Question 1

A patient suffered severe trunk and lower extremity injury in a motor vehicle accident.Which injuries would indicate to the nurse that this patient may have dysfunction of normal hemostasis? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
A)Contusion of the spleen
B)Laceration of the liver
C)Femur fractures
D)Bruising of the heart
E)Pneumothorax

Accepted Answer

A,B,C

Question 2

A wound on a patient's leg has stopped bleeding.The nurse would attribute this to which physiologic occurrence?
A)Tumor necrosis factor has sealed the wound.
B)Neutrophils have invaded the wound.
C)Macrophages have been released into the general circulation.
D)Platelets retracted the clot,reducing leakage.

Accepted Answer

Platelets are responsible for forming clots and stopping bleeding. When a wound occurs, platelets immediately adhere to the injured site and release chemicals that attract more platelets and initiate the clotting cascade. Once the clot is formed, the platelets retract it, reducing leakage and preventing further bleeding. Tumor necrosis factor, neutrophils, and macrophages are all involved in the inflammatory response to injury and infection, but they do not directly contribute to stopping bleeding.

Question 3

A patient is admitted with iron deficiency anemia.The nurse assesses this patient for the presence of which most likely finding?
A)Hypoxia
B)Reduced urine output
C)Bleeding
D)Dehydration

Accepted Answer

Iron deficiency anemia can lead to hypoxia because there is a reduced capacity of the blood to carry oxygen due to a lack of hemoglobin.

Question 4

A patient is prescribed vitamin B12 injections.What information should the nurse provide when starting this medication?
A)"Vitamin B12 will strengthen the red blood cells' membranes and prevent them from being damaged so easily."
B)"Vitamin B12 is needed for normal manufacture of red blood cells."
C)"Vitamin B12 will increase the ability of your blood to carry oxygen."
D)"Vitamin B12 helps build the components of white blood cells."

Accepted Answer

Vitamin B12 is needed for the normal manufacture of red blood cells.

Question 5

A patient is admitted with left lower thoracic rib injuries.The nurse realizes this injury could result in which problem for this patient?
A)Decrease in platelet maturation
B)Decreased availability of B cells
C)Reduction in T cell formation
D)Reduction in filtering of foreign matter in the blood

Accepted Answer

The answer of A patient is admitted with left lower...

Question 6

The mother of a young child tells the nurse that when she was breastfeeding her baby,he never had any colds or infections but now that he is weaned,he seems to be sick all of the time.What should the nurse explain to the mother?
A)"The breast milk provided passive immunity to the baby that he no longer is receiving."
B)"The child should be immunized to prevent these common illnesses."
C)"Some children are just prone to getting more infections than others."
D)"Most babies won't get sick until they are past the age of 12 months."

Accepted Answer

Breast milk contains antibodies that provide passive immunity to the baby. When the baby is weaned, he is no longer receiving these antibodies, which may make him more susceptible to infections.

Question 7

A patient is being treated for anemia after a postpartum hemorrhage.The nurse would expect that this patient's erythrocytes would have which appearance? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
A)Microcytic
B)Normochromic
C)Macrocytic
D)Hypochromic
E)Normocytic

Accepted Answer

Postpartum hemorrhage leads to blood loss anemia, which typically results in normocytic, normochromic erythrocytes. This means the red blood cells maintain a normal size (normocytic) and normal hemoglobin concentration (normochromic), reflecting the body's response to acute blood loss rather than a deficiency in iron, vitamin B12, or folate.

Question 8

A patient is being evaluated for a kidney transplant.Which individual is most likely the best candidate to donate this organ?
A)A live donor from a donor bank
B)Live kidney transplant from the patient's spouse
C)Cadaver kidney transplant
D)Live kidney transplant from a brother

Accepted Answer

Live kidney transplants generally have better outcomes than those from deceased donors, and a sibling, due to genetic similarities, is often the best match for organ compatibility, reducing the risk of rejection.

Question 9

The patient has developed a "shift to the left." The nurse would expect which value on the complete blood count?
A)Increased bands
B)Increased eosinophils
C)Decreased lymphocytes
D)Increased monocytes

Accepted Answer

A "shift to the left" means there is an increase in immature white blood cells, or bands. Therefore, the nurse would expect an increased number of bands on the complete blood count.

Question 10

A man with assessment findings associated with prostate cancer is having the tumor-associated antigen PSA drawn.The nurse anticipates this level will be used for which purposes? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
A)To confirm the diagnosis of prostate cancer
B)To rule out the presence of prostate cancer
C)To screen for the probability of prostate cancer
D)To assess efficacy of treatment
E)To determine presence of metastasis

Accepted Answer

PSA levels are used to screen for the probability of prostate cancer and to assess the efficacy of treatment, but not to confirm diagnosis, rule out cancer, or determine metastasis.

Question 11

A patient tells the nurse that he thought he had a varicella vaccine as a child.His daughter has just developed varicella.What information should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
A)"Since you were vaccinated,you won't contract varicella from your daughter."
B)"Your innate immunity will protect you from contracting this disease."
C)"It is dangerous to give a second injection of vaccines."
D)"You may need an injection to boost your immunity."
E)"We can check your blood titer to check your immunity."

Accepted Answer

Option A is incorrect because breakthrough cases can still occur even in vaccinated individuals, although they are typically milder. Option B is incorrect because while innate immunity may offer some protection, acquired immunity through vaccines or natural infection is still the best protection against varicella. Option C is incorrect because it is generally safe to receive a second dose of vaccines, and in fact, the varicella vaccine is routinely given in a two-dose series. Therefore, the correct choices are D and E, as the patient may benefit from a vaccine booster to increase their immunity and a blood titer can be checked to determine if additional vaccination is necessary.

Question 12

A patient's admission laboratory work reveals a platelet count of 90,000/mcL.Which interventions should the nurse implement? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
A)Implement bleeding precautions.
B)Monitor urine output.
C)Limit the ingestion of green leafy vegetables.
D)Restrict fluids.
E)Review the patient's medication history.

Accepted Answer

A platelet count of 90,000/mcL is lower than normal (150,000-450,000/mcL), indicating a risk for bleeding. Therefore, implementing bleeding precautions (A) is essential to prevent further complications. Reviewing the patient's medication history (E) is important since some medications can cause thrombocytopenia (low platelet count) as a side effect. Monitoring urine output (B) and restricting fluids (D) are not necessary interventions for a low platelet count. Limiting the ingestion of green leafy vegetables (C) is not necessary unless the patient is taking warfarin, which interacts with vitamin K found in green leafy vegetables.

Question 13

A patient is scheduled to have his tonsils removed.The nurse realizes that this procedure could result in deficiency of which immunoglobulin?
A)Immunoglobulin D
B)Immunoglobulin A
C)Immunoglobulin E
D)Immunoglobulin G

Accepted Answer

Tonsils are a part of the body's immune system and are responsible for producing immunoglobulin A (IgA). IgA is the primary immunoglobulin found in the mucosal lining of the respiratory and digestive tracts, and is important in protecting against bacterial and viral infections. Removal of the tonsils could result in a deficiency of IgA production, which may increase the risk of upper respiratory and gastrointestinal infections.

Question 14

A patient is diagnosed with a low red blood cell count.The nurse should assess this patient for which finding?
A)History of fractures
B)Carbohydrate intake
C)Location of joint replacements
D)Renal functioning

Accepted Answer

Renal functioning is important to assess in a patient with a low red blood cell count because the kidneys produce erythropoietin, a hormone that stimulates the bone marrow to produce red blood cells. Impaired renal function can lead to decreased erythropoietin production and, consequently, anemia.

Question 15

A patient is admitted with a leg wound with a large amount of pus exudate.The nurse assesses that which part of the immune process is functioning?
A)The complement system causing cellular destruction
B)The natural killer lymphocytes circulating through the lymph
C)The neutrophils arriving at the wound as the first line of defense
D)The macrophages circulating in the blood

Accepted Answer

The presence of a large amount of pus exudate suggests that the wound is in the inflammatory phase of healing. Neutrophils are the first cells to arrive at the site of infection or inflammation and are responsible for phagocytosis of bacteria and debris. The complement system and natural killer cells are not typically involved in the inflammatory phase of healing. Macrophages are present later in the healing process to phagocytose remaining debris and to release cytokines to stimulate angiogenesis and fibroblast proliferation.

Question 16

A patient is concerned that the disease that has affected his horses will cause him to become ill.What information should the nurse provide?
A)"You will probably contract the same illness but in a milder form."
B)"Many illnesses are species specific.It is not likely that you will contract the same illness as your horses."
C)"All illnesses can be transmitted between animals and humans,so I am glad you came in to be checked."
D)"There are vaccinations against diseases caused by horses.I would talk with the veterinarian."

Accepted Answer

While some illnesses can be transmitted between animals and humans, many are species specific and it is not likely that the patient will contract the same illness as his horses. It is important to provide accurate and reassuring information to the patient in order to alleviate any concerns they may have.

Question 17

A patient diagnosed with leukemia has minimal white blood cells.The nurse realizes which intervention may be indicated for this patient?
A)Infusion of fresh frozen plasma
B)Infusion of red blood cells
C)Bone marrow transplant
D)Immunizations

Accepted Answer

A bone marrow transplant may be indicated for a patient diagnosed with leukemia who has minimal white blood cells as this procedure can replace the patient's diseased bone marrow with healthy bone marrow, which can produce new white blood cells. Infusion of fresh frozen plasma and red blood cells would not address the patient's low white blood cell count. Immunizations would not be appropriate until the patient's white blood cell count has recovered to a safe level.

Question 18

The nurse caring for a patient with an infected leg wound realizes that neutrophils and macrophages will arrive to the wound as a part of the natural body response.How would the nurse explain this process to the patient?
A)"Your white blood cells will travel through your lymph system to the wound."
B)"Chemical signals from the injured tissue help guide the white blood cells to where they are needed."
C)"Only the white blood cells already in your system will be able to fight this infection."
D)"The white blood cells attach to red blood cells for transport to the wound."

Accepted Answer

Chemical signals released by the damaged tissue will attract neutrophils and macrophages to the wound site to help fight off infection.

Question 19

A patient being admitted for knee surgery says,"Everyone in my office is sick all of the time,but I never get sick." How would the nurse evaluate this statement?
A)The patient may have a strong antigen-antibody response.
B)This patient's poorly differentiated histocompatibility antigens may be a problem during postoperative recovery.
C)The patient's coworkers must have immune system compromise.
D)The patient must have strong passive immunity.

Accepted Answer

The patient's statement suggests that they may have a strong immune system, indicated by their ability to avoid getting sick despite exposure to sick coworkers. This may be due to a strong antigen-antibody response, which is a key component of the body's immune system.

Question 20

A patient was admitted through the emergency department with fractures of the skull,ribs,and both femurs sustained from a motor vehicle accident.The nurse provides care based on changes in which pathophysiological process?
A)Formation of red blood cells
B)Cellular and humoral immune responses
C)Formation of plasma
D)Antigen-antibody formation

Accepted Answer

The patient has multiple fractures, which can lead to significant blood loss and a need for increased red blood cell production to compensate for the loss. Therefore, the nurse should focus on changes in the formation of red blood cells.

Quiz 28: Determinants and Assessment of Hematologic Function

A wound on a patient's leg has stopped bleeding.The nurse would attribute this to which physiologic occurrence?

A patient is admitted with iron deficiency anemia.The nurse assesses this patient for the presence of which most likely finding?

A patient is prescribed vitamin B12 injections.What information should the nurse provide when starting this medication?

A patient is admitted with left lower thoracic rib injuries.The nurse realizes this injury could result in which problem for this patient?

The mother of a young child tells the nurse that when she was breastfeeding her baby,he never had any colds or infections but now that he is weaned,he seems to be sick all of the time.What should the nurse explain to the mother?

A patient is being treated for anemia after a postpartum hemorrhage.The nurse would expect that this patient's erythrocytes would have which appearance? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A patient is being evaluated for a kidney transplant.Which individual is most likely the best candidate to donate this organ?

The patient has developed a "shift to the left." The nurse would expect which value on the complete blood count?

A man with assessment findings associated with prostate cancer is having the tumor-associated antigen PSA drawn.The nurse anticipates this level will be used for which purposes? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A patient tells the nurse that he thought he had a varicella vaccine as a child.His daughter has just developed varicella.What information should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A patient's admission laboratory work reveals a platelet count of 90,000/mcL.Which interventions should the nurse implement? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A patient is scheduled to have his tonsils removed.The nurse realizes that this procedure could result in deficiency of which immunoglobulin?

A patient is diagnosed with a low red blood cell count.The nurse should assess this patient for which finding?

A patient is admitted with a leg wound with a large amount of pus exudate.The nurse assesses that which part of the immune process is functioning?

A patient is concerned that the disease that has affected his horses will cause him to become ill.What information should the nurse provide?

A patient diagnosed with leukemia has minimal white blood cells.The nurse realizes which intervention may be indicated for this patient?

The nurse caring for a patient with an infected leg wound realizes that neutrophils and macrophages will arrive to the wound as a part of the natural body response.How would the nurse explain this process to the patient?

A patient being admitted for knee surgery says,"Everyone in my office is sick all of the time,but I never get sick." How would the nurse evaluate this statement?

A patient was admitted through the emergency department with fractures of the skull,ribs,and both femurs sustained from a motor vehicle accident.The nurse provides care based on changes in which pathophysiological process?