C
(Hemolytic allergic reactions are fairly common and may cause chills, fever, urticaria, tachycardia, dyspnoea, chest
pain, hypotension, and other signs of anaphylaxis a few minutes after blood transfusion begins. Although rare, a
hemolytic reaction to mismatched blood can occur, triggering a more severe reaction and, possibly, leading to
disseminated intravascular coagulation. A hemolytic reaction to Rh-incompatible blood is less severe and occurs
several days to 2 weeks after the transfusion. Bacterial contamination of donor blood causes a high fever, nausea,
vomiting, diarrhoea, abdominal cramps and, possibly, shock.)
A few minutes after beginning a blood transfusion, a nurse notes that a client has chills, dyspnea, and urticaria. The nurse reports this to the physician
immediately because the client probably is experiencing which problem?
A. A hemolytic reaction to mismatched blood
B. A hemolytic reaction to Rh-incompatible blood
C. A hemolytic allergic reaction caused by an antigen reaction
D. A hemolytic reaction caused by bacterial contamination of donor blood
C
(A normal platelet count is 140,000 to 400,000/mm3 in adults. Chemotherapeutic agents produce bone marrow
depression, resulting in reduced red blood cell counts (anemia), reduced white blood cell counts (leukopenia), and
reduced platelet counts (thrombocytopenia). Neutropenia is the presence of an abnormally reduced number of
neutrophils in the blood and is caused by bone marrow depression induced by chemotherapeutic agents.)
After receiving chemotherapy for lung cancer, a client's platelet count falls to 98,000/mm3. What term should the nurse use to describe this low
platelet count?
A. Anemia
B. Leukopenia
C. Thrombocytopenia
D. Neutropenia
D
(Intestinal bacteria synthesize such nutritional substances as vitamin K, thiamine, riboflavin, vitamin B12, folic acid,
biotin, and nicotinic acid. Antibiotic therapy may interfere with synthesis of these substances, including vitamin K.
Intestinal bacteria don't synthesize vitamins A, D, or E.)
During preparation for bowel surgery, a client receives an antibiotic to reduce intestinal bacteria. The nurse knows that hypoprothrombinemia may
occur as a result of antibiotic therapy interfering with synthesis of which vitamin?
A. Vitamin A
B. Vitamin D
C. Vitamin E
D. Vitamin K
A
(The client with ITP is at greatest risk for cerebral hemorrhage when the platelet count falls below 10,000/?l. Although
platelet counts of 20,000/?l and 75,000/?l are below normal and increase the client's risk for bleeding, they don't
increase the risk as much as a platelet count below 10,000/?l. A platelet count of 135,000/?l is normal and wouldn't
occur in a client with ITP.)
A client with idiopathic thrombocytopenic purpura (ITP), an autoimmune disorder, is admitted to an acute care facility. Concerned about hemorrhage,
the nurse monitors the client's platelet count and observes closely for signs and symptoms of bleeding. The client is at greatest risk for cerebral
hemorrhage when the platelet count falls below:
A. 10,000/?l.
B. 20,000/?l.
C. 75,000/?l.
D. 135,000/?l.
, C
(Low preoperative HCT and Hb levels indicate the client may require a blood transfusion before surgery. If the HCT
and Hb levels decrease during surgery because of blood loss, the potential need for a transfusion increases. Possible
renal failure is indicated by elevated BUN or creatinine levels. Urine constituents aren't found in the blood. Coagulation
is determined by the presence of appropriate clotting factors, not electrolytes.)
A complete blood count is commonly performed before a client goes into surgery. What does this test seek to identify?
A. Potential hepatic dysfunction indicated by decreased blood urea nitrogen (BUN) and creatinine levels
B. Low levels of urine constituents normally excreted in the urine
C. Abnormally low hematocrit (HCT) and hemoglobin (Hb) levels
D. Electrolyte imbalance that could affect the blood's ability to coagulate properly
C
(For a client with leukemia, the nurse should apply prolonged pressure to needle sites or other sources of external
bleeding. Reduced platelet production results in a delayed clotting process and increases the potential for
hemorrhage. Implementing neutropenic precautions and eliminating direct contact with others are interventions to
address the risk for infection.)
Which nursing intervention should be incorporated into the plan of care to manage the delayed clotting process in a client with leukemia?
A. Implement neutropenic precautions
B. Eliminate direct contact with others who are infectious
C. Apply prolonged pressure to needle sites or other sources of external bleeding
D. Monitor temperature at least once per shift
A
(Myeloid stem cells are responsible not only for all nonlymphoid white blood cells (WBC) but also for the production of
red blood cells and platelets. Lymphoid cells produce either T or B lymphocytes. A monocyte is large WBC that
becomes a macrophage when is leaves the circulation and moves into body tissues. A neutrophil is a fully mature
WBC capable of phagocytosis.)
Which cell of hematopoiesis is responsible for the production of red blood cells (RBCs) and platelets?
A. Myeloid stem cell
B. Lymphoid stem cell
C. Monocyte
D. Neutrophil
B
(Megaloblasts are abnormally large erythrocytes. Blast cells are primitive white blood cells (WBCs). Mast cells are
cells found in connective tissue involved in defense of the body and coagulation. Monocytes are large WBCs that
become macrophages when they leave the circulation and move into body tissues.)
Vitamin B and folic acid deficiencies are characterized by production of abnormally large erythrocytes called
A. Blast cells.
B. Megaloblasts.
C. Mast cells.
D. Monocytes.
B
(Aplastic crisis results from infection with the human parvovirus. Sequestration crisis results when other organs pool
the sickled cells. Sickle cell crisis results from tissue hypoxia and necrosis due to inadequate blood flow to a specific
region of tissue or organ. Acute chest syndrome is manifested by a rapidly decreasing hemoglobin concentration,
tachycardia, fever, and bilateral infiltrates seen on chest x-ray.)
Which type of sickle crisis occurs as a result of infection with the human parvovirus?
A. Sequestration crisis
B. Aplastic crisis
C. Sickle cell crisis
D. Acute chest syndrome
(Hemolytic allergic reactions are fairly common and may cause chills, fever, urticaria, tachycardia, dyspnoea, chest
pain, hypotension, and other signs of anaphylaxis a few minutes after blood transfusion begins. Although rare, a
hemolytic reaction to mismatched blood can occur, triggering a more severe reaction and, possibly, leading to
disseminated intravascular coagulation. A hemolytic reaction to Rh-incompatible blood is less severe and occurs
several days to 2 weeks after the transfusion. Bacterial contamination of donor blood causes a high fever, nausea,
vomiting, diarrhoea, abdominal cramps and, possibly, shock.)
A few minutes after beginning a blood transfusion, a nurse notes that a client has chills, dyspnea, and urticaria. The nurse reports this to the physician
immediately because the client probably is experiencing which problem?
A. A hemolytic reaction to mismatched blood
B. A hemolytic reaction to Rh-incompatible blood
C. A hemolytic allergic reaction caused by an antigen reaction
D. A hemolytic reaction caused by bacterial contamination of donor blood
C
(A normal platelet count is 140,000 to 400,000/mm3 in adults. Chemotherapeutic agents produce bone marrow
depression, resulting in reduced red blood cell counts (anemia), reduced white blood cell counts (leukopenia), and
reduced platelet counts (thrombocytopenia). Neutropenia is the presence of an abnormally reduced number of
neutrophils in the blood and is caused by bone marrow depression induced by chemotherapeutic agents.)
After receiving chemotherapy for lung cancer, a client's platelet count falls to 98,000/mm3. What term should the nurse use to describe this low
platelet count?
A. Anemia
B. Leukopenia
C. Thrombocytopenia
D. Neutropenia
D
(Intestinal bacteria synthesize such nutritional substances as vitamin K, thiamine, riboflavin, vitamin B12, folic acid,
biotin, and nicotinic acid. Antibiotic therapy may interfere with synthesis of these substances, including vitamin K.
Intestinal bacteria don't synthesize vitamins A, D, or E.)
During preparation for bowel surgery, a client receives an antibiotic to reduce intestinal bacteria. The nurse knows that hypoprothrombinemia may
occur as a result of antibiotic therapy interfering with synthesis of which vitamin?
A. Vitamin A
B. Vitamin D
C. Vitamin E
D. Vitamin K
A
(The client with ITP is at greatest risk for cerebral hemorrhage when the platelet count falls below 10,000/?l. Although
platelet counts of 20,000/?l and 75,000/?l are below normal and increase the client's risk for bleeding, they don't
increase the risk as much as a platelet count below 10,000/?l. A platelet count of 135,000/?l is normal and wouldn't
occur in a client with ITP.)
A client with idiopathic thrombocytopenic purpura (ITP), an autoimmune disorder, is admitted to an acute care facility. Concerned about hemorrhage,
the nurse monitors the client's platelet count and observes closely for signs and symptoms of bleeding. The client is at greatest risk for cerebral
hemorrhage when the platelet count falls below:
A. 10,000/?l.
B. 20,000/?l.
C. 75,000/?l.
D. 135,000/?l.
, C
(Low preoperative HCT and Hb levels indicate the client may require a blood transfusion before surgery. If the HCT
and Hb levels decrease during surgery because of blood loss, the potential need for a transfusion increases. Possible
renal failure is indicated by elevated BUN or creatinine levels. Urine constituents aren't found in the blood. Coagulation
is determined by the presence of appropriate clotting factors, not electrolytes.)
A complete blood count is commonly performed before a client goes into surgery. What does this test seek to identify?
A. Potential hepatic dysfunction indicated by decreased blood urea nitrogen (BUN) and creatinine levels
B. Low levels of urine constituents normally excreted in the urine
C. Abnormally low hematocrit (HCT) and hemoglobin (Hb) levels
D. Electrolyte imbalance that could affect the blood's ability to coagulate properly
C
(For a client with leukemia, the nurse should apply prolonged pressure to needle sites or other sources of external
bleeding. Reduced platelet production results in a delayed clotting process and increases the potential for
hemorrhage. Implementing neutropenic precautions and eliminating direct contact with others are interventions to
address the risk for infection.)
Which nursing intervention should be incorporated into the plan of care to manage the delayed clotting process in a client with leukemia?
A. Implement neutropenic precautions
B. Eliminate direct contact with others who are infectious
C. Apply prolonged pressure to needle sites or other sources of external bleeding
D. Monitor temperature at least once per shift
A
(Myeloid stem cells are responsible not only for all nonlymphoid white blood cells (WBC) but also for the production of
red blood cells and platelets. Lymphoid cells produce either T or B lymphocytes. A monocyte is large WBC that
becomes a macrophage when is leaves the circulation and moves into body tissues. A neutrophil is a fully mature
WBC capable of phagocytosis.)
Which cell of hematopoiesis is responsible for the production of red blood cells (RBCs) and platelets?
A. Myeloid stem cell
B. Lymphoid stem cell
C. Monocyte
D. Neutrophil
B
(Megaloblasts are abnormally large erythrocytes. Blast cells are primitive white blood cells (WBCs). Mast cells are
cells found in connective tissue involved in defense of the body and coagulation. Monocytes are large WBCs that
become macrophages when they leave the circulation and move into body tissues.)
Vitamin B and folic acid deficiencies are characterized by production of abnormally large erythrocytes called
A. Blast cells.
B. Megaloblasts.
C. Mast cells.
D. Monocytes.
B
(Aplastic crisis results from infection with the human parvovirus. Sequestration crisis results when other organs pool
the sickled cells. Sickle cell crisis results from tissue hypoxia and necrosis due to inadequate blood flow to a specific
region of tissue or organ. Acute chest syndrome is manifested by a rapidly decreasing hemoglobin concentration,
tachycardia, fever, and bilateral infiltrates seen on chest x-ray.)
Which type of sickle crisis occurs as a result of infection with the human parvovirus?
A. Sequestration crisis
B. Aplastic crisis
C. Sickle cell crisis
D. Acute chest syndrome
