Hematology

1. The nurse is caring for a client who has a history of aplastic anemia. Which of the
following data from the nursing history indicates that the anemia is not being managed
effectively?
a. Pallor of skin and mucous membranes
b. Heart rate of 6 bpm! bounding pulse
c. "lood pressure of 1#6$%& mm Hg
d. Poor skin turgor
Ans: A ' a common clinical manifestation of severe anemia includes pallor of skin and
mucous membranes. (ther clinical indicators include fatigue! tachycardia! tachypnea! and
dyspnea as well as anore)ia! sensitivity to cold! and weight loss.
b. Anemias are characterized by increase Heart rate; not likely to have this HR
c. Not commonly associated with anemias usually blood is less viscous and BP
usually decreased.
d. his is a mani!estation o! dehydration not anemia.
". * client with iron+deficiency anemia is prescribed li,uid iron supplements. The nurse
evaluates the client-s understanding of how to take this drug. Which of the following
statements indicates the client has ade,uate knowledge?
a. ./ can use anti+diarrheal drugs if / develop diarrhea.0
b. ./ will report any black stools to the physician.0
c. ./ will check my gums for any bleeding.0
d. ./ will dilute the medication and drink it with a straw.0
Ans: D ' li,uid iron supplements should be diluted and taken through a straw to help
decrease the likelihood of staining the teeth. *. 1e causes constipation2 not diarrhea. ". This
is an e)pected outcome and need not be reported. 3. 1e does not cause bleeding gums.
4. The nurse should plan care for the client with cancer based on the fact that an important
principle of using medication to manage cancer pain is to5
a. *void giving the client addictive medications
b. Provide the medications as soon as the client re,uests them
c. 6iscontinue the medications periodically to discourage the development of drug
tolerance
d. /ndividuali7e the medication therapy to the client
Ans: D ' the most important principle related to the management of cancer pain is to
individuali7e the therapy to the client.
#. /f none of the following bed positions is contraindicated! which position would be preferred
for the client with hypovolemic shock?
a. 8upine c. 8upine with the legs elevated 19 degrees
b. 8emi+fowler-s d. Trendelenburg-s
Ans: C ' a client in hypovolemic shock is best positioned supine in bed with the feet
elevated 19 degrees to bring peripheral blood into the central circulation.
#. *fter confirming the diagnosis of iron+deficiency anemia through laboratory values! the
ne)t essential test is5
a. 8tool guaiac ) 4 c. :ipid profile
b. :iver function d. ;ndoscopy
Ans: A ' stool guaiac would identify blood loss from the gastrointestinal tract! the most
common cause of iron+deficeincy anemia. 8tool guaiac is an easy! ine)pensive! noninvasive
method of determine if gastrointestinal bleeding is the cause of the anemia.
6. When developing a teaching plan for a se)uality class at a community center about
human immunodeficiency virus <H/=> transmission! the nurse would include which of the
following behaviors as a measure to greatly reduce the risk of transmission?
a. *voiding inhalant drugs
b. *voiding prolonged se)
c. ?sing late) condoms with se)ual intercourse
d. 6ouching before and after se)ual intercourse
Ans: C ' using a late) condom in con@unction with a spermicide during se)ual intercourse
greatly reduces the risk of H/= transmission. "ecause H/= is most concentrated in blood and
vaginal and seminal fluids! protective measures during intercourse are necessary to prevent
transmission.
$. When developing the plan of care for a client with aplastic anemia! which of the following
goals would be most appropriate to include?
a. Perform activities of daily living without e)cessive fatigue or dyspnea
b. :earn how to administer weekly vitamin "1A in@ections
c. 3orrectly demonstrate how to take prescribed anticoagulant drug therapy
d. 6escribe self+care behaviors to prevent the transmission to family members
Ans: A ' with aplastic anemia! measures to conserve energy and reduce o)ygen
re,uirements are key. Therefore! an appropriate goal would be to strive to perform activities
of daily living without e)cessive fatigue or dyspnea.
. * client has a total serum cholesterol level of 4A6 mg$d:. The nurse e)plains to the client
that this level5
a. /s normal and re,uires no further treatment
b. /s high and will re,uire dietary modification
c. /s low and re,uire no further treatment
d. /s borderline normal and may re,uire dietary modification
Ans: B ' a total serum cholesterol level of 4A6 mg$d: is high. * client with a cholesterol
level of 4A6 will re,uire dietary modifications and may be placed on lipid+lowering
medication.
%. When developing a Bplan of care that includes interventions aimed at preventing
complications of a low platelet count in a child with leukemia! which of the following is most
appropriate?
a. 3onsulting with a physician about the use of a stool softener
b. Placing the child in protective isolation
c. ?sing heparin instead of saline to flush an intermittent /= access device
d. ;liminating raw vegetables and fruits from the child-s diet
Ans: A ' a stool softener would assist in preventing damage to the rectal mucosa due to
hard stool! thereby decreasing the chances of rectal bleeding.
1&.