Question 1

The nurse caring for an older adult with a diagnosis of leukemia would encourage the client to use an electric razor. Why?

Accepted Answer

Trauma and microabrasions may contribute to anemia.

Question 2

The Oncology Advanced Practice Nurse (APN) is assessing a client with leukemia. How would the Oncology APN assess for enlargement and tenderness over the liver and spleen?

Accepted Answer

Enlargement and tenderness over the liver and spleen can be assessed by palpating the abdomen. This involves using gentle pressure to feel for any abnormalities or discomfort in those organs. Reviewing laboratory test results or calculating the absolute neutrophil count may provide information related to the diagnosis and management of leukemia, but they do not specifically assess for liver and spleen enlargement or tenderness. Looking for evidence of bruising may be indicative of a bleeding disorder, which can be a complication of leukemia, but it also does not specifically assess for liver and spleen enlargement or tenderness.

Question 3

An 81-year-old male with acute lymphoblastic leukemia is terminal. The family asks you why the prognosis is so poor for this client. What would be your best response?

Accepted Answer

Older age and acute lymphoblastic leukemia lead to a poor prognosis due to the inability to produce sufficient healthy blood cells, affecting the body's ability to fight the disease.

Question 4

You are caring for a 13-year-old diagnosed with sickle cell anemia. The client asks you what they can do to help prevent sickle cell crisis. What would be an appropriate answer to this client?

Accepted Answer

Drinking enough water can prevent dehydration, which is a common trigger of sickle cell crisis. Dehydration can cause the sickle-shaped red blood cells to become more rigid and sticky, which can lead to blockages in blood vessels. It is important for individuals with sickle cell anemia to stay properly hydrated by drinking at least 8 glasses of water every day. Avoiding sports or activities that tire out the client or make them short of breath may limit their physical activity and overall health. Oxygen therapy may be useful during a crisis, but it is not a preventative measure.

Question 5

You are studying the different forms of leukemia in your pathophysiology class. Which of the following would you be studying? Select all that apply.

Accepted Answer

The answer of You are studying the different forms of...

Question 6

The clinic nurse is caring for a client diagnosed with leucopenia. What does the nurse know this client has?

Accepted Answer

Leucopenia is a condition characterized by a decrease in the total number of white blood cells (leukocytes) in the blood, which can affect the body's ability to fight off infections.

Question 7

A client comes to the walk-in clinic complaining of weakness and fatigue. While assessing this client, you find evidence of petechiae and ecchymoses. You note that the spleen appears enlarged. What would you suspect is wrong with this client?

Accepted Answer

Aplastic anemia can lead to symptoms such as weakness, fatigue, and the appearance of petechiae and ecchymoses due to the failure of the bone marrow to produce adequate amounts of blood cells, including platelets, which can lead to these bleeding manifestations. An enlarged spleen can also be associated with this condition as the body tries to compensate for the bone marrow failure.

Question 8

You are assessing vital signs on a hemophiliac who has come to the clinic complaining of an upper respiratory infection. What is the suggested method to check the temperature for a client with hemophilia?

Accepted Answer

Taking the temperature tympanically (in the ear) is the suggested method for clients with hemophilia as it avoids invasive procedures such as rectal temperatures that can cause bleeding. Forehead temperatures are also not as accurate as tympanic temperatures. Taking the temperature orally can also cause bleeding if the client bites down on the thermometer.

Question 9

A client with a diagnosis of thrombocytopenia has been admitted to your unit for IV corticosteroid treatment. As the nurse caring for this client, you would expect the physician's orders to include which of the following?

Accepted Answer

Thrombocytopenia is a condition where the client has a low platelet count, which can lead to abnormal bleeding. IV corticosteroids are given to help increase the platelet count. A tapering course of solumedrol (a corticosteroid medication) at discharge is appropriate for this client. A sleeping medication (A) may not be necessary unless the client is having difficulty sleeping. Small frequent meals throughout the day (B) may be recommended for clients with gastrointestinal issues, but is not necessarily related to thrombocytopenia. Oxycodone (D) is not typically given for steroid-induced headaches.

Question 10

A client with a diagnosis of pernicious anemia comes to the clinic complaining of numbness and tingling in their arms and legs. What do these symptoms indicate?

Accepted Answer

Numbness and tingling in the arms and legs are symptoms of neurologic involvement, which can be a complication of pernicious anemia. This is due to a deficiency of vitamin B12, which is necessary for the proper functioning of the nervous system.

Question 11

A client diagnosed with Polycythemia vera has come into the clinic because they have developed a night-time cough, fatigue, and shortness of breath. What complication would you suspect in this client?

Accepted Answer

Congestive heart failure (CHF) is a potential complication in patients with Polycythemia vera due to increased blood volume and viscosity, leading to an increased workload on the heart. Symptoms such as night-time cough, fatigue, and shortness of breath are indicative of CHF.

Question 12

You are caring for a client with thalassemia who is being transfused. What your role during a transfusion?

Accepted Answer

During a transfusion, it is crucial to closely monitor the rate of administration to ensure the patient does not experience complications such as fluid overload or transfusion reactions.

Question 13

Your client was admitted to the Emergency Department after an accident with a chain saw. The client is exhibiting signs and symptoms of acute hypovolemic anemia from severe blood loss. What signs and symptoms would you assess for?

Accepted Answer

The answer of Your client was admitted to the Emergency...

Question 14

A client at the clinic has just been diagnosed with iron deficiency anemia. What would you recommend the client consume to promote the absorption of iron?

Accepted Answer

Consuming rich sources of vitamin C, such as citrus fruits, berries, kiwi, bell peppers, and broccoli, can help enhance the absorption of iron in the body. Vitamin C can convert the non-heme iron (found in plant-based foods) into a form that is better absorbed by the body.

Question 15

The nurse, caring for a client in the emergency room with a severe nosebleed, becomes concerned when the client asks for a bedpan. The nurse documents the stool as loose, tarry, and black looking. The nurse suspects the client may have thrombocytopenia. What should be the nurse's priority action?

Accepted Answer

The nurse's priority action should be to notify the physician of the client's stool assessment indicating possible gastrointestinal bleeding. This may be a possible complication of thrombocytopenia, but the physician needs to be notified and orders obtained to confirm and treat the potential bleeding. Stopping the nosebleed and putting in an IV line may be important interventions, but they are not the priority in this situation. Cleaning the bedpan can wait until after the medical assessment has been completed.

Question 16

You are caring for a client with multiple myeloma. Why would it be important to assess this client for fractures?

Accepted Answer

Multiple myeloma is a type of cancer that affects plasma cells in the bone marrow. These plasma cells produce antibodies for the immune system, but in multiple myeloma they become abnormal and can form tumors in the bones. Osteoclasts, cells that break down bone tissue, are activated in response to these tumors, leading to bone destruction and weakening. This increases the risk for pathologic fractures, or fractures that occur because of weakened bone rather than trauma. Therefore, it is important to assess clients with multiple myeloma for fractures to prevent complications and ensure timely treatment.

Question 17

You are caring for a client who has had prolonged treatment for osteoarthritis with Celecoxib. The client complains of fatigue, fever, chills, headache, and a vaginal infection. What would you suspect is wrong with this client?

Accepted Answer

The symptoms described by the client suggest a potential case of agranulocytosis, which is a rare but serious side effect of Celecoxib. Agranulocytosis is a severe reduction in the number of white blood cells, specifically the neutrophils, which increases the risk of infections. The vaginal infection reported by the client could be indicative of this condition, and the other symptoms, such as fatigue, fever, and chills, are consistent with an infection resulting from neutropenia. Options A, C, and D are not usually associated with these symptoms or Celecoxib treatment.

Question 18

A nurse caring for a client who has hemophilia is getting ready to take the client's vital signs. What should the nurse do before taking a blood pressure?

Accepted Answer

Before taking a blood pressure, the nurse should ask if taking a blood pressure has ever produced bleeding under the skin or in the arm joints. This is important because with hemophilia, bleeding can occur easily and taking a blood pressure may cause bleeding in the arm joints or under the skin. The nurse needs to take precautions to prevent bleeding, such as using a blood pressure cuff that is appropriate for the client's size and using a lower pressure when taking the blood pressure.

Question 19

The Pediatric Nurse Practitioner is doing a physical examination of a client with sickle cell anemia. Why would the nurse practitioner auscultate the lungs and heart?

Accepted Answer

Auscultating the lungs and heart can help the nurse practitioner detect abnormal sounds suggestive of acute chest syndrome and heart failure, which are common complications of sickle cell anemia.

Question 20

The nursing instructor is talking with their clinical group about coagulopathies. How should the instructor define coagulopathies?

Accepted Answer

Coagulopathies are bleeding disorders that involve platelets or clotting factors. These abnormalities can result in either excessive bleeding or excessive clotting. Examples of coagulopathies include hemophilia, von Willebrand disease, and disseminated intravascular coagulation (DIC).

Quiz 31: Caring for Clients With Disorders of the Hematopoietic System