Chapter 31: Caring for Clients with Disorders of the Hematopoietic System Test Questions All Solved And Passed.
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Hematopoietic System
The nurse is currently planning the care of a patient with multiple myeloma who is experiencing bone destruction. When reviewing the patient's most recent blood work, what value would the nurse pay particular attention to?
a. Hypercalcemia
b. Hyperproteinemia
c. Elevated serum viscosity
d. El...
Chapter 31: Caring for Clients with
Disorders of the Hematopoietic System
Test Questions All Solved And Passed.
The nurse is currently planning the care of a patient with multiple myeloma who is experiencing bone
destruction. When reviewing the patient's most recent blood work, what value would the nurse pay
particular attention to?
a. Hypercalcemia
b. Hyperproteinemia
c. Elevated serum viscosity
d. Elevated red blood cell (RBC) count - Answer a
Hypercalcemia may occur when bone destruction occurs due to the disease process. Elevated serum
viscosity occurs because plasma cells excrete excess immunoglobulin. RBC count will be decreased.
Hyperproteinemia would not be present.
A client admitted to the hospital in preparation for a splenectomy to treat autoimmune hemolytic
anemia asks the nurse about the benefits of splenectomy. Which statement best explains the expected
effect of splenectomy?
a. It will remove the major site of red blood cell (RBC) destruction.
b. It will reduce the destruction of platelets by macrophages.
c. It will increase production of platelets by the bone marrow.
d. It will increase red blood cell (RBC) production to compensate for blood loss. - Answer a
For clients with autoimmune hemolytic anemia, if corticosteroids do not produce remission, a
splenectomy (i.e., removal of the spleen) may be performed because it removes the major site of RBC
destruction.
,A critical care nurse is caring for a client with immune hemolytic anemia. The client is not responding to
conservative treatments, and his condition is now becoming life-threatening. The nurse is aware that a
treatment option in this case may include what?
a. Hepatectomy
b. Vitamin K administration
c. Platelet transfusion
d. Splenectomy - Answer d
A splenectomy may be the course of treatment if autoimmune hemolytic anemia does not respond to
conservative treatment. Vitamin K administration is treatment for vitamin K deficiency and does not
resolve anemia. Platelet transfusion may be the course of treatment for some bleeding disorders.
Hepatectomy would not help the patient.
The nurse is assessing a patient who comes to the clinic and reports feeling constantly tired and very
weak. The patient also has a very sore tongue, and upon observing the patient's oral cavity, the nurse
notices the tongue is beefy red. What type of anemia does the nurse know these symptoms indicate?
a. Iron deficiency anemia
b. Megaloblastic anemia
c. Sickle cell anemia
d. Aplastic anemia - Answer b
Weakness, fatigue, and general malaise are common in anemia, as are pallor of the skin and mucous
membranes (conjunctivae, oral mucosa) (Fig. 33-1). Jaundice may be present in patients with
megaloblastic anemia or hemolytic anemia. The tongue may be smooth and red (in iron deficiency
anemia) or beefy red and sore (in megaloblastic anemia).
While assessing a client, the nurse discovers the client has a history of restless leg syndrome. Which
hematological condition does the nurse associate with this condition?
a. Thalassemia
b. Folate deficiency anemia
,c. Sickle cell disease
d. Iron deficiency anemia - Answer d
Restless leg syndrome is common in as many as 24% of those with iron deficiency anemia.
A young mother with a 2 year old and a 6 month old is experiencing fatigue related to anemia. The client
states that she is having difficulty performing the activities needed for her job, family, and home. With
what task is it most appropriate for the nurse to assist the client?
a. Obtaining assistance from someone to help with cleaning in the home.
b. Requesting a leave of absence from her job.
c. Prioritizing and balancing activities and rest.
d. Finding a babysitter to take care of her children. - Answer c
Fatigue is the most common symptom and complication of anemia. The nurse should assist the client to
prioritize activities and to establish a balance between activity and rest that the client finds acceptable.
With the other options, the nurse is jumping to conclusions that these things will help the client.
The nurse is assessing a client who lives in a community that is at a very high altitude. When reviewing
the client's most recent laboratory values, the nurse notes that the client has elevated red blood cell
levels. The client denies having any unwanted symptoms. What is the nurse's best response?
a. Document the assessment finding.
b. Promptly inform the primary care provider.
c. Perform a focused cardiovascular assessment.
d. Monitor vital signs every 4 hours. - Answer a
For people who live at high altitudes, erythrocytosis is a normal phenomenon and usually requires no
treatment. Further referrals or assessments are likely unnecessary.
The nurse on the pediatric unit is caring for a 10-year-old boy with a diagnosis of hemophilia. The nurse
should assess carefully for indication of what nursing diagnosis?
, a. Hypothermia
b. Diarrhea
c. Ineffective coping
d. Imbalanced nutrition: Less than body requirements - Answer c
Most clients with hemophilia are diagnosed as children. They often require assistance in coping with the
condition because it is chronic, places restrictions on their lives, and is an inherited disorder that can be
passed to future generations. Children with hemophilia are not at risk of hypothermia, diarrhea, or
imbalanced nutrition.
A client lives with a diagnosis of sickle cell disease and receives frequent blood transfusions. The nurse
should recognize the client's consequent risk of what complication of treatment?
a. Hypovolemia
b. Vitamin B12 deficiency
c. Thrombocytopenia
d. Iron overload - Answer d
Clients with chronic transfusion requirements can quickly acquire more iron than they can use, leading
to iron overload. These individuals are not at risk for hypovolemia and there is no consequent risk for
low platelet or vitamin B12 levels.
A patient with chronic anemia has had many blood transfusions over the last 3 years. What type of
transfusion reaction should the nurse monitor for that is commonly found in patients who frequently
receive blood transfusions?
a. Allergic reactions
b. Acute hemolytic reaction
c. Circulatory overload
d. Febrile nonhemolytic reactions - Answer d
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