Question 1

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

Accepted Answer

Persons with pernicious anemia are especially sensitive to cold.The provision of a light blanket is beneficial.

Question 2

B cells and T cells fit under which classification?

Accepted Answer

B cells and T cells,the major players in the antigen/antibody conflict,are both lymphocytes.

Question 3

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?

Accepted Answer

Hemophilia A is an X-linked trait.Females are carriers;therefore,the patient's daughter could pass the disease to her sons.The patient's sons are not at risk for hemophilia A.

Question 4

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

Accepted Answer

The spleen stores 1 pint of blood,approximately 500 mL,which can be released during emergencies.

Question 5

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

Accepted Answer

An increase in immature neutrophils (bands)is called bandemia,and it indicates an overwhelming bacterial infection.

Question 6

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.

Accepted Answer

A differential white blood cell count is an examination in which the different kinds of WBCs are counted and reported as percentages of the total examined.It is a common diagnostic tool because of its reliability and the predictability of the body's response to infection or its progress in recovery.

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?

Accepted Answer

Asking what the child has drawn is a neutral and nonthreatening question.Drawings can give a clue to perceptions and emotions that a young child may not be able to verbalize.The nurse should not try to interpret the drawing.

Question 8

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

Accepted Answer

Coke-colored urine is hematuria that should be documented and reported to the charge nurse.The purpura will fade as they are absorbed.Boredom and smelly stools are normal for a 14-year-old.

Question 9

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

Accepted Answer

Severely anemic persons need to conserve their energy.Observing a rest period after a period of activity will reduce hypoxia.Oxygen may be used as necessary.

Question 10

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

Accepted Answer

The Schilling test is a laboratory blood test for diagnosing pernicious anemia.The normal reading 24 hours after the administration of radioactive vitamin B?? is 8% to 40%.The test measures the absorption of radioactive vitamin B??.

Question 11

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

Accepted Answer

Histamine is released by the basophils during the invasion of an allergen.

Question 12

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

Accepted Answer

Liquid iron preparations should be drunk through a straw to prevent tooth staining.All oral iron preparations should be taken before meals.Dairy products interfere with the absorption of iron.

Question 13

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:

Accepted Answer

Long bone pain is the result of bone marrow that is congested with immature white cells.

Question 14

What must a patient undergo before a bone marrow transplant?

Accepted Answer

Before the actual marrow transplant,the patient must undergo total body irradiation or chemotherapy to kill all the marrow cells and the leukemic cells.The patient is at a major risk for infection at this time.

Question 15

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

Accepted Answer

Normal values of eosinophils are 1% to 4%.An elevation to 10% would indicate the presence of an allergic reaction.

Question 16

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?

Accepted Answer

Pain control during the crisis is the focus.Continuous opioids are the mainstay of pain management.Certainly IV fluids to reduce viscosity of blood and oxygen for relief of dyspnea are important,but pain control is paramount in the acute phase.

Question 17

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

Accepted Answer

Phagocytosis is the process by which bacteria,cellular debris,and solid particles are destroyed and removed.

Question 18

In an adult,where are erythrocytes continuously produced?

Accepted Answer

Erythrocytes are continuously produced in the red bone marrow,principally in the vertebrae,ribs,and sternum.

Question 19

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

Accepted Answer

Children with leukemia should have an annual influenza vaccine and a pneumococcal vaccine every 5 years.

Question 20

The presence of excess bands in the peripheral blood that indicate severe infection is called:

Accepted Answer

The presence of excess bands in the peripheral blood is called a shift to the left (i.e. ,a shift toward immature cells)and indicates severe infection.

Quiz 7: Care of the Patient with a Blood or Lymphatic Disorder