Question 1

A child diagnosed with aplastic anemia is admitted to the hospital.The parents ask the nurse what aplastic anemia is.Which response by the nurse is accurate?

Accepted Answer

Aplastic anemia is a disorder in which the bone marrow is unable to produce enough new cells to replace the dying cells, leading to a deficiency of red blood cells, white blood cells, and platelets. Choice A is incorrect as aplastic anemia is characterized by a deficiency of blood cells, not an excess. Choice B is incorrect as sickle cell anemia is a disorder characterized by abnormally shaped red blood cells. Choice D is incorrect as aplastic anemia can be caused by a variety of factors including medications, radiation therapy, and exposure to toxic chemicals as well as viral illnesses.

Question 2

The home healthcare nurse is preparing a care plan for a patient with severe anemia.The patient currently lives alone and states,"I can't even walk to the kitchen without getting winded." What would be the priority nursing diagnosis for this patient?

Accepted Answer

The patient's statement of being unable to walk to the kitchen without getting winded indicates a significant limitation in physical activity, suggesting Activity Intolerance as the priority nursing diagnosis. The other options may also be appropriate for this patient, but they are not as immediately concerning as the potential for further physical limitations and complications due to the anemia.

Question 3

A pediatric nurse is caring for a child with acute lymphoblastic leukemia (ALL).When providing education to the child's parents regarding this disease,which topic should the nurse include?

Accepted Answer

Acute lymphoblastic leukemia (ALL) is the most common type of leukemia among children and adolescents. Option A is incorrect because ALL is characterized by abnormal proliferation of lymphoid cells, not all bone marrow elements. Option C is incorrect because ALL is actually one of the most common types of cancer in children. Option D is incorrect because the onset of ALL is usually sudden and rapid.

Question 4

The health-care provider prescribes laboratory tests following the initiation of treatment for a child who is diagnosed with iron-deficiency anemia.Which laboratory result should the nurse share with the child's family as an indication of improvement?

Accepted Answer

A high reticulocyte count indicates that new red blood cells are being produced by the bone marrow, which is a positive sign of improvement in iron-deficiency anemia. Low hemoglobin, low hematocrit, and normal platelet count do not necessarily indicate improvement in this condition.

Question 5

Which is the priority nursing diagnosis for the child diagnosed with idiopathic thrombocytopenic purpura (ITP)?

Accepted Answer

The child with ITP is at risk for injury due to the low platelet count, which affects blood clotting. Monitoring for signs of bleeding and preventing trauma is a priority nursing intervention. While the other options may be present, they are not the priority for this condition.

Question 6

A nurse is planning care for a patient with sickle cell disease and chooses Acute Pain as the nursing diagnosis.Which intervention is inappropriate for the nurse to include in this plan of care?

Accepted Answer

Using heat or cold packs is inappropriate for patients with sickle cell disease, as cold can cause vasoconstriction and worsen sickling, while heat can increase the risk of burns due to decreased sensation.

Question 7

The nurse is evaluating a patient's understanding of dietary needs to treat anemia.Which patient statement indicates a need for additional teaching?

Accepted Answer

This statement indicates a misunderstanding as vitamin C actually increases iron absorption. The patient needs additional teaching to correct this misinformation.

Question 8

The nurse is instructing a patient with iron-deficiency anemia about appropriate menu choices.Which diet choice indicates that teaching has been effective?

Accepted Answer

D) Roast beef, steamed spinach, tomato soup, orange juice. This choice is the most effective for a patient with iron deficiency anemia because it includes foods high in iron (roast beef, spinach) and vitamin C (tomato soup, orange juice), which enhances iron absorption.

Question 9

An emergency department nurse is caring for a child in a sickle cell crisis.The nurse suspects the etiology of the crisis as being thrombotic in nature due to which clinical manifestations?

Accepted Answer

Thrombotic sickle cell crisis, also known as vaso-occlusive crisis, is characterized by extreme pain due to the blockage of blood vessels by sickled cells.

Question 10

Which is the priority teaching point for the nurse to include in the discharge instructions for the parents of a child who was admitted to the hospital in a sickle cell crisis?

Accepted Answer

Adequate hydration is a priority teaching point for the nurse to include in the discharge instructions for parents of a child who was admitted to the hospital in a sickle cell crisis. Sickle cell disease causes red blood cells to become rigid and sticky, increasing the risk of blood clots and reducing the flow of oxygen and nutrients to various organs, including the kidneys. Adequate hydration can help prevent the blood from becoming too concentrated, reducing the risk of sickling and blood clots. It is also important to encourage parents to monitor their child's fluid intake and urine output to ensure adequate hydration. While pain medication management and activity restriction may also be important teaching points, they are not as essential as adequate hydration in preventing complications of sickle cell disease. A diet high in protein may be recommended to promote growth and healing, but it is not the highest priority teaching point.

Question 11

A patient is admitted to the emergency department in a sickle cell crisis.The nurse assesses the patient and documents the following clinical findings: temperature 102°F,O₂ saturation of 89%,and complaints of severe abdominal pain.Based on the assessment findings,which intervention is the greatest priority?

Accepted Answer

The greatest priority is to address the patient's oxygen saturation of 89%, which is below normal levels, indicating hypoxia. Applying oxygen can help improve oxygen saturation and alleviate symptoms related to sickle cell crisis.

Question 12

The nurse is planning care for a patient with acute myeloid leukemia (AML).Which is the priority nursing diagnosis to minimize the risk of complications associated with AML?

Accepted Answer

Acute myeloid leukemia (AML) is associated with a higher risk of bleeding due to decreased production of normal blood cells and impaired clotting mechanisms. Therefore, the priority nursing diagnosis is "Risk for Bleeding." The other options may also be applicable to patients with AML but are of lower priority compared to the risk of bleeding.

Question 13

A child who has polycythemia is prescribed radiation.The child's parents ask why this is necessary since the child does not have cancer.Which response by the nurse is accurate?

Accepted Answer

Radiation is used to suppress the bone marrow in cases of polycythemia to reduce the overproduction of red blood cells.

Question 14

A nurse is providing discharge instructions to a patient with iron-deficiency anemia who is experiencing glossitis.Which patient statement indicates the need for further education?

Accepted Answer

Using an alcohol-based mouthwash can further irritate and dry out the mouth, exacerbating the patient's glossitis. The patient should be educated to use a non-alcohol based mouthwash or saline solution instead. All of the other options indicate appropriate education for a patient with glossitis and iron-deficiency anemia.

Question 15

The nurse is caring for a patient who was admitted to a medical-surgical unit in a sickle cell crisis.Which medication should the nurse expect to administer to this patient?

Accepted Answer

The answer of The nurse is caring for a patient...

Question 16

A nurse is providing discharge teaching for a patient with iron-deficiency anemia.The patient has been prescribed ferrous sulfate and has been told to increase the intake of foods that are naturally high in iron.Which patient statement indicates correct understanding?

Accepted Answer

The answer of A nurse is providing discharge teaching for...

Question 17

The nurse is providing care to a patient who is receiving treatment for sickle cell disease.The patient is at risk for infection.Which medication does the nurse expect to administer to this patient?

Accepted Answer

Patients with sickle cell disease are at risk for bacterial infections due to damage to the spleen. Penicillin is commonly given prophylactically to these patients to prevent bacterial infections. Acetaminophen is a pain reliever, morphine sulfate is a pain reliever and Tamoxifen is used for breast cancer treatment, none of which are appropriate for infection prevention in sickle cell disease patients.

Question 18

A pediatric patient being treated for acute lymphocytic leukemia (ALL)has a white blood cell count of 1,000/mm3.Which nursing diagnosis would be a priority for this patient?

Accepted Answer

A white blood cell count of 1,000/mm3 indicates severe neutropenia and places the patient at a heightened risk for infection. Therefore, the nursing priority should be to prevent the patient from contracting an infection.

Question 19

A nurse is planning care for a patient with leukemia.The nurse chooses Risk for Bleeding as the nursing diagnosis.Which intervention supports this nursing diagnosis?

Accepted Answer

The answer of A nurse is planning care for a...

Question 20

A patient in sickle cell crisis reports taking a recent skiing trip that caused a respiratory infection from the cold weather.Which nursing diagnosis is a priority for this patient?

Accepted Answer

Acute Pain is a priority nursing diagnosis for a patient in sickle cell crisis, as pain is a common symptom of the condition and can be severe and debilitating. The recent respiratory infection may exacerbate the pain, making it an even higher priority. Choices A, B, and C are not as relevant to the situation.

Quiz 34: Coordinating Care for Patients With Hematological Disorders