Hematology Ch 33 NCLEX review questions – Flashcards
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the nurse is beginning an assessment of a patient with moderate anemia. which manifestation should the nurse expect to assess in this patient? 1. pulse rate 140 bpm 2. hematocrit 45% 3. WBC 14,000 4. complaints of shortness of breath with exercise
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4. complaints of shortness of breath with exercise This is the answer because anemia can lead to tissue hypoxia and this can cause dyspnea on exertion.
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the nurse is concerned that a patient recovering from gastric resection may develop nutritional deficiency anemia related to malabsorption. Of which manifestation should the nurse assess this patient? 1. bone pain 2. steatorrhea 3. dark yellow or bronze skin color 4. numbness and tingling of extremities
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4. numbness and tingling, paresthesia, of extremities because during gastric resection, intrinsic factor production may decrease leading to vitamin b12 deficiency anemia with associated neurologic deficits such as numbness and tingling of extremities
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The nurse is identifying diagnoses appropriate for a patient receiving a bone marrow transplant for treatment of acute myelocytic anemia. which diagnoses would be the highest priority for this patient? (select all that apply) 1. anxiety 2. risk for infection 3. ineffective protection 4. disturbed body image 5. imbalanced nutrition: less than body requirements
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2. risk for infection 3. ineffective protection because prior to bone marrow transplant, chemotherapy or total body irradiation is used to destroy leukemic cells in the bone arrow. normal blood cells are also destroyed causing significant risk for infection and bleeding.
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the nurse is planning care for a patient with acute myeloid leukemia. which interventions ware priorities for this patient? (select all that apply) 1. place in private room 2. request soft bland diet 3. monitor rectal temperature every 4 hours 4. assist with oral hygiene after meals 5. implement airborne infection control precautions
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1. place in a private room 2. request soft , bland diet 4. assist with oral hygiene after meals because acute myeloid leukemia causes both neutropenia and thrombocytopenia, with resulting increased risk for infection and bleeding so a private room and oral hygiene help reduce infection risk and a soft, bland diet reduces trauma to oral mucosal membranes.
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a patient with non hodgkins lymphoma tells the nurse " i might as well give up on dating. no woman will want me now.: what is the most appropriate response for the nurse to make? 1. lots of women find bald men attractive besides your hair may grow back soft and curl 2. it sounds like you are concerned about the effects of this disease and the proposed treatment plan. 3. don't worry. malignant lymphomas are very treatable when caught in an early state of the disease 4. well you may never be able to have children all right but there are other ways to have a satisfying relationship with a woman
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2. it sounds like you are concerned about he effects of this disease and the proposed treatment plan because the nurse should assess the patients perception of body image through subjective information such as what the patient likes most and least about his body, pre-illness perception of people who are sick or have a disability, current understanding of health and limitations imposed by illness or treatment, and feelings about the illness and its effect on perception of self and others.
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a patient with lymphoma is prescribed the CHOP chemotherapy regimen. what should the nurse explain about he purpose of combining these medications as treatment for the disorder? 1. targets different phases of the cell cycle 2. targets malignant cells in different organs 3. prevents the development of adverse effects 4. supports growth and development of normal cells
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1. targets different phases of the cell cycle because multiple drug chemotherapy regimens are effective at different phases of the cell cycle, allowing lower does of individual drugs to decrease adverse effects and produce more effective tumor destruction.
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a patient with multiple myeloma calls the home health nurse complaining of a new onset of severe back pain. what should the nurse respond to this patient? 1. suggest use of a back brace to reduce pain 2. notify the provider of the new pain 3. reassure the patient that bone pain is expected with this disease 4. inquire about the patients use of NSAIDs and analgesics to manage pain
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2. notify the provider of the new pain because pathological fractures are a common and reoccurring problem with multiple myeloma. a new onset of severe pain may signal a pathological fracture and needs to be reported.
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during an assessment the nurse observes reddish-purple spots and areas of purple bruising on a patients arms and legs. which lab result would be consistent with this assessment finding? 1. INR 4.0 2. hematocrit 28% 3. WBC 4,500 4. platelets 50 x 103 cubic millimeters
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4. platelets 50 x 103 cubic millimeters because a platelet count of 6,000/ cubic millimeter is significantly low, normal is 150,000 to 450,000, which increases the patients risk of bleeding and bruising with minor trauma.
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A patient whose husband has hemophilia asks if her newborn baby girl could have the the disease. what information should the nurse use when responding to this patient? 1. hemophilia is an autosomal dominant disorder; therefore her daughter has a 50 percent change of having the disorder 2. the most common forms of hemophilia are transmitted as sex-linked recessive disorders; her daughter is at risk for carrying the defective gene 3. although hemophilia is genetically transmitted, its pattern of inheritance is unknown and her daughter will need to be tested for the defective gene 4. because hemophilia is a sex-linked recessive disorder carried on the y chromosome, her daughter has no risk of having or carrying the disease
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2. the most common forms of hemophilia are transmitted as sex-linked recessive disorders; her daughter is at risk for carrying the defective gene because hemophilia A, the most common form, occurs in about 1 in 10,000 male births and is transmitted on the x chromosome: each male offspring has a 50 percent risk of inheriting the defective gene. each female offspring has a 50 percent risk of becoming a carrier. Von Williebrands's disease affects about 1 in 100 to 500 people, usually inherited as an autosomal dominant trait. offspring of an affected person have a 50 percent risk of inheriting the trait and the disorder. it is unknown if the husband has this type of hemophilia.
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the nurse is administering platelets to a patient with disseminated intravascular coagulation, DIC. what is the intended effect of this treatment? 1. replace the depleted platelets2. restore tissue oxygenation 3. promote intravascular clotting 4. replace specific clotting factors
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1. Replace depleted platelets because when bleeding is the major manifestation of DIC, platelet concentrates are given to restore clotting factors and platelets. an infusion of platelets does not replace specific clotting factors. the infusion of platelets is not used to restore tissue oxygenation. the patient is experiencing intravascular clotting and medications will be used to prevent further clot formation.
