Deck 46: Care of the Patient with a Blood or Lymphatic Disorder

Question 1

A patient who had a Schilling test shows a 20% excretion of the radioactive vitamin B??. What would this indicate?

A) The patient has a low reserve of iron and has iron deficiency anemia.
B) The patient has a normal finding and does not have pernicious anemia.
C) The patient has a deficiency of thrombocytes and has a clotting disorder.
D) The patient has an excess of RBCs and has polycythemia.

Answer 1

The patient has a normal finding and does not have pernicious anemia.

Question 2

What must a patient undergo before a bone marrow transplant?

A) A thorough nutritional plan to support new marrow
B) Total body irradiation to kill all the marrow cells
C) A physical therapy program to strengthen the body
D) Inhalation therapy to reduce possible pathogens in the lungs

Answer 2

Total body irradiation to kill all the marrow cells

Question 3

In an adult, where are erythrocytes continuously produced?

A) Yellow bone marrow
B) Lymphatic system
C) Spleen
D) Red bone marrow

Answer 3

Red bone marrow

Question 4

The nurse explains that in the event of an invasion of an allergen, the basophils release a strong vasodilator, which is:

A) lysozyme.
B) prothrombin.
C) hematocrit.
D) histamine.

Question 5

A 23-year-old male patient with hemophilia A says, "How can I keep my children from having hemophilia A?" Which of the following is the most informative response?

A) "You need to select a very dependable mode of birth control."
B) "You can only pass hemophilia B to your sons."
C) "Your daughter may be a carrier and her children may have hemophilia A. Your son is not at risk."
D) "Your sons should have coagulation studies."

Question 6

Approximately how much blood is stored in the spleen that can be released in a hypovolemic emergency?

A) 100 mL
B) 300 mL
C) 500 mL
D) 1000 mL

Question 7

The 9-year-old child with leukemia who is on palliative care has drawn a picture of a boy under a huge black cloud that has lightning coming out of it. Which of the following would be an appropriate intervention for the nurse?

A) "What is this picture about?"
B) "Are you afraid of lightning?"
C) "I bet this is a picture of you, isn't it?"
D) "Is it about to rain in your picture?"

Question 8

The mother of a 4-year-old child with leukemia says to the nurse, "I don't understand why he is crying about his legs hurting." The nurse's most informative response would be based on the information that bone pain is related to:

A) Elevated WBCs in differential
B) Long periods of inactivity
C) Splenomegaly
D) Bone marrow congested with white cells

Question 9

When the 14-year-old African American boy comes into the emergency room in sickle cell crisis, what should be the primary focus of care?

A) Instruct patient about transfusion procedure
B) Starting of IV fluids
C) Pain control
D) Relief of dyspnea

Question 10

Which patient statement from a 15-year-old girl with thrombocytopenia would require more assessment to report to the charge nurse?

A) "I think these red spots on my skin are going away."
B) "I am so bored lying in bed I could scream."
C) "My bowel movement is brown and stinks."
D) "I have this really weird Coke-colored urine."

Question 11

The nurse assessing a differential sees an increase in immature neutrophils (bands) and is aware that this indicates:

A) a significant hemorrhage.
B) aplastic anemia.
C) an overwhelming bacterial infection.
D) beginning recovery from an infection.

Question 12

What does the elevation in the eosinophil count to 10% indicate?

A) Anemia
B) Allergy
C) Infection
D) Hypoxia

Question 13

B cells and T cells fit under which classification?

A) Erythrocytes
B) Basophils
C) Lymphocytes
D) Monocytes

Question 14

When instructing the patient taking an oral liquid iron preparation, what should the nurse include?

A) Information relative to taking the iron with milk
B) Information relative to the bowel movement color changing to dark red
C) Information relative to taking preparation through a straw to prevent staining of teeth
D) Information relative to taking a drug with meals or a snack

Question 15

The home health nurse recommends to the mother of a 12-year-old child with leukemia that the child should have:

A) the series for prevention of hepatitis B.
B) an annual influenza vaccine.
C) an annual pneumococcal vaccine.
D) vitamin B12 shots.

Question 16

The nurse caring for a patient with pernicious anemia should make provisions for:

A) frequent iced drinks.
B) lightweight blanket.
C) a fan to circulate the air.
D) reverse isolation.

Question 17

What would a nurse include in a teaching plan for a home health patient with a hemoglobin of 8.4 mg?

A) Exercising for periods of 30 minutes daily
B) Limiting fluid intake
C) Alternating activity with rest periods
D) Avoiding the use of oxygen

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

The nurse explains that because it is a reliable and predictable indicator of the body's level of infection or recovery the _____________________ is a common diagnostic tool.

A) Hemoglobin
B) Hematocrit
C) Mean cell volume (MCV)
D) Differential

Question 20

What is the process by which certain cells engulf and digest microorganisms and cellular debris?

A) Erythrocytosis
B) Hematocrit
C) Phagocytosis
D) Hemostasis

Question 21

The nurse caring for a patient in the emergency room with suspected internal injuries will assess for hypovolemic shock, which is evidenced by (select all that apply):

A) irritability.
B) restlessness.
C) slow bounding pulse.
D) decreased respirations.
E) pallor.
F) hypotension.

Question 22

The nurse is aware that persons of the Jehovah's Witness faith accept which types of blood transfusions?

A) No type of blood transfusion
B) Blood that has been blessed by their religious leader
C) Transfusions only for persons who have not yet been baptized
D) Autologous blood transfusions

Question 23

The typical medical treatment of polycythemia vera involves repeated phlebotomies and medications such as busulfan (Myleran) in order to:

A) stimulate bone marrow.
B) inhibit bone marrow activity.
C) increase hemoglobin.
D) reduce gout.

Question 24

The nurse explains that a positron emission tomography (PET) has been ordered to:

A) assess bone marrow depression.
B) measure bone density.
C) radiate and destroy diseased lymph nodes.
D) measure lymph node response to therapy.

Question 25

The nurse caring for a child with hemophilia who is hospitalized with hemarthrosis should include which of the following in the plan of care?

A) Splint the affected leg to maintain anatomic alignment
B) Apply warm compresses to reduce hemorrhage in the joint
C) Use analgesia sparingly
D) Encourage vigorous ROM exercises several times a day to keep knee flexible

Question 26

Because older adults suffer from conditions such as colonic diverticula, hiatal hernia, and ulcerations that can cause occult bleeding, the nurse should assess for symptoms of:

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

Question 27

The spleen is a highly vascularized organ located in the left upper quadrant of the abdominal cavity. What are the main functions of the spleen? (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 28

The peripheral smear is a diagnostic test that:

A) assesses the level of hemoglobin.
B) measures antibody production.
C) examines the shape and structure of RBCs.
D) identifies infection.

Question 29

What are the most likely matches for a bone marrow transplant to a 10-year-old with leukemia? (Select all that apply.)

A) Uncle
B) Self
C) Mother
D) Brother
E) Sister
F) Father

Question 30

What is the average life span of an erythrocyte?

A) 7 days
B) 60 days
C) 120 days
D) Up to several years

Question 31

Which mandatory practice is the most effective and significant nursing practice to prevent the spread of infection?

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 32

Which of the following are necessary factors that support healthy erythropoiesis? (Select all that apply.)

A) Dietary magnesium
B) Healthy bone marrow
C) Adequate oxygen source
D) Vitamin B12
E) Amino acids
F) Vitamin B2

Question 33

The nurse examines the complete blood count (CBC) to assess (select all that apply):

A) hematocrit.
B) red cell count.
C) differential white cell count.
D) plasma level.
E) blood type.
F) hemoglobin.

Question 34

The nurse is aware that a person with Hodgkin disease, who has two or more abnormal lymph nodes on the same side of the diaphragm and involvement of extranodal involvement on the same side of the diaphragm, would be in:

A) stage I
B) stage II
C) stage III
D) stage IV

Question 35

Which of the following are "B" symptoms of a patient with Hodgkin disease? (Select all that apply.)

A) Hematuria
B) Night sweats
C) Severe diarrhea
D) Weight gain from edema
E) Fever
F) Persistent dry cough

Question 36

Which of the following foods would the nurse recommend to a person with iron deficiency anemia as an excellent meat source for erythropoiesis?

A) Dark meat of chicken
B) Cured ham
C) Pork chops
D) Processed meat

Question 37

From which location would the bone marrow sample come in the aspiration of a 25-year-old patient?

A) Sternum
B) Posterior superior iliac crest
C) Posterior iliac crest
D) Femur

Question 38

In caring for a patient with multiple myeloma, what should the nurse include in the daily care?

A) Provisions for limiting fluid intake to less than 1000 mL/day
B) Provisions for close supervision and assistance when ambulating
C) Provisions for straining all urine
D) Provisions for limiting use of an analgesic

Question 39

Which of the following would the nurse explain as the most common type of leukemia that affects children?

A) Chronic lymphocytic leukemia (CLL)
B) Acute myeloid leukemia (AML)
C) Acute lymphocytic leukemia (ALL)
D) Chronic myeloid leukemia (CML)

Question 40

The nurse explains that the treatment of hemophilia A has been revolutionized with the advent of the use of:

A) corticosteroids.
B) large doses of testosterone.
C) recombinant factor VIII.
D) transfusion with packed red cells.

Question 41

Outline the sequence of the process that stimulates the increase in the production of red blood cells. (Separate letters by a comma and space as follows: A, B, C, D)

A) Kidneys release erythropoietic factor
B) Increase in red blood cell production
C) Enzyme stimulates red bone marrow
D) Oxygen delivery increased to the tissues
E) Oxygen delivery decreased to the tissues
F) Decrease in red blood cell production

Question 42

The person with aplastic anemia is said to be _________________ because all three major blood elements (RBCs, WBCs, and platelets) are diminished or absent.

Question 43

The nurse clarifies that ____________ _______________ replaces iron stores needed for red blood cell production.

Question 44

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

Question 45

The Reed-Sternberg cell is the hallmark diagnostic indicator for _______________ __________.

Question 46

Arrange the process of hemostasis in sequence. (Separate letters by a comma and space as follows: A, B, C, D)

A) Release of clotting factor from injured tissue
B) Formation of thrombin
C) Formation of fibrin
D) Trapping of RBC and platelets
E) Clot
F) Release of thromboplastin

Question 47

Neutrophils release ______________, an enzyme that destroys certain bacteria.