Question 1

The nurse is caring for a patient who has a white blood cell (WBC)count of 8000/mm³.What concern should the nurse have about this finding?

Accepted Answer

A normal WBC count is 5000 to 10,000/mm³.8000 is not a concern.A.A high count is a sign of infection.B.A low count places a patient at risk for infection.C.Any variation from normal may signal a hematological disorder.

Question 2

A patient with type O+ blood is to receive 4 units of packed red blood cells.Which type of blood should the nurse expect to see prepared for this patient? (Select all that apply.)

Accepted Answer

The ABO type (A,B,O,or AB)indicates the antigens present (or not present,as in the case of type O)on the red blood cells.In the plasma are antibodies for antigens that are not present in the blood.Type O blood therefore has antibodies to all blood types except type O,so type O is the only type that is safe to transfuse.

Question 3

The nurse is assisting with the collection of data from a patient with a hematologic disorder.On which body system should the nurse expect to focus when collecting this data?

Accepted Answer

A hematologic disorder can affect all body systems.The nurse should collect data on as many body systems as possible.A.B.C.Hematologic disorders affect body systems other than the respiratory,genitourinary,and cardiovascular systems.

Question 4

A patient receiving a unit of packed red blood cells as treatment for anemia begins to vomit and experience extreme gastrointestinal cramping.What should the nurse do? (Select all that apply.)

Accepted Answer

Anaphylactic reactions are not common but may be seen more often in patients who have received many transfusions.In this type of reaction,the very first milliliters of blood containing the allergens to pass into the patient's system may be enough to cause the patient to develop respiratory or cardiovascular collapse.Other more common symptoms include severe gastrointestinal cramping and instant vomiting.The nurse should stop the transfusion at once and stay with the patient.Have someone else notify the RN and the HCP.Provide CPR if necessary.B.IV heparin is not used to treat this blood reaction.E.Flushing the blood tubing with normal saline will not help reduce the effects of this transfusion reaction.

Question 5

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?

Accepted Answer

Older patients have less cardiac and renal ability to adapt to changes in blood volume,so they have a much higher risk of fluid overload when receiving blood transfusions.New onset of dyspnea,crackles,hypertension,or bounding pulse should be reported to the RN or physician immediately.Raising the head of the bed will help ease breathing.D.Diphenhydramine is helpful for allergic reactions.A.C.Assessing vital signs and encouraging deep breathing and coughing may be helpful,but the first priority is positioning the patient to breathe more easily.

Question 6

The nurse is reviewing the activated partial thromboplastin time for a patient receiving heparin.Which value indicates that the medication is within the therapeutic range?

Accepted Answer

For a patient receiving heparin the therapeutic range for the activated partial thromboplastin time is 1.5 to 2.0 times normal.A.A normal bleeding time is 2.5 to 9.5 minutes.B.A normal prothrombin time for a female is 9.5 to 11.3 seconds.D.For a patient taking warfarin the therapeutic range for The INR is 2.0 to 3.0 times normal.

Question 7

A female patient's hematocrit level is 50% and oxygen saturation is 98% on room air.What should the nurse suspect as being the cause for this patient's hematocrit level?

Accepted Answer

Hematocrit levels are increased in chronic hypoxia and dehydration.Since the oxygen saturation level is 98% on room air,the nurse should suspect that this patient is dehydrated.B.C.D.The hemoglobin level will most likely be low if the patient has chronic renal failure,bone marrow suppression,or bleeding esophageal varices.

Question 8

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 does the nurse suspect this patient is most likely experiencing?

Accepted Answer

Lymphocytes fight viral infections and are elevated during a virus.Segmented and banded neutrophils are elevated with bacterial infection.B.There are no particular white blood cell level changes associated with fungal infections.C.Eosinophils respond to parasitic infections.

Question 9

A patient with a bleeding disorder is considering surgery to have the spleen removed.What should the nurse explain as being functions of the spleen in a healthy adult? (Select all that apply.)

Accepted Answer

The spleen contains B cells and T lymphocytes,which mediate immune responses.It also contains fixed macrophages that phagocytize pathogens and worn or defective blood cells and platelets.The heme unit from red blood cell destruction forms bilirubin.Bilirubin is sent to the liver by way of portal circulation for excretion in the bile.The spleen also stores up to one-third of the body's platelets.C.Red blood cells are produced in the bone marrow,not the spleen.D.Neutrophils and eosinophils are produced in the red bone marrow,not in the spleen.

Question 10

The nurse is reviewing the contents of blood plasma prior to participating in a seminar for nursing students.What should the nurse include as proteins in the plasma? (Select all that apply.)

Accepted Answer

Plasma proteins include clotting factors,albumin,and globulins.Clotting factors,such as prothrombin and fibrinogen,are synthesized by the liver and circulate until activated in the clotting mechanism.Albumin,also synthesized by the liver,helps maintain blood volume and blood pressure by pulling tissue fluid into the venous ends of the capillary networks.Alpha and beta globulins are synthesized by the liver to be carrier molecules for substances such as fats,and gamma globulins are the antibodies produced by lymphocytes.A.E.F.Electrolytes and iron are not proteins,and hemoglobin is in red blood cells,not plasma.

Question 11

A patient has a platelet count of 75,000 /mm³.What action should the nurse take to support this patient?

Accepted Answer

A normal platelet count is 150,000-450,000/mm³.There is an increased risk of bleeding with a low platelet count.The patient's blood draws should be limited because of the risk of bleeding after a venipuncture.B.C.Protective isolation and wearing a mask would be appropriate if the white blood cell count was low.D.Rectal temperatures would be contraindicated in the patient with a low platelet count because of the risk for rectal bleeding.

Question 12

The nurse is reviewing the results of a patient's arterial blood gas analysis.What should the nurse recognize as being a normal blood pH?

Accepted Answer

The normal pH range of blood is 7.35 to 7.45 A.B.A pH less than 7.35 is acidic.D.A pH of 7.48 is alkaline.

Question 13

The nurse is assisting with the preparation of a blood transfusion for a patient.Which type of fluid should the nurse select to transfuse with the blood?

Accepted Answer

Only normal saline solution is compatible with a blood transfusion.B.C.D Solutions that contain dextrose can cause red cells to lyse.

Question 14

A patient who underwent lymphangiography the day before asks the licensed practical nurse (LPN),"Why does my urine look blue?" What should the LPN respond to this patient's concern?

Accepted Answer

Lymphangiography uses a dye that may turn skin,urine,or feces blue-tinged for about 2 days.B.There is no reason to notify the RN or physician.C.It is inappropriate to advise the patient about results and incorrect that it indicates an abnormal finding.A.Stating that it is nothing to be concerned about does not address the patient's concern.

Question 15

The nurse is evaluating laboratory values for a group of patients.Which values should the nurse identify as being within normal limits? (Select all that apply.)

Accepted Answer

Normal red blood cell (RBC)count for males is 4.6 to 6.2 million/mm³ and for females is 4.2 to 5.4 million/mm³.Normal hematocrit (Hct)for males is 40% to 54% and for females is 38% to 47%.Normal hemoglobin (Hgb)for males is 13.5 to 18 g/100 mL and for females is 12 to 16 g/100 mL.

Question 16

While receiving a unit of packed red blood cells,the patient begins to experience hives around the neck and upper chest.What actions should the nurse perform because of this reaction? (Select all that apply.)

Accepted Answer

On discovery of a urticarial reaction,the nurse should stop the transfusion and notify the HCP immediately.Expect that the patient will be given a dose of an antihistamine,such as diphenhydramine (Benadryl).If the transfusion is restarted,continue to monitor the patient closely.C.The blood will most likely not be returned to the blood bank but transfused into the patient.

Question 17

A patient is prescribed a transfusion of washed packed red blood cells.What should the nurse realize as being the rationale for the using this type of blood?

Accepted Answer

The washing process removes almost all the plasma and can decrease the risk or severity of a febrile reaction.A.Hypothermia risk is reduced by warming blood.B.There is no process that removes impurities from cells.D.Harmful particles can be removed with filtering.

Quiz 27: Hematologic and Lymphatic System Function,Assessment,and Therapeutic Measures

The nurse is caring for a patient who has a white blood cell (WBC) count of 8000/mm³.What concern should the nurse have about this finding?