Question 1

The nurse is assisting in the development of a care plan for a patient with anemia.Which nursing diagnosis is most common in a patient with anemia?

Accepted Answer

Patients with anemia are fatigued related to poor oxygenation,making Activity Intolerance the best diagnosis.B.Anemia generally does not cause airway clearance problems,although it may cause dyspnea.D.Anemia is low RBCs,not WBCs.C.Pain is not a typical problem with anemia.

Question 2

The nurse is caring for a patient with thrombocytopenia.Which activity should be avoided?

Accepted Answer

The patient with thrombocytopenia is at risk for bleeding.Intramuscular injections can cause bleeding into the muscle.C.D.Visits from family and fresh produce are concerns with low WBC counts.A.Ambulation is not a concern.

Question 3

The nurse is reviewing the care plan for a patient with disseminated intravascular coagulation.Which nursing intervention is most likely to cause an acute complication in this patient?

Accepted Answer

Intramuscular injections can cause bleeding into the muscle.A,B,and D are not desirable,but they do not cause the most immediate risk.

Question 4

The nurse is caring for a patient with PV.Which laboratory study should the nurse monitor to help evaluate the effectiveness of treatment for this patient?

Accepted Answer

Hematocrit reflects the RBC count and monitors the "thickness" of the blood,the main concern in PV.B.C.D.Total protein,WBCs,and BUN are not generally affected in PV.

Question 5

The nurse is caring for a patient with a bleeding disorder.Which medication order should the nurse question?

Accepted Answer

Aspirin has antiplatelet action and could increase risk for bleeding.B.C.D.Digoxin,thyroid hormone,and morphine do not increase risk for bleeding.

Question 6

The nurse is caring for a patient in sickle cell crisis.What is the rationale for providing warm compresses and blankets for this patient?

Accepted Answer

Warm compresses help dilate vessels to reduce clumping of cells.A.Sickle cell crises are not associated with shivering.B.C.Heat will not prevent sickling or speed production of blood cells.

Question 7

A patient is diagnosed with anemia and asks the nurse what nutrients are important for RBC formation.The nurse bases an answer on the understanding that which nutrients are essential for production of healthy red cells?

Accepted Answer

Iron,folic acid,and vitamin B₁₂ are all essential to production of healthy RBCs.A deficiency of any of these nutrients can cause anemia.B,C,and D are not associated with anemia.

Question 8

The nurse is teaching a patient with sickle cell anemia how to prevent crises.Which foods should the nurse teach the patient to avoid?

Accepted Answer

Alcohol can trigger a sickle cell crisis.A.C.D.Citrus,chocolate,and whole grains are not known to trigger crises.

Question 9

The nurse is preparing to give an injection of iron (Imferon)to a patient with anemia.What is the rationale for using the Z-track method for injection?

Accepted Answer

Administer intramuscular iron injections by Z-track method to avoid staining the injection site.A.C.Z-track will not prevent pain or improve absorption.B.Tissue damage is not usually a problem.

Question 10

The nurse is caring for a patient with a clotting disorder.Which blood product should the nurse anticipate being prescribed?

Accepted Answer

Cryoprecipitates replace specific missing clotting factors.D.A.Packed RBCs replace lost blood,and albumin expands volume.B.Normal saline is not a blood product.

Question 11

The nurse is planning discharge teaching for a patient with polycythemia.Which nursing intervention should the nurse consider to help prevent complications in this patient?

Accepted Answer

Patients should drink 3 liters of water daily to reduce blood viscosity.A.Intake and output will not prevent complications.B.Injections are contraindicated in patients with bleeding disorders,not polycythemia.C.Bedrest will further hinder circulation.

Question 12

The nurse is caring for a patient with anemia.Which blood component is deficient in this patient?

Accepted Answer

The term anemia describes a condition in which there is a deficiency of RBCs,hemoglobin,or both,in the circulating blood.B.C.Deficiency of WBCs is called leukopenia,and deficient platelets is called thrombocytopenia.D.A deficiency of plasma would cause dehydration.

Question 13

The nurse is caring for a patient with a bleeding disorder.Which manifestation might first alert the nurse to the possibility of disseminated intravascular coagulation?

Accepted Answer

Petechiae indicate bleeding into the skin,a symptom of the reduced clotting that occurs in disseminated intravascular coagulation.B.C.Paralysis and pulse absence are too general and can be symptoms of many disorders.D.If the patient is bleeding,the blood pressure will decrease.

Question 14

A patient with thrombocytopenia is having pain.If each of the following medications is ordered,which should the nurse choose to administer?

Accepted Answer

Acetaminophen with codeine is an oral medication,making it the best choice.A.B.C.Injections increase risk for bleeding,as does oral aspirin.The patient with thrombocytopenia is already at risk for bleeding.

Question 15

A patient is admitted in sickle cell crisis with symptoms of dyspnea and leg pain.The patient's significant other asks,"I don't really understand why he is hurting so badly." Which response by the nurse is best?

Accepted Answer

As sickling occurs,blood becomes sluggish and does not flow easily.It tends to collect in the capillaries and veins of the organs of the chest and abdomen,as well as joints and bones,and can cause infarction (tissue necrosis resulting from lack of blood supply).Tissue necrosis results in pain,fever,and swelling.A.B.Pain from sickle cell anemia is not associated with changes in cellular metabolism or bone marrow pathology.D.Bleeding into joints is more common with hemophilia.

Question 16

The nurse is providing dietary teaching to an individual with iron-deficiency anemia.Which patient statement indicates that teaching has been effective?

Accepted Answer

Red meat; dark green leafy vegetables; dried fruits; and enriched,fortified,or whole grain products are relatively good sources of iron that are commonly included in Western diets.Foods rich in vitamin C can be used to enhance absorption of iron from nonmeat sources.Likewise,stewing acidic foods such as tomatoes in iron cookware increases their iron content.A.Green vegetables may contain iron however dairy products are not an identified source of iron.B.Berries and natural cereals are not good sources of iron.D.Yellow vegetables and green tea are not good sources of iron.

Question 17

A patient with iron-deficiency anemia has been taking oral iron supplements.Which test should the nurse review to determine the effectiveness of this intervention?

Accepted Answer

Hemoglobin and hematocrit are below normal in anemia.C.Electrolyte,BUN,and creatinine abnormalities usually indicate kidney pathology.D.Thrombin clotting time and PT monitor the effectiveness of anticoagulant therapy.B.WBC counts are used to monitor the effectiveness of antibiotic therapy for infections.Platelets are monitored to determine clotting ability.

Question 18

A patient with aplastic anemia is to receive an injection of erythropoietin (Epogen).The patient asks what the injection is intended to do.Which should the nurse respond to the patient?

Accepted Answer

Erythropoietin (Epogen)stimulates the production of RBCs.A.B.It does not provide extra cells or stop the disease process.D.It may help increase energy however many patients do not recover from aplastic anemia.

Question 19

A patient is admitted to the hospital with hypertension and vertigo related to polycythemia vera (PV).For which treatment should the nurse prepare the patient?

Accepted Answer

Phlebotomy reduces the RBCs and viscosity of the blood and the patient usually feels more comfortable quickly.D.Colony-stimulating factors would stimulate more cell production,which would worsen symptoms.A.B.Splenectomy and myelogram are not treatments associated with PV.

Question 20

The nurse is reviewing the current patient census on a care area.Which individual is most likely to present with signs or symptoms of sickle cell anemia?

Accepted Answer

In the United States,sickle cell anemia is most often found in those of African or eastern Mediterranean origin.B.Children of Hispanic origin are the least likely to demonstrate symptoms of sickle cell anemia.A.D.Symptoms are not present until after the age of 6 months due to the hemoglobin made during fetal life.

Quiz 28: Nursing Care of Patients With Hematologic and Lymphatic Disorders