Deck 7: Care of the Patient With a Blood or Lymphatic Disorder

Question 1

An examination in which the different kinds of white blood cells are counted and reported as percentages of the total examined or absolute (actual number) is called

A) reticulocyte.
B) ABO system.
C) mean cell volume (MCV).
D) differential.

Answer 1

differential.

Question 2

A patient is to begin taking iron supplements. The nurse evaluates the patient's understanding of the use of this drug. Which indicates that she has an adequate knowledge base?

A) Using antidiarrheal drugs if she has diarrhea
B) Understanding that black stools may occur
C) Checking her gums for bleeding
D) Brushing her teeth with a soft-bristled brush

Answer 2

Understanding that black stools may occur

Question 3

The patient has a history of iron deficiency anemia. The value most indicative of iron deficiency anemia is

A) a hemoglobin of 8 g/dL.
B) a leukocyte count of 8,000/mm³.
C) an RBC of 6 million/mm³.
D) a platelet count of 20,000/mm³.

Answer 3

a hemoglobin of 8 g/dL.

Question 4

In an adult, erythrocytes are continuously produced in the

A) yellow bone marrow.
B) lymphatic system.
C) spleen.
D) red bone marrow.

Question 5

The patient has agranulocytosis with a neutrophil count of 10%. The most important nursing intervention would be

A) restoring fluid volume deficit.
B) providing oxygen per mask.
C) instituting bleeding precautions.
D) avoiding infection.

Question 6

When developing a care plan for a patient just diagnosed with leukemia, which two nursing diagnoses are the most appropriate to use?

A) Deficient knowledge and Hopelessness
B) Risk for infection and Risk for injury
C) Ineffective coping and Chronic pain
D) Fatigue and Chronic pain

Question 7

The patient, age 35, is admitted with aplastic anemia. He asks the nurse what aplastic anemia is. An accurate response would be that

A) the activity of the bone marrow is depressed.
B) the bone marrow fails to produce lymphocytes.
C) the bone marrow fails to produce red blood cells.
D) red cells are absent as a result of chronic blood loss.

Question 8

Erythrocytes are also known as

A) WBCs.
B) platelets.
C) RBCs.
D) oxygen.

Question 9

Pernicious anemia results from inadequate absorption of

A) vitamin B₁₂.
B) iron.
C) vitamin K.
D) protein.

Question 10

Which is a normal blood value for lymphocytes?

A) 5%
B) 10%
C) 30%
D) 60%

Question 11

A patient, age 24, is admitted with idiopathic thrombocytopenic purpura and a platelet count of 18,000/mm³. An appropriate nursing intervention would be to

A) monitor the administration of cryoprecipitate.
B) administer vitamin B12.
C) institute bleeding precautions.
D) use the Z-track method for DexFerrum administration.

Question 12

The element that makes up 55% of the blood is

A) plasma.
B) RBCs.
C) WBCs.
D) platelets.

Question 13

Leukocytes are also known as

A) WBCs.
B) platelets.
C) RBCs.
D) hemoglobin.

Question 14

The spleen stores how many milliliters of blood that can be released in emergencies?

A) 500 mL (1 pint)
B) 1500 mL (3 pints)
C) 100 mL (1/5 pint)
D) 2000 mL (4 pints)

Question 15

A patient, an African American, is the mother of a 9-year-old child with sickle cell anemia. She asks the nurse if sickle cell anemia occurs frequently in her race. The correct response is that

A) it is a very rare disease.
B) approximately 1 of 500 African Americans has sickle cell anemia.
C) approximately 1 of 2,500 African Americans has the disease.
D) approximately 1 of 10 African Americans has the disease.

Question 16

A patient has a test ordered to determine why he is having fatigue and soreness of the tongue. A test that will measure the absorption of radioactive vitamin B₁₂ is

A) gastric analysis.
B) Schilling test.
C) peripheral smear.
D) red cell indices.

Question 17

The process by which certain cells engulf and digest microorganisms and cellular debris is called

A) erythrocytosis.
B) hematocrit.
C) phagocytosis.
D) hemostasis.

Question 18

The presence of excess bands in the peripheral blood that indicate severe infection is called

A) shift to the left.
B) shift to the right.
C) bone marrow aspiration.
D) thrombocytosis.

Question 19

Which is a normal blood value for eosinophils?

A) 0%
B) 3%
C) 6%
D) 12%

Question 20

Which nursing intervention does the nurse plan for a patient who has multiple myeloma?

A) Maintaining fluid intake of 3 to 4 L/day to dilute calcium load
B) Limiting activity to prevent pathological fractures
C) Administering narcotic analgesics continuously to control bone pain
D) Assessing for changes in size and characteristics of lymph nodes

Question 21

Many older adults suffer from conditions such as colonic diverticula, hiatal hernia, and ulcerations that can cause occult bleeding. Older adults with these conditions should be observed for

A) leukemia.
B) iron deficiency anemia.
C) sickle cell anemia.
D) polycythemia.

Question 22

The nurse is administering a blood transfusion to an older adult for hypovolemic shock. During the transfusion, which nursing intervention would be the most important?

A) Prevention of infection
B) Balanced nutritional diet with sodium reduction
C) Cardiopulmonary function assessment
D) Monitoring of hemoglobin and hematocrit levels

Question 23

If a patient is diagnosed with anemia, how are the tissues and cells affected?

A) More oxygen is able to be distributed in the cells and tissue.
B) More carbon monoxide is rapidly delivered to the cells and tissue.
C) Insufficient amounts of oxygen are delivered to the cells and tissue.
D) The tissue and cells are not affected.

Question 24

The typical medical treatment of polycythemia vera involves

A) transfusion of packed cells.
B) therapeutic phlebotomy.
C) cryoprecipitate infusion.
D) appendectomy.

Question 25

A patient, age 52, is admitted with thrombocytopenia. The most important nursing intervention to prevent hemorrhage in this patient is to

A) prevent trauma and falling.
B) avoid catheterization.
C) monitor vitals every hour.
D) begin immunocompromised (neutropenic) precautions.

Question 26

A sudden reduction in blood volume may lead to _________ shock.

Question 27

A patient is admitted with fatigue; discomfort; enlarged, painless cervical lymph nodes; and pruritus. A lymph node biopsy yields a diagnosis of Hodgkin's disease. The nurse is aware that the abnormal cells noted by the pathologist in Hodgkin's disease are called

A) Rodem-Lee cells.
B) Bullus-Frendelenburg cells.
C) Stevens-Jorgens cells.
D) Reed-Sternberg cells.

Question 28

The appropriate nursing intervention to relieve the symptom of pruritus in a patient with Hodgkin's disease would be to

A) decrease fluid intake to decrease fluid retention in the interstitial area.
B) soothing bath with prescribed antipruritic medication.
C) give a hot bath to decrease pruritus.
D) apply warm, moist packs to the pruritic area.

Question 29

The organ that forms lymphocytes is the __________.

Question 30

Hematological diseases are often associated with skin impairment. Petechiae and ecchymoses are seen in

A) iron-deficiency anemia.
B) pernicious anemia.
C) hemophilia A.
D) agranulocytosis.

Question 31

Donors who are less likely to be adequate bone marrow transplant would include: (Select all that apply.)

A) uncle.
B) nephew.
C) parent.
D) sibling.

Question 32

Which should the nurse implement as the most important measure in preventing transmission of harmful pathogens to patients with depressed bone marrow function?

A) Strict and frequent handwashing by all people having contact with the patient
B) Placement of patients in private rooms with high-efficiency particulate air (HEPA) filtration
C) Administration of combinations of prophylactic antibiotics
D) Creation of a "sterile" environment for the patient with the use of laminar airflow rooms

Question 33

The nurse is caring for a 34-year-old obstetric patient who has disseminated intravascular coagulation (DIC). The nurse is aware that DIC is

A) an acquired hemorrhagic syndrome of clotting cascade overstimulation and anticlotting processes.
B) a hereditary coagulation disorder in which factor VIII is absent.
C) a deficiency of the number of circulating platelets with thrombocytopenia present.
D) a malignant disorder characterized by painless, progressive enlargement of lymphoid tissue.

Question 34

Patients with pernicious anemia must receive injections of which medication for the rest of their lives?

A) Ferrous sulfate
B) 6-Mercaptopurine
C) Vitamin B₁₂
D) DexFerrum (iron)

Question 35

The spleen is a highly vascularized organ located in the left upper quadrant of the abdominal cavity. The main functions of the spleen are (Select all that apply)

A) Serve as reservoir for blood
B) Destroy worn-out RBCs
C) Promote phagocytosis
D) Responsible for development of T Lymphocytes
E) Continuously produce RBCs during lifetime

Question 36

The average life span of an erythrocyte is

A) a few days to several years.
B) 120 days.
C) 5 to 9 days.
D) several years.

Question 37

The patient, age 44, has polycythemia vera. The nurse recognizes that the primary pathophysiologic feature of this disorder is

A) hyperproduction of erythropoietin.
B) capillary fragility and hemorrhage.
C) fatty infiltration of the bone marrow.
D) increase in red blood cells and hemoglobin and hyperviscosity.

Question 38

MATCHING
Match the medication below with its action.

Replaces iron stores needed for RBC development

A) Folic acid
B) Ferrous sulfate
C) Vitamin B₁₂
D) Neupogen

Question 39

A patient, age 23, is admitted with enlarged lymph nodes, decreased production of RBCs, thrombocytopenia, and a severe increase in his WBC count. A bone-marrow aspiration shows abnormal lymphocytes present. These abnormalities are present in which disease?

A) Thrombocytopenia
B) Hemophilia
C) Acute leukemia
D) Sickle cell anemia

Question 40

_____________ are leukocytes which destroy and remove cellular waste, bacteria, and solid particles.

Question 41

MATCHING
Match the medication below with its action.

Stimulates proliferation and differentiation of neutrophils

A) Folic acid
B) Ferrous sulfate
C) Vitamin B₁₂
D) Neupogen

Question 42

MATCHING
Match the medication below with its action.

Needed for adequate nerve functioning

A) Folic acid
B) Ferrous sulfate
C) Vitamin B₁₂
D) Neupogen

Question 43

MATCHING
Match the medication below with its action.

Needed for erythropoiesis

A) Folic acid
B) Ferrous sulfate
C) Vitamin B₁₂
D) Neupogen