Deck 29: Alterations in Red Blood Cell Function and Hemostasis

Question 1

A critically ill patient is diagnosed with disseminated intravascular coagulation (DIC).Which history would the nurse evaluate as indicating increased risk for this development?

A)The patient had a transfusion reaction yesterday.
B)The patient was intubated and placed on mechanical ventilation 2 days ago.
C)The patient has a long history of hypertension.
D)The patient passed a kidney stone this morning.

Answer 1

The patient had a transfusion reaction yesterday.

Question 2

A female patient diagnosed with acute renal failure has a hemoglobin level of 12 mg/dL.The nurse plans care for a patient with which level of anemia?

A)Normal
B)Mild
C)Severe
D)Life threatening

Answer 2

Normal

Question 3

The nurse is providing care for a young woman diagnosed with idiopathic thrombocytopenia.Which information should the nurse provide?

A)Take a low-dose aspirin daily.
B)Use pads during menstrual cycle instead of tampons.
C)Brush and floss teeth carefully.
D)Use glycerin suppositories to prevent constipation.

Answer 3

Use pads during menstrual cycle instead of tampons.

Question 4

A patient has been admitted with a tentative diagnosis of thrombocytopenia.Which patient statement would the nurse evaluate as significant to that disorder?

A)"I started taking cimetidine for heartburn about a month ago."
B)"My family and I just got back from a vacation in the mountains."
C)"I spend a lot of time working at my computer."
D)"I have been taking a new calcium supplement."

Question 5

A patient with thrombocytopenia has developed a nosebleed.She is confused and keeps trying to get out of bed.Which problem is this patient demonstrating?

A)Intolerance of physical activity
B)Increased pain
C)Inability to cope with hospitalization
D)Alteration in circulation to the brain

Question 6

A patient being treated for thrombocytopenia is not responding to therapy.The nurse would begin to prepare the patient for which medical intervention?

A)Intravenous fluids
B)Bone marrow transplant
C)Splenectomy
D)Blood transfusion

Question 7

The nurse is making a follow-up call to a patient recently released from the acute care unit following treatment for thrombocytopenia.Which patient statements would the nurse consider reason to suggest contacting the primary health provider? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)"You didn't tell me that I would have such bad,smelly diarrhea once I got home."
B)"I feel fine but my skin is a little off color."
C)"My appetite is coming back slowly."
D)"I was able to take a walk with my dog yesterday."
E)"I keep getting headaches in the late afternoon if I am tired."

Question 8

A patient with rheumatoid arthritis has a hemoglobin level of 10 g/dL.The nurse would consider this anemia to be related to inflammation if which other findings are present? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)The patient has low vitamin B12 levels.
B)Laboratory testing shows elevated hepcidin level.
C)Increased destruction of erythrocytes is occurring.
D)Serum iron levels are low.
E)The patient's stools are guaiac positive.

Question 9

The nurse is caring for a patient with acute disseminated intravascular coagulation (DIC)who is bleeding from the gastrointestinal tract with a platelet count of 45,000.The nurse would anticipate which intervention for this patient?

A)Heparin
B)Intravenous platelets
C)Warfarin
D)Aspirin

Question 10

A patient has been brought to the emergency department after a traumatic amputation of his leg.His skin is pale and very cool,heart rate is 120,respirations are 28,and systolic blood pressure is dropping.From these findings the nurse would estimate that this patient has lost which percent of blood?

A)Less than 15%
B)15%-30%
C)30%-40%
D)Over 40%

Question 11

A patient with a 40-pack per year smoking history has increased hemoglobin and hematocrit.The nurse expects that which test will be done to assess for erythrocytosis?

A)Serum electrolytes
B)Sedimentation rate
C)Platelet count
D)Carboxyhemoglobin level

Question 12

A patient with sickle cell disease tells the nurse that she knows when the disease is going to flare because she has pain in her arms and legs.Which explanation would the nurse provide?

A)"The shape of your blood cells blocks the small capillaries in your arms and legs."
B)"The pain is really due to your history of malaria along with having sickle cell anemia."
C)"Your spleen is destroying all the malformed red blood cells,which makes you anemic and causes arm and leg pain."
D)"The chronic blood loss associated with sickle cell anemia causes pain in the arms and legs."

Question 13

A patient receiving chemotherapy for cancer is diagnosed with anemia secondary to bone marrow depression.The nurse would expect which intervention?

A)Recombinant erythropoietin therapy
B)Iron supplements
C)Fresh frozen plasma
D)Hematopoietic stem-cell transplantation

Question 14

A patient arrives at the emergency department following a gunshot wound to the abdomen.He is unresponsive and has cool,clammy skin.Paramedics were unable to initiate a peripheral IV and the patient's abdominal wound is bleeding briskly.The nurse bases emergency interventions on which priority patient problems? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Decrease in cardiac output
B)Deficit in fluid volume
C)Increased risk for development of shock
D)Breathing problem disturbance
E)Decreased cerebral blood flow

Question 15

A patient has developed disseminated intravascular coagulation (DIC).Which assessment would the nurse evaluate as reflecting the microthrombosis results of this disorder?

A)Oozing from older intravenous access sites
B)Jaundice
C)Petechiae
D)Ecchymoses

Question 16

A 25-year-old patient with sickle cell disease says,"My sister is having a baby.I can't wait until I have kids of my own." Which nursing response is indicated?

A)"You should use barrier protection until you are ready to have a child."
B)"Have you thought about adopting children?"
C)"Genetic counseling will be important for you and your partner."
D)"I hope that infertility does not cause problems for you."

Question 17

A patient is admitted with the tentative diagnosis of polycythemia vera.Which assessment findings would the nurse evaluate as supporting that diagnosis? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Plethora
B)Fingers that are dark and cool to the touch
C)Report of night sweats
D)Complaint of shortness of breath
E)Hypotension

Question 18

The nurse is providing care for a patient diagnosed with secondary polycythemia.Which finding is most significant for the nurse to discuss with the primary healthcare provider immediately?

A)The patient becomes short of breath on exertion.
B)The patient has had no appetite for the last two days.
C)The patient is confused.
D)The patient's fingers are red and warm to the touch.

Question 19

A critically ill patient who is being mechanically ventilated was started on an antibiotic,a steroid,and intravenous heparin one week ago.This morning the nurse notes the patient has red rashlike eruptions across his abdomen and chest.What nursing action is indicated?

A)Notify the primary care provider immediately.
B)Monitor the rash to see if it spreads.
C)Apply a non-petroleum-based lotion over the affected area.
D)Hold the antibiotic.

Question 20

The nurse is planning to instruct a patient with sickle cell disease on ways to avoid a painful crisis.What should the nurse include in this instruction? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Do not drink alcohol.
B)Eat a diet low in protein.
C)Avoid tiring exercise.
D)Avoid carbohydrates.
E)Do not smoke.