Question 1

A major focus in a teaching plan for a teenager with sickle cell anemia would be:

Accepted Answer

The maintenance of adequate fluid intake (4 to 6 L/day)prevents hemoconcentration.The use of alcohol and tobacco are contraindicated for the patient with sickle cell anemia as the cause vasoconstriction.Warm environments are more therapeutic as warm environments do not cause vasoconstriction.

Question 2

Based on the nursing assessment,an appropriate nursing diagnosis for a patient with hemophilia would be:

Accepted Answer

Patients with hemophilia have severe pain caused by bleeding into the joints.

Question 3

The foods that the nurse would include in a nutrition teaching plan for a patient with iron-deficiency anemia are:

Accepted Answer

Iron-rich foods include beans,dried fruit,liver,red meat,fish,and whole-grain breads.

Question 4

A 3-year-old African-American child is diagnosed with sickle cell anemia.The parents know that sickle cell anemia is hereditary but do not understand why their child has the disease,because neither of them has it.The nurse explains that:

Accepted Answer

Sickle cell anemia is a genetic disease carried by the recessive genes of both parents,who will not exhibit any symptoms of the disease.

Question 5

A 35-year-old man is examined in an urgent care clinic.His presenting symptoms suggest polycythemia vera.The laboratory value that would confirm this possible diagnosis is an extremely:

Accepted Answer

The symptoms of polycythemia vera are extremely high hemoglobin and hematocrit values because of the excessive production of red blood cells.Patients with polycythemia vera have 1 pint of blood taken from them until the blood values become more normal.The blood is collected as it would be for a blood donation,but it cannot be used for transfusion purposes.

Question 6

At the end of a shift,a nurse documents the effectiveness of parent teaching concerning the transmission of hemophilia.Which of the following statements by the mother would best indicate an accurate parental perception?

Accepted Answer

Women carry the trait and pass it on to their sons.

Question 7

The nurse explains that sickle cell crisis occurs when the sickle-shaped red blood cells:

Accepted Answer

Circulatory obstruction causes severe pain in patients with sickle cell anemia,which is the major symptom in sickle cell crisis.The hemoglobin S does not,in itself,cause the crises until the cells obstruct a vessel.

Question 8

The rationale for administering injections of vitamin B12 to patients with pernicious anemia is that:

Accepted Answer

The patient with pernicious anemia lacks the intrinsic factor,found in the stomach,which is essential for vitamin B12 absorption.

Question 9

A child with sickle cell anemia is placed prescribed the drug hydroxyurea.The nurse explains that this drug will:

Accepted Answer

Hydroxyurea produces a hemoglobin that resists sickling.

Question 10

A nurse is completing an initial assessment on a new patient being seen in the hospital clinic.The presentation of this female patient includes vague symptoms of tiredness and large areas of ecchymosis.The question that would be most important to ask is:

Accepted Answer

Bleeding gums are indicative of general bleeding tendencies.Sleep and frequency of menstrual periods are not significant,but the heaviness of the period is significant.History can reveal information pertinent to assisting the physician in making a diagnosis.

Question 11

A 52-year-old man has a diagnosis of aplastic anemia.The information that the nurse recognizes as being pertinent to this diagnosis is that the man:

Accepted Answer

Exposure to toxic chemicals can cause aplastic anemia.

Question 12

The nurse caring for a patient receiving a transfusion assesses that the patient is wheezing and is complaining of back pain.After the nurse stops the transfusion,the nurse should:

Accepted Answer

The charge nurse should be notified immediately after the transfusion is stopped.The charge nurse will notify the physician and the laboratory or blood bank.The head of the bed should be raised to aid in respiration,and oxygen should be administered in high doses.The blood tubing and bag should not be discarded because the blood bank will want it to check the accuracy of the typing.

Question 13

When the nurse prepares to give ferrous sulfate (Feosol)to a home health care patient,the nurse will:

Accepted Answer

Patients should avoid taking iron with milk or caffeine because both inhibit drug absorption.The drug is offered with food in a diluted form through a straw to prevent staining the teeth.

Question 14

The nurse caring for a patient who is having radiation treatment for cancer is alert to the threat of thrombocytopenia ______ days after the start of radiation.

Accepted Answer

Thrombocytopenia becomes a nursing concern 10 to 14 days after therapy has begun.This concern is true for radiation and chemotherapy.

Question 15

A newborn infant has developed significant jaundice and has a positive Coombs test result from high levels of bilirubin.The nurse has assessed the symptoms as being indicative of:

Accepted Answer

Newborns can develop hemolytic anemias resulting from blood incompatibility to their mother.These are typical signs of hemolytic anemia in the newborn.

Question 16

The nurse explains that a normal hematocrit value is approximately:

Accepted Answer

Hematocrit is approximately three times the hemoglobin value.

Question 17

The nurse taking the history of a patient who has come in for evaluation of the large areas of purpura on her limbs is alarmed when the patient confesses that she uses an alternative therapy of __________ for her menopausal symptoms.

Accepted Answer

Black cohosh interferes with blood clotting.

Question 18

The patient receiving Epogen asks how soon an increase in his red blood cell count will occur.The nurse's best reply is that the initial increase in red blood cells should be seen in:

Accepted Answer

Epoetin alfa (Epogen)stimulates the bone marrow to produce more red blood cells in approximately 2 days.

Question 19

When the patient with a platelet count of 20,000/mm³ receives 1 unit of platelets,the platelet count should rise to:

Accepted Answer

Platelet transfusions are given when the platelet count falls below 20,000/mm³.One unit is expected to raise the count by 5000 to 10,000/mm³.

Question 20

In preparing discharge plans for a patient recently diagnosed with pernicious anemia,the nurse must include information regarding:

Accepted Answer

Fatigue and weakness are seen in all anemias.

Quiz 32: Hematologic Disorders