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Lewis: MED-SURG: Chapter 31: Hematologic Problems NCLEX Detailed Questions and Expert Answers
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Lewis: MED-SURG: Chapter 31: Hematologic Problems NCLEX Detailed Questions and Expert Answers
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Lewis: MED-SURG: Chapter 31: HematologicProblems NCLEX Detailed Questions and Expert
Answers
In a severely anemic patient, the nurse would expect to find
a. dyspnea and tachycardia.
b. cyanosis and pulmonary edema.
c. cardiomegaly and pulmonary edema.
d. ventricular dysrhythmias and wheezing. - ANS a
When obtaining assessment data from a patient with a microcytic, hypochromic
anemia, the nurse would question the patient about
a. folic acid intake.
b. dietary intake of iron
c. a history of gastric surgery
d. a history of sickle cell anemia - ANS b
Nursing interventions for a patient with severe anemia related to peptic ulcer
disease include (select all that apply)
a. monitoring stools for guaiac.
b. instructions for high-iron diet.
c. taking vital signs every 8 hours.
d. teaching self-injection of erythropoietin.
,e. administering of cobalamin (vitamin B12) injections. - ANS a
The nursing management of a patient in sickle cell crisis includes (select all that
apply)
a. monitoring CBC.
b. optimal pain management and O2 therapy.
c. blood transfusions if required and iron chelation.
d. rest as needed and deep vein thrombosis prophylaxis.
e. administration of IV iron and diet high in iron content. - ANS a, b, c, d
A complication of the hyperviscosity of polycythemia is
a. thrombis.
b. cardiomyopathy.
c. pulmonary edema.
d. disseminated intravascular coagulation (DIC). - ANS a
When caring for a patient with thrombocytopenia, the nurse instructs the patient
to
a. dab his or her nose instead of blowing.
b. be careful when shaving with a safety razor.
c. continue with physical activities to stimulate thrombopoiesis.
d. avoid aspirin because it may mask the fever that occurs with thrombocytopenia.
- ANS a
, The nurse would anticipate that a patient with von Willebrand disease undergoing
surgery would be treated with administration of vWF and
a. thrombin.
b. factor VI.
c. factor VII.
d. factor VIII. - ANS d
DIC is a disorder in which
a. the coagulation pathway is genetically altered, leading to thrombus formation in
all major blood vessels.
b. an underlying disease depletes hemolytic factors in the blood, leading to diffuse
thrombotic episodes and infarcts.
c. a disease process stimulates coagulation processes with resultant thrombosis, as
well as depletion of clotting factors, leading to diffuse clotting and hemorrhage.
d. an inherited predisposition causes a deficiency of clotting factors that leads to
overstimulation of coagulation processes in the vasculature. - ANS c
Priority nursing actions when caring for a hospitalized patient with a new-onset
temperature of 102.2 F and severe neutropenia include (select all that apply)
a. administering the prescribed antibiotic STAT.
b. drawing peripheral and central line blood cultures.
c. ongoing monitoring of the patient's vital signs for septic shock.
d. taking a full set of vital signs and notifying the physician immediately.
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