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Hematology, Immunology & Oncology 1.

The blood cells that transport oxygen and carbon dioxide to and from body tissues are: A. RBCs. B. WBCs. C. platelets. D. granulocytes. Answer: A. RBCs transport oxygen and carbon dioxide. Because of their biconcave shape, they have the flexibility to travel through blood vessels of different sizes. 2. A patient with blood type B can receive a transfusion of: A. type A or type O blood. B. type B or type O blood. C. type AB or type O blood. D. type A or type B. Answer: B. Type B blood contains B antigens and anti-A antibodies, but no anti-B antibodies. Therefore, a patient with type B blood can receive type B or type O blood (which contains neither anti-A nor anti-B antibodies). 3. Which type of anemia results from deficiency of all the blood’s formed elements, caused by failure of the bone marrow to generate enough new cells? A. Sickle cell anemia B. Folic acid deficiency anemia C. Aplastic anemia D. Iron deficiency anemia Answer: C. Aplastic anemia usually develops when damaged or destroyed stem cells inhibit RBC production. 4. Which disorder results from a deficiency of circulating platelets? A. Hemophilia B. Sickle cell anemia C. Von Willebrand’s disease D. Thrombocytopenia Answer: D. Thrombocytopenia, the most common hemorrhagic disorder, results from a deficiency of circulating platelets. 1. If a patient who’s allergic to peanut butter eats peanut butter cookies, which antigen-specific immunoglobulin will his body produce? A. IgA B. IgD C. IgE D. IgG Answer: C. IgE is responsible for allergic reactions. 2. The most common anaphylaxis-causing agent is: A. shellfish. B. contrast dye. C. bee venom. D. penicillin. Answer: D. Penicillin is the most common anaphylaxis-causing antigen because of its systemic effects on the body.

Once every 3 years starting at age 21 B. In most cases. Asthma is most strongly associated with: A. B. D. being older than age 40. cervical cancer. B. prostate cancer. Answer: C. The leading cause of cancer death in women is: A. Every 5 years starting at age 30 D. high blood pressure. breast cancer. About one-third of asthmatics share the condition with at least one member of their immediate family. B. 2. Which medication is used to treat RA? A. Once a year starting at age 40 Answer: D. multiple myeloma. a history of anaphylactic reactions. a family history of asthma. Lung cancer is the second most common cancer among females in the United States (after breast cancer) and is the leading cause of cancer death in women. One risk factor for prostate cancer is: A. how often should a woman have a mammogram? A. Calcitonin D. D. D. corticosteroids. 1. C. Once a year starting at age 35 C. C. Answer: D. malignant melanoma. D. C. and threefourths of children with two asthmatic parents also have asthma. C. 4. a history of frequent upper respiratory infections. antifungals. 3. antibiotics. poverty.3. lung cancer. Prostate cancer seldom develops before age 40. Socioeconomic status and infertility don’t appear to affect the risk of this cancer. a history of infertility. Etidronate (Didronel) . Answer: C. C. Aspirin B. the treatment of choice for SLE is: A. The ACS recommends a yearly mammogram for all women age 40 and older. 5. B. cyclosporine. Reed-Sternberg cells are associated with: A. Acetominophen (Tylenol) C. The diagnosis of Hodgkin disease hinges on the presence of Reed-Sternberg cells. D. 4. Answer: A. B. being between ages 15 and 34. Corticosteroids are the treatment of choice for systemic symptoms of SLE. Answer: B. ovarian cancer. According to the ACS. Hodgkin disease.

A client with major abdominal trauma needs an emergency blood transfusion. Telling the client to chew the tablets thoroughly before swallowing 4. provide the mainstay of RA therapy because they decrease inflammation and relieve joint pain.Answer: A. the safest type for the nurse to administer is: 1. Exposure to sunlight will help control skin rashes. B negative. Crushing the tablets and mixing them with fruit juice 2. 3. 4. 2. Didanosine is an antiretroviral .Monitor body temperature. The client should monitor his temperature because fever can signal an exacerbation and should be reported to the physician. 1. Corticosteroids may be stopped when symptoms are relieved. Rh negative) can receive A negative. 2. AB positive. and AB negative blood. a potentially life-threatening situation. Instructing the client to swallow the tablets whole with water 3. Dissolving the tablets in fruit juice Answer: 3. 2. Individuals with AB negative blood (AB type. It’s unsafe to give Rh-positive blood to an Rh-negative person. Answer: 3. 3. A nurse is preparing a client with systemic lupus erythematosus for discharge. Sunlight and other sources of ultraviolet light may precipitate severe skin reactions and exacerbate the disease. Of the blood types available. Answer: 3. Abruptly stopping corticosteroids can cause adrenal insufficiency. Salicylates. A positive. Which intervention is most appropriate? 1. Corticosteroids must be gradually tapered because they can suppress the function of the adrenal gland. 4. 3. and clients should be encouraged to pace activities and plan for rest periods. The nurse is administering didanosine (Videx) to a client with acquired immunodeficiency syndrome. There are no activity limitations between flare-ups. Which instructions should the nurse include in the teaching plan? 1. The client’s blood type is AB negative. O positive. Fatigue can cause a flare-up of systemic lupus erythematosus. B negative. particularly aspirin.

A 25G needle is used for a subcutaneous injection. The nurse should instruct the client to: 1. A Z-track or zig-zag technique should be used to administer an iron injection. A client with thrombocytopenia. Administering a Z-track injection 3. Using the same needle to draw up the solution and to administer the injection 4.drug (reverse transcriptase inhibitor) that’s given to treat human immunodeficiency virus infections. Didanosine tablets contain buffers that raise stomach pH to levels that prevent degradation of the active drug. injection (such as that needed to administer iron).M. The needle should be changed after drawing up the iron solution to avoid staining and irritating the tissues. They may also be crushed and mixed with water. The upright position. Answer: 2. develops epistaxis. hold his nose while bending forward at the waist. They shouldn’t be added to fruit juices or other acidic liquids. 4. Preparing the deltoid site for injection Answer: 2. avoids increasing the vascular pressure in the nose and helps the client avoid aspirating blood. site such as the upper outer quadrant of the buttocks should be used to administer iron. The finding that would most strongly support a diagnosis of acute leukemia is the presence of a large number of immature: 1. . 3. leaning slightly forward. A nurse is reviewing the laboratory report of a client who underwent a bone marrow biopsy. Tablets must be chewed thoroughly before swallowing. sit upright. Nose blowing can dislodge any clotting that has occurred.M. monocytes. 2. lie supine with his neck extended. blow his nose and then put lateral pressure on his nose. Which action is appropriate? 1. secondary to leukemia. This prevents iron from leaking into and irritating the subcutaneous tissue. Tablets may be dispersed in a nonacidic liquid for administration. 5. The nurse is preparing to administer iron dextran (Imferon) to a client with iron deficiency anemia. the deltoid site doesn’t provide enough muscle mass for an iron injection. A deep I. 6. 4. Didanosine tablets aren’t taken whole. Bending at the waist increases vascular pressure in the nose and promotes bleeding rather than halting it. leaning slightly forward. Lying supine won’t prevent aspiration of the blood. not for a deep I. Using a 25G needle 2.

choosing clothes with Velcro fasteners to aid in dressing. Selecting clothing that has Velcro fasteners 6. nonpharmacologic measures for a client with rheumatoid arthritis include applying splints to rest inflamed joints. and applying moist heat to joints to relax muscles and relieve pain. thrombocytes. 8. Because a common manifestation of PCP is activity intolerance and loss of vitality. What is the best evidence that the therapy is succeeding? 1. A sudden gain in lost body weight 2. Improving client vitality and activity tolerance 4. The client is receiving aerosolized pentamidine isethionate (NebuPent). 4. Massaging inflamed joints 2. A nurse is providing care for a client with acquired immunodeficiency syndrome (AIDS) and Pneumocystis pneumonia (PCP). Sudden weight gain. Whitening of lung fields on the chest X-ray 3. Answer: 4. 3. Supportive. 6. leukocytes. Afebrile body temperature and development of leukocytosis Answer: 3. 9. improvements in these areas would suggest success of pentamidine isethionate therapy. 1. A large number of thrombocytes indicates polycythemia vera. Applying splints to inflamed joints 4. A physical therapy program including ROM exercises and carefully individualized therapeutic exercises prevents loss of joint function. basophils. Which nonpharmacologic interventions should a nurse include in the care plan for a client who has moderate rheumatoid arthritis? Select all that apply. An increased number of basophils may result from an allergic reaction. Avoiding range-of-motion (ROM) exercises 3. Leukemia is manifested by an abnormal overproduction of immature leukocytes in the bone marrow. An increased number of monocytes may result from a viral infection. 7. Assistive devices should be used only when marked loss of ROM occurs. and leukocytosis aren’t evidence of therapeutic success. Inflamed joints should never be massaged because doing so can aggravate inflammation. Applying moist heat to joints Answer: 3. whitening of the lung fields on chest X-ray. Using assistive devices at all times 5. 5.2. A nurse is documenting her care for .

Phenytoin (Dilantin) 2. Apply moist heat and administer analgesics based on pain assessment. Impaired gas exchange 2. Transdermal route 3. Iron deficiency anemia doesn’t cause deficient fluid volume and is less directly related to ineffective airway clearance and breathing pattern than it is to impaired gas exchange. A nurse is administering cyanocobalamin (vitamin B12) to a client with pernicious anemia.a client with iron deficiency anemia. Which administration route should the nurse use? 1. Phenytoin. Ineffective breathing pattern Answer: 1. Enteral route 4. 2. Topical and transdermal administrations aren’t available. Apply ice compresses to the affected areas and initiate range-of-motion exercises. or deep subcutaneous). Deficient fluid volume 3. furosemide. 2. the client no longer has the intrinsic factor available to promote vitamin B12 absorption in his GI tract. The history reveals the use of several medications. Iron is necessary for hemoglobin synthesis. which impair tissue oxygenation and impair gas exchange. Aspirin use has been implicated in the development of Reye syndrome in children with a history of recent acute viral infection. Furosemide (Lasix) 3. . To manage the pain associated with this crisis. Iron deficiency anemia causes subnormal hemoglobin levels. Following a gastrectomy. A nurse is taking a history from the mother of a child suspected of having Reye syndrome. and the enteral route is inappropriate in a gastrectomy. 10. secondary to gastrectomy. Vitamin B12 is administered parenterally (I. Which medication might be implicated in the development of Reye syndrome? 1. 1. Ineffective airway clearance 4. Parenteral route Answer: 4. Hemoglobin is responsible for oxygen transport in the body. A 3-year-old child has been hospitalized in a vaso-occlusive crisis. Which nursing diagnosis is most appropriate? 1. Phytonadione 4. and phytonadione aren’t associated with the development of Reye syndrome.M. Topical route 2. Aspirin Answer: 4. the nurse should perform which intervention? 1.

” 4. 3. and aren’t limited to acetaminophen. Naturally acquired passive immunity is received through placental transfer and breast-feeding. Natural immunity 2. Analgesics should be administered based on the child’s pain level. “I know I should try to keep my child’s body temperature normal by keeping him away from fluctuations in temperature. Naturally acquired active immunity 3. The major clinical feature of sickle cell anemia is pain from a vaso-occlusive crisis. Artificially acquired active immunity Answer: 3. Naturally acquired active immunity occurs when the immune system makes antibodies after exposure to disease. He’s 4 months old. Answer: 1. and he has never been sick before. Moist heat is applied to promote tissue oxygenation. The mother should notify the physician if the child vomits so that treatment can be initiated to prevent dehydration. “My child can’t possibly have sickle cell anemia.” 2. Which type of immunity is passed on to the infant during breast-feeding? 1. The child should receive a pneumococcal vaccine when appropriate.3.” Answer: 1. Cold should be avoided because it promotes vasoconstriction and sickling.” 3. A nurse is teaching a mother about the benefits of breast-feeding her infant. “I know my child should receive a pneumococcal vaccine when the doctor suggests. 4. Symptoms of sickle cell anemia rarely appear before age 4 months because the predominance of fetal hemoglobin prevents excessive sickling. Natural immunity is present at birth. which can precipitate crisis. Provide a cooling blanket and administer acetaminophen (Tylenol). Further teaching is indicated if the mother states that her child can’t have sickle cell anemia because he’s 4 months old and has never been sick before. 4. “I know I should call the pediatrician immediately if my child begins to vomit. Which statement by the mother indicates a need for further teaching? 1. Artificially acquired immunity . Changes in body temperature may also trigger crisis and should be avoided. Naturally acquired passive immunity 4. A nurse is teaching the mother of a child with sickle cell anemia. Elevate the affected areas and administer analgesics.

providing pain control. so skiing should be avoided. A nurse is teaching a child with sickle cell anemia and the child’s mother about activities that may promote a vaso-occlusive crisis. Which nursing interventions should a nurse anticipate when caring for a child in acute sickle cell crisis? Select all that apply. Dark leafy vegetables. The mother should be instructed to give her child iron-rich foods. Attending to the child’s play needs Answer: 1.occurs when medically engineered substances are ingested or injected to stimulate the immune response against a specific disease (immunizations) 5. Mountain . Monitoring vital signs frequently 6. 5. encourage healthy eating habits. and whole grains 3. dark leafy vegetables. Deep sea diving 4. chicken. Which activity is acceptable for this child? 1. Providing adequate pain control 3. maintaining adequate hydration. Extremes in temperature can also promote a crisis. Yogurt is a good source of calcium but isn’t high in iron. A child with sickle cell anemia should be instructed to avoid activities that promote a crisis. Bowling Answer: 4. and monitoring vital signs frequently are priority points of care. and yogurt 4. and whole grains 2. liver. mountain climbing. Which iron-rich foods should the nurse instruct the mother to include in her child’s diet? 1. Whole grains. but it isn’t high in iron. Citrus fruit. citrus fruit. Assessing family education needs 4. and whole grains Answer: 1. 2. A nurse is providing dietary teaching for the mother of a child with iron deficiency anemia. After the child’s condition is stabilized. 6. dark leafy vegetables. Mountain climbing 3. and attend to the child’s play needs. Because the child is in acute crisis. or deep sea diving. Maintaining adequate hydration 2. and whole grains. 1. such as excessive exercise. Chicken is a good source of protein. the nurse can then evaluate family learning needs. Encouraging healthy eating habits 5. Skiing 2. Liver. 7. Citrus fruits aid iron absorption but aren’t high in iron. such as liver.

The school-age child is also able to participate in his care. The nurse encourages fantasy play and participation in his care. poor healing of leg wounds. Signs of hemophilia include prolonged bleeding after circumcision. The adolescent (ages 12 to 18) Answer: 1. mouth. Which instruction should the nurse include in her teaching? 1. hematemesis. School-age children engage in fantasy play and daydreaming. Therefore. it’s appropriate for the nurse to encourage this type of play for the hospitalized child. 9. A neonate experiences prolonged bleeding after his circumcision and has multiple bruises without petechiae. lymph ade nopathy.climbing and deep sea diving may expose the child to altered atmospheric pressures and a deoxygenated state. Doll play is helpful for the preschool hospitalized child. Sickle cell anemia 4.” . hematuria. enuresis. The preschool child (ages 3 to 5) 3. and thorax. This developmental approach is most appropriate for which pediatric age-group? 1. multiple bruises without petechiae. These conditions can lead to a sickle cell crisis 8. “Discontinue administration of all antibiotics. petechiae. “Restrict the child’s nighttime fluids. A nurse is providing instructions to the parents of an infant recovering from a sickle cell crisis. and hemarthrosis. A child is admitted to the pediatric floor with hemophilia. Signs and symptoms associated with sickle cell anemia include pain at the site of occlusion. Signs and symptoms associated with leuke mia include history of infections. and delayed growth and sexual maturity. These assessment findings suggest which condition? 1. The school-age child (ages 5 to 12) 2. and listlessness. peripheral neuropathies from bleeding near peripheral nerves.” 3. immunizations. priapism. Leukemia Answer: 2. The toddler (ages 1 to 3) 4. Hemophilia 3. fatigue. blood in stools. “Keep the child isolated from all family members. Iron deficiency anemia 2. The toddler enjoys push-pull toys and games of peek-a-boo. The adolescent can engage in role playing in various situations. 10. Some of the signs associated with iron deficiency anemia include dyspnea on exertion. bleeding into the throat. or minor injuries.” 2. and ecchymosis.

but there’s no reason to isolate him from all family members. Infants with sickle cell anemia have altered immune function and are highly susceptible to bacterial sepsis. The child should receive antibiotics until he is at least 5 years old. “Make sure you hold the thermometer tightly under the arm. Hydration is necessary for hemodilution and the prevention of sickling . A fever in a child with sickle cell anemia is a medical emergency that requires prompt evaluation. The infant should be isolated from persons with a known illness.” Answer: 4.4.