shift to the left" refers to the presence of immature or band neutrophils in the white blood cell count, indicating an increased demand for neutrophils due to infection, inflammation, or other causes. Therefore, the nurse would expect changes in the white blood cell count, specifically an increase in the percentage of band neutrophils and a decrease in the percentage of segmented neutrophils, leading to a left shift. Platelets, erythrocytes, and ANC are not typically affected by a left shift.

Question 4

How would the nurse explain primary and secondary hemostasis to the parents of a child newly diagnosed with a platelet disorder?. Select all that apply.

Accepted Answer

Primary hemostasis involves vasoconstriction and the formation of a platelet plug. Secondary hemostasis stabilizes the clot through the coagulation cascade.

Question 5

When assessing an older adult for possible hematologic problems, the nurse should pay particular attention to which portions of the assessment?. Select all that apply.

Accepted Answer

The answer of When assessing an older adult for possible...

Question 6

A patient's mean corpuscular volume (MCV) is low. How would the nurse explain this finding to the patient?

Accepted Answer

A low mean corpuscular volume (MCV) indicates that the red blood cells are smaller than normal, which is what choice D accurately describes.

Question 7

A differential blood count has been ordered on a patient being admitted for surgery. How would the nurse explain the purpose of this test?

Accepted Answer

A differential blood count measures the percentages of different types of white blood cells in the blood. This can help determine if a patient has an infection or other conditions that affect the immune system. This test does not measure clotting ability or assess blood transfusion response.

Question 8

The nurse would immediately collaborate with the health care provider if a patient experiences a "shift to the left" in laboratory values. What is the rationale for this collaboration?

Accepted Answer

A "shift to the left" in laboratory values refers to an increase in the number of immature white blood cells, which can indicate an active infection or inflammation. This shift may also suggest the potential for a severe infection, which would require collaboration between the nurse and the health care provider to determine appropriate treatment and management.

Question 9

A middle-aged couple has had their hemoglobin and hematocrit levels measured at a community health fair. How would the nurse explain the results of these tests?

Accepted Answer

Normal hematocrit values are typically about three times the hemoglobin value, which is a standard relationship used in interpreting these lab results.

Question 10

What phrases would the nurse use to describe red blood cells?. Select all that apply.

Accepted Answer

Red blood cells maintain the chemical integrity of hemoglobin and carry oxygen to tissues. They are not formed from monoblasts, have a life span of about 120 days, and are flexible, not rigid, when filled with hemoglobin.

Question 11

The nurse asks specific questions about alcohol consumption when collecting data about a patient's hematologic system. What rationale would the nurse offer for these questions?

Accepted Answer

Excessive alcohol consumption can lead to vitamin deficiencies, specifically deficiencies in B vitamins and folic acid, which can negatively impact the hematologic system by decreasing the production of red blood cells and impairing the immune system. The nurse asks about alcohol consumption to assess for these potential vitamin deficiencies.

Question 12

A patient is admitted to the unit with a high count of lymphocytes. The nurse knows that a greater number of which types of cells are present?. Select all that apply.

Accepted Answer

The answer of A patient is admitted to the unit...

Question 13

A patient's white blood cell count is 11,000/mm³. The nurse evaluates this value as representing which component of the hematologic system?

Accepted Answer

The white blood cell count represents the total number of circulating leukocytes in the blood.

Question 14

The patient's laboratory testing reveals a decreased red blood cell count. The nurse anticipates further testing to determine if the patient has which disorder?. Select all that apply.

Accepted Answer

The answer of The patient's laboratory testing reveals a decreased...

Question 15

Physical examination related to the hematologic system of the adult patient should include inspection of which areas of the body?. Select all that apply.

Accepted Answer

The answer of Physical examination related to the hematologic system...

Question 16

While reviewing the white blood cell count differential for a patient, the nurse notes that the basophil count is elevated. What does this laboratory value indicate to the nurse?

Accepted Answer

An elevated basophil count is often seen in an acute hypersensitivity reaction, such as an allergic reaction or asthma. Basophils are involved in the immune response to allergens and their release of histamine can cause symptoms such as itching and inflammation.

Question 17

A patient with a family history of anemia is admitted to the unit. What type of blood cell would be characteristic of an anemia with a familial pattern?

Accepted Answer

Sickle cell anemia is a genetic disorder that affects hemoglobin in red blood cells, leading to anemia. It is inherited in an autosomal recessive pattern, making it characteristic of an anemia with a familial pattern.

Question 18

Which statements would the nurse make when discussing age-related changes in the hematologic system?. Select all that apply.

Accepted Answer

A) Hemoglobin levels tend to decrease slightly with age due to changes in bone marrow activity.
B) While there is a decrease in the amount of red marrow with age, it still plays an important role in blood cell production.
C) There may be some variations in blood cell counts for older individuals, but not necessarily big differences.
D) Age-related changes in the immune system can result in a decreased response to immunizations.
E) With age, the body's ability to produce new blood cells may slow down, resulting in a longer recovery time from injury or illness.

Question 19

A patient's laboratory results reveal a low platelet count. The nurse would assess the patient for which skin finding?

Accepted Answer

Petechiae are small, pinpoint, red or purple colored spots on the skin that occur due to bleeding under the skin. A low platelet count (thrombocytopenia) can cause easy bruising and spontaneous bleeding, including the formation of petechiae. Jaundice (A) is a yellowing of the skin and eyes due to liver dysfunction, whereas a brown or dark tinge to the skin (C) and a flushed appearance (D) are not specifically associated with a low platelet count.

Question 20

Which patient statements would the nurse document as part of the chief complaint?. Select all that apply.

Accepted Answer

The chief complaint is the main reason the patient is seeking healthcare. Statements B, C, and E all describe symptoms that the patient is currently experiencing and would be documented as part of the chief complaint. Statements A and D provide relevant medical history or environmental exposure history but do not describe a current symptom or reason for the patient's visit.

Quiz 55: Nursing Assessment of the Patient With Hematological Disorders