Deck 31: Caring for Clients With Disorders of the Hematopoietic System

Question 1

The nurse caring for an older adult with a diagnosis of leukemia would encourage the client to use an electric razor. Why?

A) Trauma and microabrasions may contribute to anemia.
B) Fragile tissues and altered clotting mechanisms may result in hemorrhage.
C) The client is at risk for spontaneous and uncontrolled bleeding.
D) The client is at risk for infection from microorganisms.

Answer 1

Trauma and microabrasions may contribute to anemia.

Question 2

The Oncology Advanced Practice Nurse (APN) is assessing a client with leukemia. How would the Oncology APN assess for enlargement and tenderness over the liver and spleen?

A) By reviewing laboratory test results
B) By calculating the absolute neutrophil count
C) By looking for evidence of bruising
D) By palpating the abdomen

Answer 2

By palpating the abdomen

Question 3

An 81-year-old male with acute lymphoblastic leukemia is terminal. The family asks you why the prognosis is so poor for this client. What would be your best response?

A) "Your family member is old and just can't fight any more."
B) "This disease has been going on for a long time."
C) "Leukemia is cancer of the blood and cancer is hard to beat."
D) "Your family member doesn't have enough blood cells of all kinds."

Answer 3

"Your family member doesn't have enough blood cells of all kinds."

Question 4

You are caring for a 13-year-old diagnosed with sickle cell anemia. The client asks you what they can do to help prevent sickle cell crisis. What would be an appropriate answer to this client?

A) Avoid any sports that tire you out.
B) Drink at least 8 glasses of water every day.
C) Avoid any activity that makes you short of breath.
D) Stay on oxygen therapy 24/7.

Question 5

You are studying the different forms of leukemia in your pathophysiology class. Which of the following would you be studying? Select all that apply.

A) Chronic myelocytic
B) Acute pernicious
C) Chronic aplastic
D) Acute lymphocytic
E) Acute myelocytic

Question 6

The clinic nurse is caring for a client diagnosed with leucopenia. What does the nurse know this client has?

A) Too many erythrocytes
B) A decrease in granulocytes
C) A general reduction in all white blood cells
D) A general reduction in neutrophils and basophils

Question 7

A client comes to the walk-in clinic complaining of weakness and fatigue. While assessing this client, you find evidence of petechiae and ecchymoses. You note that the spleen appears enlarged. What would you suspect is wrong with this client?

A) Aplastic anemia
B) Pernicious anemia
C) Iron deficiency anemia
D) Agranulocytosis

Question 8

You are assessing vital signs on a hemophiliac who has come to the clinic complaining of an upper respiratory infection. What is the suggested method to check the temperature for a client with hemophilia?

A) Taking the temperature orally
B) Taking the temperature tympanically
C) Taking the temperature rectally
D) Taking the temperature on the forehead

Question 9

A client with a diagnosis of thrombocytopenia has been admitted to your unit for IV corticosteroid treatment. As the nurse caring for this client, you would expect the physician's orders to include which of the following?

A) A sleeping medication
B) Small frequent meals throughout the day
C) A tapering course of solumedrol at discharge
D) An order for oxycodone for steroid induced headaches

Question 10

A client with a diagnosis of pernicious anemia comes to the clinic complaining of numbness and tingling in their arms and legs. What do these symptoms indicate?

A) Loss of vibratory and position senses
B) Neurologic involvement
C) Severity of the disease
D) Insufficient intake of dietary nutrients

Question 11

A client diagnosed with Polycythemia vera has come into the clinic because they have developed a night-time cough, fatigue, and shortness of breath. What complication would you suspect in this client?

A) Stroke
B) Tissue infarction
C) Congestive heart failure
D) Pulmonary embolus

Question 12

You are caring for a client with thalassemia who is being transfused. What your role during a transfusion?

A) To closely monitor the rate of administration
B) To administer vitamin B12injections
C) To instruct the client to rest immediately if chest pain develops
D) To assess for enlargement and tenderness over the liver and spleen

Question 13

Your client was admitted to the Emergency Department after an accident with a chain saw. The client is exhibiting signs and symptoms of acute hypovolemic anemia from severe blood loss. What signs and symptoms would you assess for?

A) Malabsorption disorders
B) Postural hypotension
C) Fatigue
D) Reduced urine output

Question 14

A client at the clinic has just been diagnosed with iron deficiency anemia. What would you recommend the client consume to promote the absorption of iron?

A) Vitamin E
B) Meat, egg yolks, oysters, and shellfish
C) Rich sources of vitamin C
D) Sources of vitamin B12

Question 15

The nurse, caring for a client in the emergency room with a severe nosebleed, becomes concerned when the client asks for a bedpan. The nurse documents the stool as loose, tarry, and black looking. The nurse suspects the client may have thrombocytopenia. What should be the nurse's priority action?

A) Stop the nosebleed
B) Put in an IV line
C) Ask someone to clean the bedpan
D) Notify the physician

Question 16

You are caring for a client with multiple myeloma. Why would it be important to assess this client for fractures?

A) Osteopathic tumors destroy bone causing fractures.
B) Osteoclasts break down bone cells so pathologic fractures occur.
C) Osteolytic activating factor weakens bones producing fractures.
D) Osteosarcomas form producing pathologic fractures.

Question 17

You are caring for a client who has had prolonged treatment for osteoarthritis with Celecoxib. The client complains of fatigue, fever, chills, headache, and a vaginal infection. What would you suspect is wrong with this client?

A) Multiple myeloma
B) Agranulocytosis
C) Leukopenia
D) Leukemia

Question 18

A nurse caring for a client who has hemophilia is getting ready to take the client's vital signs. What should the nurse do before taking a blood pressure?

A) Ask if taking a blood pressure has ever produced bleeding under the skin or in the arm joints.
B) Ask if taking a blood pressure has ever produced pain in the upper arm.
C) Ask if taking a blood pressure has ever caused bruising in the hand and wrist.
D) Ask if taking a blood pressure has ever produced the need for medication.

Question 19

The Pediatric Nurse Practitioner is doing a physical examination of a client with sickle cell anemia. Why would the nurse practitioner auscultate the lungs and heart?

A) To detect the abnormal sounds suggestive of acute chest syndrome and heart failure
B) To detect the evidence of infection such as fever and tachycardia
C) To detect the evidence of dehydration that might have triggered a sickle cell crisis
D) To detect the motor strength and stroke-related signs and symptoms

Question 20

The nursing instructor is talking with their clinical group about coagulopathies. How should the instructor define coagulopathies?

A) Coagulopathies are bleeding disorders that are characterized by abnormalities in the numbers and types of red blood cells in the body.
B) Coagulopathies are bleeding disorders that involve platelets or clotting factors.
C) Coagulopathies are bleeding disorders that are characterized by a deficiency of globulins in the plasma.
D) Coagulopathies are bleeding disorders that involve the destruction of stem cells in the bone marrow.

Question 21

The nursing instructor is discussing disorders of the hematopoietic system with the pre-nursing pathophysiology class. What disease would the instructor list with a primary characteristic of erythrocytosis?

A) Polycythemia Vera
B) Sickle Cell Disease
C) Aplastic anemia
D) Pernicious anemia

Question 22

What is the rationale for the classification of leukemia?

A) Whether it attacks younger or older people
B) Whether it is acute or chronic
C) Which bone marrow it arises from, red, or yellow
D) Which bone marrow stem cell line is dysfunctional

Question 23

You are assisting your client with multiple myeloma to ambulate. What is the most important nursing diagnosis to help prevent fractures in this client?

A) Increased mobility
B) Adequate hydration
C) Safety
D) Adequate nutrition