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Worksheets216 Hematology
Total questions: 100
Worksheet time: 1hrs 15mins
Name
Class
Date
1.
The nurse is caring for a patient who is being discharged after an emergency splenectomy following an automobile accident. Which instructions should the nurse include in the discharge teaching?
a)
Watch for excess bruising.
b)
Check for swollen lymph nodes.
c)
Take iron supplements to prevent anemia.
d)
Wash hands and avoid persons who are ill.
2.
A nurse reviews the laboratory data for an older patient. The nurse would be mostconcerned about which finding?
a)
Hematocrit of 35%
b)
Hemoglobin of 11.8 g/dL
c)
Platelet count of 400,000/µL
d)
White blood cell (WBC) count of 2800/µL
3.
A patient with pancytopenia has a bone marrow aspiration from the left posterior iliac crest. Which action would be important for the nurse to take after the procedure?
a)
Elevate the head of the bed to 45 degrees.
b)
Apply a sterile 2-inch gauze dressing to the site.
c)
Use a half-inch sterile gauze to pack the wound.
d)
Have the patient lie on the left side for 1 hour.
4.
The nurse assesses a patient with pernicious anemia. Which assessment finding would the nurse expect?
a)
Yellow-tinged sclerae
b)
Shiny, smooth tongue
c)
Numbness of the extremities
d)
Gum bleeding and tenderness
5.
The nurse is reviewing laboratory results and notes an aPTT level of 28 seconds. The nurse should notify the health care provider in anticipation of adjusting which medication?
a)
Aspirin
b)
Heparin
c)
Warfarin
d)
Erythropoeitin
6.
The nurse examines the lymph nodes of a patient during a physical assessment. Which assessment finding would be of most concern to the nurse?
a)
A 2-cm nontender supraclavicular node
b)
A 1-cm mobile and nontender axillary node
c)
An inability to palpate any superficial lymph nodes
d)
Firm inguinal nodes in a patient with an infected foot
7.
A patient who had a total hip replacement had an intraoperative hemorrhage 14 hours ago. Which laboratory result would the nurse expect to find?
a)
Hematocrit of 46%
b)
Hemoglobin of 13.8 g/dL
c)
Elevated reticulocyte count
d)
Decreased white blood cell (WBC) count
8.
The complete blood count (CBC) indicates that a patient is thrombocytopenic. Which action should the nurse include in the plan of care?
a)
Avoid intramuscular injections.
b)
Encourage increased oral fluids.
c)
Check temperature every 4 hours.
d)
Increase intake of iron-rich foods.
9.
The health care provider’s progress note for a patient states that the complete blood count (CBC) shows a “shift to the left.” Which assessment finding will the nurse expect?
a)
Cool extremities
b)
Pallor and weakness
c)
Elevated temperature
d)
Low oxygen saturation
10.
Which menu choice indicates that the patient understands the nurse’s teaching about bestdietary choices for iron-deficiency anemia?
a)
Omelet and whole wheat toast
b)
Cantaloupe and cottage cheese
c)
Strawberry and banana fruit plate
d)
Cornmeal muffin and orange juice
11.
A 52-year-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, “I
a)
need to start eating more red meat and liver.”
b)
will stop having a glass of wine with dinner.”
c)
could choose nasal spray rather than injections of vitamin B12.”
d)
will need to take a proton pump inhibitor like omeprazole (Prilosec).”
12.
An appropriate nursing intervention for a hospitalized patient with severe hemolytic anemia is 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.
13.
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.”
d)
“I should increase my fluid and fiber intake while I am taking iron tablets.”
14.
It is important for the nurse providing care for a patient with sickle cell crisis to
a)
limit the patient’s intake of oral and IV fluids.
b)
evaluate the effectiveness of opioid analgesics.
c)
encourage the patient to ambulate as much as tolerated.
d)
teach the patient about high-protein, high-calorie foods.
15.
A critical action by the nurse caring for a patient with an acute exacerbation of polycythemia vera is to
a)
place the patient on bed rest.
b)
administer iron supplements.
c)
avoid use of aspirin products.
d)
monitor fluid intake and output.
16.
Which intervention will be included in the nursing care plan for a patient with immune thrombocytopenic purpura (ITP)?
a)
Assign the patient to a private room.
b)
Avoid intramuscular (IM) injections.
c)
Use rinses rather than a soft toothbrush for oral care.
d)
Restrict activity to passive and active range of motion.
17.
The nurse caring for a patient with type A hemophilia being admitted to the hospital with severe pain and swelling in the right knee will
a)
immobilize the joint.
b)
apply heat to the knee.
c)
assist the patient with light weight bearing.
d)
perform passive range of motion to the knee.
18.
A 28-year-old man with von Willebrand disease is admitted to the hospital for minor knee surgery. The nurse will review the coagulation survey to check the
a)
platelet count.
b)
bleeding time.
c)
thrombin time.
d)
prothrombin time.
19.
Which action will the admitting nurse include in the care plan for a 30-year old woman who is neutropenic?
a)
Avoid any injections.
b)
Check temperature every 4 hours.
c)
Omit fruits or vegetables from the diet.
d)
Place a “No Visitors” sign on the door.
20.
Which information obtained by the nurse caring for a patient with thrombocytopenia should be immediately communicated to the health care provider?
a)
The platelet count is 52,000/µL.
b)
The patient is difficult to arouse.
c)
There are purpura on the oral mucosa.
d)
There are large bruises on the patient’s back.
21.
A patient in the emergency department complains of back pain and difficulty breathing 15 minutes after a transfusion of packed red blood cells is started. The nurse’s first action should be to
a)
administer oxygen therapy at a high flow rate.
b)
obtain a urine specimen to send to the laboratory.
c)
notify the health care provider about the symptoms.
d)
disconnect the transfusion and infuse normal saline.
22.
Which patient requires the most rapid assessment and care by the emergency department nurse?
a)
The patient with hemochromatosis who reports abdominal pain
b)
The patient with neutropenia who has a temperature of 101.8° F
c)
The patient with sickle cell anemia who has had nausea and diarrhea for 24 hours
d)
The patient with thrombocytopenia who has oozing after having a tooth extracted
23.
Which problem reported by a patient with hemophilia is most important for the nurse to communicate to the physician?
a)
Leg bruises
b)
Tarry stools
c)
Skin abrasions
d)
Bleeding gums
24.
Which action will the nurse include in the plan of care for a patient who has thalassemia major?
a)
Teach the patient to use iron supplements.
b)
Avoid the use of intramuscular injections.
c)
Administer iron chelation therapy as needed.
d)
Notify health care provider of hemoglobin 11g/dL.
25.
The manifestation the nurse would question the client about that is characteristically associated with anemia is
a)
fatigue.
b)
pruritus.
c)
rash.
d)
ruddy skin color
26.
A client has anaphylaxis. Which action by the nurse takes highest priority?
a)
Administering oxygen
b)
Giving epinephrine
c)
Maintaining an open airway
d)
Starting an IV
27.
The nurse explains that in step 1 (sensitization) of becoming allergic, the body,
a)
develops immunoglobulin E (IgE) antibodies.
b)
forms mast cells.
c)
produces basophils.
d)
reacts with rhinitis, urticaria, asthma, or gastrointestinal (GI) manifestations.
28.
The nurse understands the most significant laboratory study for the client who is HIV positive is the
a)
CD4+ cell count.
b)
enzyme-linked immunosorbent assay (ELISA) test.
c)
total white blood cell count.
d)
Western blot test.
29.
A client is afraid of a recent possible HIV exposure. The nurse should explain that the period of time it takes before HIV antibodies can be detected by laboratory tests is generally
a)
1 to 3 days.
b)
7 to 10 days.
c)
1 to 3 weeks.
d)
4 to 12 weeks.
30.
The nurse is assessing a client with AIDS for the presence of Kaposi’s sarcoma (KS). The manifestation the nurse should look for is a
a)
crusty lesion on the back and groin.
b)
purple-red lesion on the body.
c)
pustular lesion with yellow exudate.
d)
thick, white exudate in the mouth.
31.
The client who has a positive enzyme immunoassay test asks the nurse if that means that he is HIV positive. The nurse’s most helpful response would be
a)
“No, many people have positive enzyme immunoassays.”
b)
“No, you need to have the Western blot test to confirm that you are positive.”
c)
“Yes, but antiretrovirals will probably combat the infection now.”
d)
“Yes, you should seek medical care for antiretroviral drugs.”
32.
The nurse providing direct client care uses specific practices to reduce the chance of acquiring infection with human immune deficiency virus (HIV) from clients. Which practice is most effective?
a)
Consistent use of Standard Precautions
b)
Double-gloving before body fluid exposure
c)
Labeling charts and armbands “HIV+”
d)
Wearing a mask within 3 feet of the client
33.
A nurse is talking with a client about a negative enzyme-linked immunosorbent assay (ELISA) test for human immune deficiency virus (HIV) antibodies. The test is negative and the client states “Whew! I was really worried about that result.” What action by the nurse is most important?
a)
Assess the client’s sexual activity and patterns.
b)
Express happiness over the test result.
c)
Remind the client about safer sex practices.
d)
Tell the client to be retested in 3 months.
34.
A client with HIV wasting syndrome has inadequate nutrition. What assessment finding by the nurse best indicates that goals have been met for this client problem?
a)
Chooses high-protein food
b)
Has decreased oral discomfort
c)
Eats 90% of meals and snacks
d)
Has a weight gain of 2 pounds/1 month
35.
A nurse caring for a client with sickle cell disease (SCD) reviews the client’s laboratory work. Which finding should the nurse report to the provider?
a)
Creatinine: 2.9 mg/dL
b)
Hematocrit: 30%
c)
Sodium: 147 mEq/L
d)
White blood cell count: 12,000/mm3
36.
A client has a serum ferritin level of 8 ng/mL and microcytic red blood cells. What action by the nurse is best?
a)
Encourage high-protein foods.
b)
Perform a Hemoccult test on the client’s stools.
c)
Offer frequent oral care.
d)
Prepare to administer cobalamin (vitamin B12).
37.
A client receiving a blood transfusion develops anxiety and low back pain. After stopping the transfusion, what action by the nurse is most important?
a)
Documenting the events in the client’s medical record
b)
Double-checking the client and blood product identification
c)
Placing the client on strict bedrest until the pain subsides
d)
Reviewing the client’s medical record for known allergies
38.
A client has thrombocytopenia. What client statement indicates the client understands self-management of this condition?
a)
“I brush and use dental floss every day.”
b)
“I chew hard candy for my dry mouth.”
c)
“I usually put ice on bumps or bruises.”
d)
“Nonslip socks are best when I walk.”
39.
A man suffers a leg wound which causes minor blood loss. As a result of bleeding, the process of primary hemostasis is activated. What occurs in primary hemostasis?
a)
Severed blood vessels constrict.
b)
Thromboplastin is released.
c)
Prothrombin is converted to thrombin.
d)
Fibrin is lysed.
40.
The nurse is describing the role of plasminogen in the clotting cascade. Where in the body is plasminogen present?
a)
Myocardial muscle tissue
b)
All body fluids
c)
Cerebral tissue
d)
Venous and arterial vessel walls
41.
A patient’s wound has begun to heal and the blood clot which formed is no longer necessary. When a blood clot is no longer needed, the fibrinogen and fibrin will be digested by which of the following?
a)
Plasminogen
b)
Thrombin
c)
Prothrombin
d)
Plasmin
42.
A patient undergoing a hip replacement has autologous blood on standby if a transfusion is needed. What is the primary advantage of autologous transfusions?
a)
Safe transfusion for patients with a history of transfusion reactions
b)
Prevention of viral infections from another person’s blood
c)
Avoidance of complications in patients with alloantibodies
d)
Prevention of alloimmunization
43.
The nurse is describing normal RBC physiology to a patient who has a diagnosis of anemia. The nurse should explain that the RBCs consist primarily of which of the following?
a)
Plasminogen
b)
Hemoglobin
c)
Hematocrit
d)
Fibrin
44.
The nurse educating a patient with anemia is describing the process of RBC production. When the patient’s kidneys sense a low level of oxygen in circulating blood, what physiologic response is initiated?
a)
Increased stem cell synthesis
b)
Decreased respiratory rate
c)
Arterial vasoconstriction
d)
Increased production of erythropoietin
45.
A patient is being treated for the effects of a longstanding vitamin B12 deficiency. What aspect of the patient’s health history would most likely predispose her to this deficiency?
a)
The patient has irregular menstrual periods.
b)
The patient is a vegan.
c)
The patient donated blood 60 days ago.
d)
The patient frequently smokes marijuana.
46.
The nurse’s review of a patient’s most recent blood work reveals a significant increase in the number of band cells. The nurse’s subsequent assessment should focus on which of the following?
a)
Respiratory function
b)
Evidence of decreased tissue perfusion
c)
Signs and symptoms of infection
d)
Recent changes in activity tolerance
47.
A nurse is educating a patient about the role of B lymphocytes. The nurse’s description will include which of the following physiologic processes?
a)
Stem cell differentiation
b)
Cytokine production
c)
Phagocytosis
d)
Antibody production
48.
An individual has accidentally cut his hand, immediately initiating the process of hemostasis. Following vasoconstriction, what event in the process of hemostasis will take place?
a)
Fibrin will be activated at the bleeding site.
b)
Platelets will aggregate at the injury site.
c)
Thromboplastin will form a clot.
d)
Prothrombin will be converted to thrombin.
49.
A client’s health history reveals daily consumption of two to three bottles of wine. The nurse should plan assessments and interventions in light of the patient’s increased risk for what hematologic disorder?
a)
Leukemia
b)
Anemia
c)
Thrombocytopenia
d)
Lymphoma
50.
A patient has been scheduled for a bone marrow biopsy and admits to the nurse that she is worried about the pain involved with the procedure. What patient education is most accurate?
a)
You’ll be given painkillers before the test, so there won’t likely be any pain.
b)
You’ll feel some pain when the needle enters your skin, but none when the needle enters the bone because of the absence of nerves in bone.
c)
Most people feel some brief, sharp pain when the needle enters the bone.
d)
I’ll be there with you, and I’ll try to help you keep your mind off the pain.
51.
The nurse’s brief review of a patient’s electronic health record indicates that the patient regularly undergoes therapeutic phlebotomy. Which of the following rationales for this procedure is most plausible?
a)
The patient may chronically produce excess red blood cells.
b)
The patient may frequently experience a low relative plasma volume.
c)
The patient may have impaired stem cell function.
d)
The patient may previously have undergone bone marrow biopsy.
52.
A patient on the medical unit is receiving a unit of PRBCs. Difficult IV access has necessitated a slow infusion rate and the nurse notes that the infusion began 4 hours ago. What is the nurse’s most appropriate action?
a)
Apply an icepack to the blood that remains to be infused.
b)
Discontinue the remainder of the PRBC transfusion and inform the physician.
c)
Disconnect the bag of PRBCs, cool for 30 minutes and then administer.
d)
Administer the remaining PRBCs by the IV direct (IV push) route.
53.
A patient is receiving a blood transfusion and complains of a new onset of slight dyspnea. The nurse’s rapid assessment reveals bilateral lung crackles and elevated BP. What is the nurse’s most appropriate action?
a)
Slow the infusion rate and monitor the patient closely.
b)
Discontinue the transfusion and begin resuscitation.
c)
Pause the transfusion and administer a 250 mL bolus of normal saline.
d)
Discontinue the transfusion and administer a beta-blocker, as ordered.
54.
The nurse is preparing to administer a unit of platelets to an adult patient. When administering this blood product, which of the following actions should the nurse perform?
a)
Administer the platelets as rapidly as the patient can tolerate.
b)
Establish IV access as soon as the platelets arrive from the blood bank.
c)
Ensure that the patient has a patent central venous catheter.
d)
Aspirate 10 to 15 mL of blood from the patient’s IV immediately following the transfusion.
55.
A patient’s electronic health record states that the patient receives regular transfusions of factor IX. The nurse would be justified in suspecting that this patient has what diagnosis?
a)
Leukemia
b)
Hemophilia
c)
Hypoproliferative anemia
d)
Hodgkin’s lymphoma
56.
A nurse is providing education to a patient with iron deficiency anemia who has been prescribed iron supplements. What should the nurse include in health education?
a)
Take the iron with dairy products to enhance absorption.
b)
Increase the intake of vitamin E to enhance absorption.
c)
Iron will cause the stools to darken in color.
d)
Limit foods high in fiber due to the risk for diarrhea.
57.
The nurse is assessing a new patient with complaints of overwhelming fatigue and a sore tongue that is visibly smooth and beefy red. This patient is demonstrating signs and symptoms associated with what form of what hematologic disorder?
a)
Sickle cell anemia
b)
Hemophilia
c)
Megaloblastic anemia
d)
Thrombocytopenia
58.
A patient with renal failure has decreased erythropoietin production. Upon analysis of the patient’s complete blood count, the nurse will expect which of the following results?
a)
An increased hemoglobin and decreased hematocrit
b)
A decreased hemoglobin and hematocrit
c)
A decreased mean corpuscular volume (MCV) and red cell distribution width (RDW)
d)
An increased MCV and RDW
59.
A patient comes to the clinic complaining of fatigue and the health interview is suggestive of pica. Laboratory findings reveal a low serum iron level and a low ferritin level. With what would the nurse suspect that the patient will be diagnosed?
a)
Iron deficiency anemia
b)
Pernicious anemia
c)
Sickle cell anemia
d)
Hemolytic anemia
60.
A patient comes into the clinic complaining of fatigue. Blood work shows an increased bilirubin concentration and an increased reticulocyte count. What would the nurse suspect the patient has?
a)
A hypoproliferative anemia
b)
A leukemia
c)
Thrombocytopenia
d)
A hemolytic anemia
61.
A patient is admitted to the hospital with pernicious anemia. The nurse should prepare to administer which of the following medications?
a)
Folic acid
b)
Vitamin B12
c)
Lactulose
d)
Magnesium sulfate
62.
A patient’s blood work reveals a platelet level of 17,000/mm3. When inspecting the patient’s integumentary system, what finding would be most consistent with this platelet level?
a)
Dermatitis
b)
Petechiae
c)
Urticaria
d)
Alopecia
63.
An adult patient has been diagnosed with iron-deficiency anemia. What nursing diagnosis is most likely to apply to this patient’s health status?
a)
Risk for deficient fluid volume related to impaired erythropoiesis
b)
Risk for infection related to tissue hypoxia
c)
Acute pain related to uncontrolled hemolysis
d)
Fatigue related to decreased oxygen-carrying capacity
64.
A woman who is in her third trimester of pregnancy has been experiencing an exacerbation of iron-deficiency anemia in recent weeks. When providing the patient with nutritional guidelines and meal suggestions, what foods would be most likely to increase the woman’s iron stores?
a)
Salmon accompanied by whole milk
b)
Mixed vegetables and brown rice
c)
Beef liver accompanied by orange juice
d)
Yogurt, almonds, and whole grain oats
65.
A nurse is planning the care of a patient with a diagnosis of sickle cell disease who has been admitted for the treatment of an acute vaso-occlusive crisis. What nursing diagnosis should the nurse prioritize in the patient’s plan of care?
a)
Risk for disuse syndrome related to ineffective peripheral circulation
b)
Functional urinary incontinence related to urethral occlusion
c)
Ineffective tissue perfusion related to thrombosis
d)
Ineffective thermoregulation related to hypothalamic dysfunction
66.
The medical nurse is aware that patients with sickle cell anemia benefit from understanding what situations can precipitate a sickle cell crisis. When teaching a patient with sickle cell anemia about strategies to prevent crises, what measures should the nurse recommend?
a)
Using prophylactic antibiotics and performing meticulous hygiene
b)
Maximizing physical activity and taking OTC iron supplements
c)
Limiting psychosocial stress and eating a high-protein diet
d)
Avoiding cold temperatures and ensuring sufficient hydration
67.
A patient with a documented history of glucose-6-phosphate dehydrogenase deficiency has presented to the emergency department with signs and symptoms including pallor, jaundice, and malaise. Which of the nurse’s assessment questions relates most directly to this patient’s hematologic disorder?
a)
When did you last have a blood transfusion?
b)
What medications have taken recently?
c)
Have you been under significant stress lately?
d)
Have you suffered any recent injuries?
68.
A patient’s absolute neutrophil count (ANC) is 440/mm3. But the nurse’s assessment reveals no apparent signs or symptoms of infection. What action should the nurse prioritize when providing care for this patient?
a)
Meticulous hand hygiene
b)
Timely administration of antibiotics
c)
Provision of a nutrient-dense diet
d)
Maintaining a sterile care environment
69.
A young man with a diagnosis of hemophilia A has been brought to emergency department after suffering a workplace accident resulting in bleeding. Rapid assessment has revealed the source of the patient’s bleeding and established that his vital signs are stable. What should be the nurse’s next action?
a)
Position the patient in a prone position to minimize bleeding.
b)
Establish IV access for the administration of vitamin K.
c)
Prepare for the administration of factor VIII.
d)
Administer a normal saline bolus to increase circulatory volume.
70.
A patient with Von Willebrand disease (vWD) has experienced recent changes in bowel function that suggest the need for a screening colonoscopy. What intervention should be performed in anticipation of this procedure?
a)
The patient should not undergo the normal bowel cleansing protocol prior to the procedure.
b)
The patient should receive a unit of fresh-frozen plasma 48 hours before the procedure.
c)
The patient should be admitted to the surgical unit on the day before the procedure.
d)
The patient should be given necessary clotting factors before the procedure.
71.
An intensive care nurse is aware of the need to identify patients who may be at risk of developing disseminated intravascular coagulation (DIC). Which of the following ICU patients most likely faces the highest risk of DIC?
a)
A patient with extensive burns
b)
A patient who has a diagnosis of acute respiratory distress syndrome
c)
A patient who suffered multiple trauma in a workplace accident
d)
A patient who is being treated for septic shock
72.
During a mumps outbreak at a local school, a patient, who is a school teacher, is exposed. She has previously been immunized for mumps. What type of immunity does she possess?
a)
Acquired immunity
b)
Natural immunity
c)
Phagocytic immunity
d)
Humoral immunity
73.
A gardener sustained a deep laceration while working and requires sutures. The patient is asked about the date of her last tetanus shot, which is over 10 years ago. Based on this information, the patient will receive a tetanus immunization. The tetanus injection will allow for the release of what?
a)
Antibodies
b)
Antigens
c)
Cytokines
d)
Phagocytes
74.
An infection control nurse is presenting an inservice reviewing the immune response. The nurse describes the clumping effect that occurs when an antibody acts like a cross-link between two antigens. What process is the nurse explaining?
a)
Agglutination
b)
Cellular immune response
c)
Humoral response
d)
Phagocytic immune response
75.
A nurse has administered a child’s scheduled vaccination for rubella. This vaccination will cause the child to develop which of the following?
a)
Natural immunity
b)
Active acquired immunity
c)
Cellular immunity
d)
Mild hypersensitivity
76.
A 16-year-old has been brought to the emergency department by his parents after falling through the glass of a patio door, suffering a laceration. The nurse caring for this patient knows that the site of the injury will have an invasion of what?
a)
Interferons
b)
Phagocytic cells
c)
Apoptosis
d)
Cytokines
77.
A patient is being treated for bacterial pneumonia. In the first stages of illness, the patient’s dyspnea was accompanied by a high fever. Currently, the patient claims to be feeling better and is afebrile. The patient is most likely in which stage of the immune response?
a)
Recognition stage
b)
Proliferation stage
c)
Response stage
d)
Effector stage
78.
A patient’s injury has initiated an immune response that involves inflammation. What are the first cells to arrive at a site of inflammation?
a)
Eosinophils
b)
Red blood cells
c)
Lymphocytes
d)
Neutrophils
79.
A nurse is planning a patient’s care and is relating it to normal immune response. During what stage of the immune response should the nurse know that antibodies or cytotoxic T cells combine and destroy the invading microbes?
a)
Recognition stage
b)
Proliferation stage
c)
Response stage
d)
Effector stage
80.
A nurse is admitting a patient who exhibits signs and symptoms of a nutritional deficit. Inadequate intake of what nutrient increases a patient’s susceptibility to infection?
a)
Vitamin B12
b)
Unsaturated fats
c)
Proteins
d)
Complex carbohydrates
81.
A nurse is explaining the process by which the body removes cells from circulation after they have performed their physiologic function. The nurse is describing what process?
a)
The cellular immune response
b)
Apoptosis
c)
Phagocytosis
d)
Opsonization
82.
A patient is admitted with cellulitis and experiences a consequent increase in white blood cell count. The nurse is aware that during the immune response, pathogens are engulfed by white blood cells that ingest foreign particles. What is this process known as?
a)
Apoptosis
b)
Phagocytosis
c)
Antibody response
d)
Cellular immune response
83.
A patient is responding to a microbial invasion and the patient’s differentiated lymphocytes have begun to function in either a humoral or a cellular capacity. During what stage of the immune response does this occur?
a)
The recognition stage
b)
The effector stage
c)
The response stage
d)
The proliferation stage
84.
A nurse is reviewing the immune system before planning an immunocompromised patient’s care. How should the nurse characterize the humoral immune response?
a)
Specialized cells recognize and ingest cells that are recognized as foreign.
b)
T lymphocytes are assisted by cytokines to fight infection.
c)
Lymphocytesare stimulated to become cells that attack microbes directly.
d)
Antibodies are made by B lymphocytes in response to a specific antigen.
85.
Diagnostic testing has revealed a deficiency in the function of a patient’s complement system. This patient is likely to have an impaired ability to do which of the following?
a)
Protecting the body against viral infection
b)
Marking the parameters of the immune response
c)
Bridging natural and acquired immunity
d)
Collecting immune complexes during inflammation
86.
A patient’s current immune response involves the direct destruction of foreign microorganisms. This aspect of the immune response may be performed by what cells?
a)
Suppressor T cells
b)
Memory T cells
c)
Cytotoxic T cells
d)
Complement T cells
87.
A patient was recently exposed to infectious microorganisms and many T lymphocytes are now differentiating into killer T cells. This process characterizes what stage of the immune response?
a)
Effector
b)
Proliferation
c)
Response
d)
Recognition
88.
A patient’s recent diagnostic testing included a total lymphocyte count. The results of this test will allow the care team to gauge what aspect of the patient’s immunity?
a)
Humoral immune function
b)
Antigen recognition
c)
Cell-mediated immune function
d)
Antibody production
89.
A clinic nurse is caring for a patient admitted with AIDS. The nurse has assessed that the patient is experiencing a progressive decline in cognitive, behavioral, and motor functions. The nurse recognizes that these symptoms are most likely related to the onset of what complication?
a)
HIV encephalopathy
b)
B-cell lymphoma
c)
Kaposi’s sarcoma
d)
Wasting syndrome
90.
A nurse is working with a patient who was diagnosed with HIV several months earlier. The nurse should recognize that a patient with HIV is considered to have AIDS at the point when the CD4+ T-lymphocyte cell count drops below what threshold?
a)
75 cells/mm3 of blood
b)
200 cells/mm3 of blood
c)
325 cells/mm3 of blood
d)
450 cells/mm3 of blood
91.
During the admission assessment of an HIV-positive patient whose CD4+ count has recently fallen, the nurse carefully assesses for signs and symptoms related to opportunistic infections. What is the most common life-threatening infection?
a)
Salmonella infection
b)
Mycobacterium tuberculosis
c)
Clostridium difficile
d)
Pneumocystis pneumonia
92.
A patient was tested for HIV using enzyme immunoassay (EIA) and results were positive. The nurse should expect the primary care provider to order what test to confirm the EIA test results?
a)
Another EIA test
b)
Viral load test
c)
Western blot test
d)
CD4/CD8 ratio
93.
An 18-year-old pregnant female has tested positive for HIV and asks the nurse if her baby is going to be born with HIV. What is the nurse’s best response?
a)
There is no way to know that for certain, but we do know that your baby has a one in four chance of being born with HIV.
b)
Your physician is likely the best one to ask that question.
c)
If the baby is HIV positive there is nothing that can be done until it is born, so try your best not to worry about it now.
d)
It’s possible that your baby could contract HIV, either before, during, or after delivery.
94.
A nurse is caring for a teenage girl who has had an anaphylactic reaction after a bee sting. The nurse is providing patient teaching prior to the patient’s discharge. In the event of an anaphylactic reaction, the nurse informs the patient that she should self-administer epinephrine in what site?
a)
forearm
b)
thigh
c)
deltoid muscle
d)
abdomen
95.
A child is undergoing testing for food allergies after experiencing unexplained signs and symptoms of hypersensitivity. What food items would the nurse inform the parents are common allergens?
a)
Citrus fruits and rice
b)
Root vegetables and tomatoes
c)
Eggs and wheat
d)
Hard cheeses and vegetable oils
96.
A patient has been admitted to the emergency department with signs of anaphylaxis following a bee sting. The nurse knows that if this is a true allergic reaction the patient will present with what alteration in laboratory values?
a)
Increased eosinophils
b)
Increased neutrophils
c)
Increased serum albumin
d)
Decreased blood glucose
97.
The nurse is teaching parents about the importance of iron in a toddler’s diet. Which explains why iron deficiency anemia is common during toddlerhood?
a)
Milk is a poor source of iron.
b)
Iron cannot be stored during fetal development.
c)
Fetal iron stores are depleted by age 1 month.
d)
Dietary iron cannot be started until age 12 months.
98.
Which should the nurse include when teaching the mother of a 9-month-old infant about administering liquid iron preparations?
a)
They should be given with meals.
b)
They should be stopped immediately if nausea and vomiting occur.
c)
Adequate dosage will turn the stools a tarry green color.
d)
Allow preparation to mix with saliva and bathe the teeth before swallowing.
99.
When both parents have sickle cell trait, which is the chance their children will have sickle cell anemia?
a)
25%
b)
50%
c)
75%
d)
100%
100.
A school-age child is admitted in vasoocclusive sickle cell crisis. The child’s care should include:
a)
correction of acidosis.
b)
adequate hydration and pain management.
c)
pain management and administration of heparin.
d)
adequate oxygenation and replacement of factor VIII.
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