With which client will the nurse apply pressure to an injection site for 5 minutes because of an increased risk for
bleeding?
1. 28-year-old who has had type 1 diabetes for 15 years.
2. 42-year-old newly diagnosed with type 2 diabetes.
3. 58-year-old with chronic hypertension and heart failure.
4. 62-year-old with extensive liver damage from cirrhosis. Answer: 4. 62-year-old with extensive liver damage from
cirrhosis.
The nurse performing a hematologic assessment on an older-adult client identifies the following findings. Which one
does the nurse associate with age-related changes rather than a specific hematologic problem? Select all that apply
Do not palpate the splenic area of the abdomen for any patient with a suspected hematologic problem. An enlarged
spleen ruptures easily and can lead to hemorrhage and death. Answer: -
Which is the most important precaution for the nurse to teach a client whose platelet counts usually range between
50,000 to 60,000/mm3
1. "Drink at least 3 liters of fluid daily"
2. "Take a multiple vitamin that contains iron"
3. "Avoid aspirin and aspirin-containing drugs"
4. "Increase your intake of dark green, leafy vegetables' Answer: 3. "Avoid aspirin and aspirin-containing drugs"
,QSEN!!
Aspiration or biopsy procedures are invasive, and sterile technique must be observed. Answer: -
QSEN!!
Hydroxyurea is teratogenic (can cause birth defects). Teach sexually active women of childbearing age using
hydroxyurea to adhere to strict contraceptive measures while taking it and for 1 month after is is discontinued. Answer:
-
Which change in laboratory test results of a client with sickle cell disease who was started on therapy with hydroxyurea
4 weeks ago indicates to the nurse that the therapy is effective?
1. Increased HbF from 2% to 10%
2. Decreased HbA from 3% to 2.5%
3. Increased platelets from 250,000/mm3 to 300,000 mm3
4. Decreased WBC from 8200/mm3 to 7700/mm3 Answer: 1. Increased HbF from 2% to 10%
Prevention of Sickle cell crisis Answer: • Drink at least 3 to 4 liters of liquids every day.
• Avoid alcoholic beverages.
• Avoid smoking cigarettes or using tobacco in any form.
• Contact your health care provider at the first sign of illness or infection.
• Be sure to get a "flu shot" every year.
• Ask your health care provider about taking the pneumonia vaccine.
• Avoid temperature extremes of hot or cold.
• Be sure to wear socks and gloves when going outside on cold days.
• Avoid planes with unpressurized passenger cabins.
• Avoid travel to high altitudes (e.g., cities like Denver and Santa Fe).
• Ensure that any health care professional who takes care of you knows you have sickle cell disease, especially the
anesthesia provider and radiologist.
• Consider genetic counseling.
• Avoid strenuous physical activities.
, • Engage in mild, low-impact exercise at least 3 times a week when you are not in crisis.
Which signs and symptoms does the nurse expect to find in clients with any type of anemia? Select all that apply
1. Exercise intolerance
2. Fatigue
3. Glossitis
4. Jaundice
5. Leukopenia
6. Microcytic red blood cells
7. Paresthesias of the hands and feet
8. Tachycardia Answer: 1. Exercise intolerance
2. Fatigue
8. Tachycardia
A client diagnosed with acute leukemia tells the nurse that his brother cannot donate stem cells for a transplant because
the brother has type O blood and he has Type A blood. How will the nurse respond?
1. "Don't worry about it. You may not need a stem cell transplant."
2. "Because you are of Asian decent, finding an unrelated donor will be easy."
3. "Blood type and tissue type are not connected. If your brother's tissue type matches yours, you can receive his stem
cells."
4. "Because type O blood is considered to be a universal donor and you have type A blood, you can receive your
brother's stem cells." Answer: 3. "Blood type and tissue type are not connected. If your brother's tissue type
matches yours, you can receive his stem cells."
QSEN!!
A temperature elevation of even 1 degree Fahrenheit above baseline is significant for a patient with leukopenia and
indicates infection until it has been proven otherwise.
-Monitor patients with reduced immunity closely to recognize indications of infection. When any temperature elevation
is present in a patient with leukemia, respond by reporting it to the primary health care provider ASAP and implement
standard infection protocols. Answer: -
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