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Ch. 34: Hematologic Problems Lewis: Medical-Surgical Nursing. Exam Questions And Correct Answers $12.49   Add to cart

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Ch. 34: Hematologic Problems Lewis: Medical-Surgical Nursing. Exam Questions And Correct Answers

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Ch. 34: Hematologic Problems Lewis: Medical-Surgical Nursing. Exam Questions And Correct Answers A 62-year old man with chronic anemia is experiencing increased fatigue and occasional palpitations at rest. The nurse would expect the patient's laboratory test findings to include a. an RBC count...

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  • October 18, 2024
  • 37
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • Medical Surgical nursing
  • Medical Surgical nursing
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sirjoel
©SIRJOEL EXAM SOLUTIONS
10/14/2024 11:14 PM


Ch. 34: Hematologic Problems Lewis:
Medical-Surgical Nursing. Exam Questions
And Correct Answers


A 62-year old man with chronic anemia is experiencing increased fatigue and occasional

palpitations at rest. The nurse would expect the patient's laboratory test findings to include

a. an RBC count of 4,500,000/L.

b. a hematocrit (Hct) value of 38%.

c. normal red blood cell (RBC) indices.


d. a hemoglobin (Hgb) of 8.6 g/dL (86 g/L). - answer✔ANS: D


The patient's clinical manifestations indicate moderate anemia, which is consistent with a Hgb

of 6 to 10 g/dL. The other values are all within the range of normal.

DIF: Cognitive Level: Understand (comprehension) REF: 607

TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity

Which menu choice indicates that the patient understands the nurse's teaching about

recommended dietary choices for iron-deficiency anemia?

, ©SIRJOEL EXAM SOLUTIONS
10/14/2024 11:14 PM
a. Omelet and whole wheat toast

b. Cantaloupe and cottage cheese

c. Strawberry and banana fruit plate


d. Cornmeal muffin and orange juice - answer✔ANS: A


Eggs and whole grain breads are high in iron. The other choices are appropriate for other

nutritional deficiencies but are not the best choice for a patient with iron-deficiency anemia.

DIF: Cognitive Level: Apply (application) REF: 610

TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity

A patient who is receiving methotrexate for severe rheumatoid arthritis develops a

megaloblastic anemia. The nurse will anticipate teaching the patient about increasing oral

intake of

a. iron.

b. folic acid.

c. cobalamin (vitamin B12).


d. ascorbic acid (vitamin C). - answer✔ANS: B


Methotrexate use can lead to folic acid deficiency. Supplementation with oral folic acid

supplements is the usual treatment. The other nutrients would not correct folic acid deficiency,

, ©SIRJOEL EXAM SOLUTIONS
10/14/2024 11:14 PM
although they would be used to treat other types of anemia.

DIF: Cognitive Level: Apply (application) REF: 612

TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity

A 52-yr-old patient has a new diagnosis of pernicious anemia. The nurse determines that the

patient understands the teaching about the disorder when the patient states,

a. "I need to start eating more red meat and liver."

b. "I will stop having a glass of wine with dinner."

c. "I could choose nasal spray rather than injections of vitamin B12."


d. "I will need to take a proton pump inhibitor such as omeprazole (Prilosec)." - answer✔ANS: C


Because pernicious anemia prevents the absorption of vitamin B12, this patient requires

injections or intranasal administration of cobalamin. Alcohol use does not cause cobalamin

deficiency. Proton pump inhibitors decrease the absorption of vitamin B12. Eating more foods

rich in vitamin B12 is not helpful because the lack of intrinsic factor prevents absorption of the

vitamin.

DIF: Cognitive Level: Apply (application) REF: 612

TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity

An appropriate nursing intervention for a hospitalized patient with severe hemolytic anemia is

, ©SIRJOEL EXAM SOLUTIONS
10/14/2024 11:14 PM
to

a. provide a diet high in vitamin K.

b. alternate periods of rest and activity.

c. teach the patient how to avoid injury.


d. place the patient on protective isolation. - answer✔ANS: B


Nursing care for patients with anemia should alternate periods of rest and activity to

encourage activity without causing undue fatigue. There is no indication that the patient has a

bleeding disorder, so a diet high in vitamin K or teaching about how to avoid injury is not

needed. Protective isolation might be used for a patient with aplastic anemia, but it is not

indicated for hemolytic anemia.

DIF: Cognitive Level: Apply (application) REF: 608

TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity

Which patient statement to the nurse indicates a need for additional instruction about taking

oral ferrous sulfate?

a. "I will call my health care provider if my stools turn black."

b. "I will take a stool softener if I feel constipated occasionally."

c. "I should take the iron with orange juice about an hour before eating."

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