Deck 32: Nursing Care of People With Hematologic Disorders

Question 1

A teenager who is in the hospital for Hodgkin's disease treatment is visited by friends who bring a pizza and coke to the person's room. Which of the following can the nurse do to ensure the person's comfort?

A)Provide the person with an antinauseant and suggest something else for the person to eat with the visitors.
B)Ask the visitors to leave.
C)Encourage the person to eat as much pizza as possible.
D)Ask the visitors to eat the pizza in the lounge.

Answer 1

Provide the person with an antinauseant and suggest something else for the person to eat with the visitors.

Question 2

The nurse is preparing an analgesic for a person with leukaemia. Which of the following routes is preferred for this person?

A)Oral
B)Intravenous
C)Rectal
D)Intramuscular

Answer 2

Oral

Question 3

Which of the following may be the cause of oedema of the hands and feet in a patient in sickle cell crisis?

A)Poor venous return
B)Hypotonicity
C)Small vessel infarction
D)Peripheral vascular disease

Answer 3

Small vessel infarction

Question 4

A 17-year-old person with oedematous lymph nodes and headaches is diagnosed with leukaemia. What condition does the person most likely have?

A)Chronic myeloblastic leukaemia (CML)
B)Acute myelogenous leukaemia (AML)
C)Acute lymphoblastic leukaemia (ALL)
D)Chronic lymphocytic leukaemia (CLL)

Question 5

A person undergoing treatment for leukaemia is scheduled for a bone marrow transplant. The nurse determines that this person is in which phase of treatment for the disorder?

A)Induction
B)Maintenance
C)Post-remission
D)Rehabilitative

Question 6

The nurse is providing dietary instructions to a vegetarian person with iron deficiency anemia. Which of the following should be included in these instructions?

A)Ensure an adequate intake of ascorbic acid when consuming non-animal-based proteins.
B)Consider adding animal sources of iron and protein to the diet.
C)Consume dairy products with all meals.
D)Avoid exercise at least 30 minutes after completing a meal or snack.

Question 7

A person is diagnosed with stage IV Hodgkin's lymphoma. The nurse interprets this information to mean that the extent of this disorder is limited to which parts of the body?

A)An extranodal site involvement with systemic symptoms
B)Upper abdominal lymph nodes without systemic symptoms
C)Two or more lymph nodes on the same side without systemic symptoms
D)Lower abdominal nodes with systemic symptoms

Question 8

A person with aplastic anemia is demonstrating signs of increased blood cell production. Which of the following should be done to support this person?

A)Encourage exercise to further stimulate blood cell production.
B)Continue with blood transfusions as prescribed.
C)Plan to administer fresh frozen plasma.
D)Plan to discontinue blood transfusions.

Question 9

What type of anemia may be present in a patient with chronic gastritis that presents with a 'tingling' feeling in their hands?

A)Thalassaemia
B)Folic acid deficiency
C)Pernicious anemia
D)Iron deficiency

Question 10

A person is prescribed an oral iron preparation. Which of the following would be appropriate for the nurse to instruct this person about this medication? Select all that apply.

A)Diarrhoea is expected with this medication.
B)Take with orange juice.
C)Take with vitamin D supplements.
D)Take at least 2 hours before a tetracycline antibiotic.

Question 11

A person who is being treated for malignant lymphoma is experiencing itchy skin. Which of the following interventions would be appropriate for this person? Select all that apply.

A)Cleanse bedding and clothing in mild detergent with a second rinse cycle.
B)Vigorously rub the skin after bathing.
C)Bathe with cool water.
D)Keep the room temperature above normal.

Question 12

A person with idiopathic thrombocytopenia purpura continues to experience symptoms of the disease after completing several courses of corticosteroid therapy. The nurse anticipates that which of the following will most likely be indicated for this person?

A)Oral anticoagulant therapy
B)Splenectomy
C)Weekly platelet transfusions
D)Lifelong steroid therapy

Question 13

A person is being treated for acquired haemolytic anemia. Which of the following assessment findings would suggest that the condition is severe?

A)Bradycardia
B)Misshaped limbs due to pathological fractures
C)Splenomegaly
D)Liver tenderness

Question 14

A person with disseminated intravascular coagulation is not responding to infusions of fresh frozen plasma and platelets. Which of the following interventions might be indicated for this person?

A)Begin heparin infusion.
B)Begin normal saline infusion.
C)Commence warfarin therapy.
D)Prepare for a bone marrow biopsy.

Question 15

Which of the following should be included in the nursing instructions for a patient prone to sickle cell crises?

A)Seek out air conditioning or other ways to keep cool during hot, humid days.
B)Maintain a regular exercise program.
C)Take appropriate actions to keep warm.
D)Ensure an adequate fluid intake.

Question 16

A person who is undergoing chemotherapy for lymphoma says, 'I thought I was ugly before this all started. Now I know for sure I'm disgusting to look at.' Which of the following is this person most at risk of developing related to their comments?

A)Inability to cope with the diagnosis and treatment
B)Dysfunctional grieving
C)Reduced sexual response
D)Changed body image perception

Question 17

The nurse is planning to instruct a person with secondary polycythaemia about ways to prevent blood stasis. Which of the following should be included in these instructions?

A)Restrict daily fluid intake.
B)Black stools are to be expected.
C)Elevate lower limbs when sitting.
D)Leg pain is to be expected.

Question 18

A person with haemophilia is admitted with acute bleeding. Until the cause of the bleeding is determined, the nurse should be prepared to do which of the following interventions?

A)Infuse heparin.
B)Infuse whole blood.
C)Infuse fresh frozen plasma.
D)Infuse Hartman's solution.

Question 19

A person diagnosed with leukaemia says, 'If I have too many white blood cells and white blood cells fight infections, why do I have to be careful not to be exposed to germs?' What is an appropriate response for the nurse to make? 10)______

A)'Your bone marrow can easily become infected.'
B)'The white blood cells with leukaemia aren't very effective in fighting infections.'
C)'That's not what leukaemia is.'
D)'Leukaemia means you have the wrong types of white blood cells.'

Question 20

Upon analysis, a person's red blood cells (RBCs)appear microcytic and hypochromic. The nurse interprets this information to mean that this person is demonstrating signs of which type of anemia?

A)Chronic blood loss
B)Iron deficiency
C)Folic acid deficiency
D)Aplastic anemia

Question 21

In which of the following factors is haemophilia A characterized by a deficiency ?

A)Factor IX
B)Factor vW
C)Factor VIII
D)Factor X

Question 22

Where would you expect to see leukaemic cells accumulate?

A)White blood cells
B)Plasma
C)Lymph
D)Bone marrow

Question 23

Which of the following is the most common symptom of early Hodgkin's disease?

A)Night sweats
B)Enlarged lymph nodes
C)Malaise
D)Persistent fever

Question 24

Which of the following are considered risk factors for MDS? Select all that apply.

A)Radiation therapy
B)Cigarette smoke
C)Lead paint
D)Ultraviolet rays

Question 25

Which of the following causes relative polycythaemia?

A)Increased RBC production
B)Erythropoietin levels are elevated
C)Fluid deficit
D)Decreased RBC production

Question 26

Which of the following symptoms marks the terminal stage of multiple myeloma?

A)Lethargy
B)Bone pain
C)Hypercalcaemia
D)Pancytopenia

Question 27

Which of the following would be considered the most common drug-induced thrombocytopenia?

A)Antibiotic therapy
B)Chemotherapy
C)Heparin therapy
D)Hormone replacement therapy

Question 28

To which if the following are neutrophils considered closely connected?

A)Platelet count
B)Immune response
C)Total white blood cell count
D)Peripheral blood