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Ch 47: Care of the Patient With a Blood or Lymphatic Disorder

Total questions: 47

Worksheet time: 27mins

Name
Class
Date
1.

Which is the process by which certain cells engulf and digest microorganisms and cellular debris?

a)

Erythrocytosis

b)

Hematocrit

c)

Phagocytosis

d)

Hemostasis

2.

The nurse explains that because it is a reliable and predictable indicator of the body’s level of infection or recovery, which is a common diagnostic tool?

a)

hemoglobin

b)

hematocrit

c)

mean cell volume (MCV)

d)

differential

3.

The nurse assessing a differential sees an increase in immature neutrophils (bands) and is aware that this indicates which concern?

a)

a significant hemorrhage.

b)

aplastic anemia.

c)

an infection or stress.

d)

beginning recovery from an infection.

4.

B cells and T cells fit under which classification?

a)

Erythrocytes

b)

Basophils

c)

Lymphocytes

d)

Monocytes

5.

The nurse is reading the results of a white blood cell count differential. Which abnormal reading indicates a severe allergic reaction?

a)

Increased basophil count

b)

Increased lymphocyte count

c)

Increased monocyte count

d)

Increased neutrophil count

6.

The presence of excess bands in the peripheral blood that indicate severe infection is indicated in which manner?

a)

shift to the left.

b)

shift to the right.

c)

bone marrow aspiration.

d)

thrombocytosis.

7.

A patient has been diagnosed with pernicious anemia. When reinforcing instructions, the nurse explains this disorder results from which process?

a)

Poor nutritional intake of iron

b)

Lack of the intrinsic factor

c)

Blood loss due to hemorrhage

d)

Excess production of red blood cells

8.

Erythropoiesis is the term referring to which process?

a)

Destruction of older red blood cells

b)

Lack of folic acid to create new red blood cells

c)

Releasing white blood cells in response to infection

d)

Production of new red blood cells in the bone marrow

9.

Which does the elevation in the eosinophil count to 10% indicate?

a)

Anemia

b)

Allergy

c)

Infection

d)

Hypoxia

10.

Which would a nurse reinforce in a teaching plan for a home health patient with a hemoglobin of 8.4 mg?

a)

Exercising for periods of 30 minutes daily

b)

Limiting fluid intake

c)

Alternating activity with rest periods

d)

Avoiding the use of oxygen

11.

Approximately how much blood is stored in the spleen that can be released in a hypovolemic emergency?

a)

100 mL

b)

300 mL

c)

500 mL

d)

1000 mL

12.

The nurse caring for a patient with pernicious anemia should make provisions for which intervention?

a)

frequent iced drinks.

b)

lightweight blanket.

c)

a fan to circulate the air.

d)

reverse isolation.

13.

When reinforcing instructions for the patient taking an oral liquid iron preparation, which should the nurse include?

a)

Information relative to taking the iron with milk

b)

Information relative to the bowel movement color changing to dark red

c)

Information relative to taking preparation through a straw to prevent staining of teeth

d)

Information relative to taking a drug with meals or a snack

14.

When the 14-year-old patient comes into the emergency room in sickle cell crisis, which should be the primary focus of care?

a)

Genetic counseling

b)

Applying ice packs

c)

Pain relief measures

d)

Providing iron replacements

15.

The nurse expects the plan of care for a patient with leukemia to focus on which aspect of care?

a)

Prevention of abnormal clotting

b)

Promotion of mobility activities

c)

Frequent transfusions of plasma

d)

Prevention of infectious diseases

16.

Which must a patient undergo before a bone marrow transplant?

a)

A thorough nutritional plan to support new marrow

b)

Chemotherapy to eradicate malignant bone marrow cells

c)

A physical therapy program to strengthen the body

d)

Inhalation therapy to reduce possible pathogens in the lungs

17.

The 9-year-old child with leukemia who is on palliative care has drawn a picture of a boy under a huge black cloud that has lightning coming out of it. Which would be an appropriate intervention for the nurse?

a)

“What is this picture about?”

b)

“Are you afraid of lightning?”

c)

“I bet this is a picture of you, isn’t it?”

d)

“Is it about to rain in your picture?”

18.

The home health nurse recommends to the mother of a 12-year-old child with leukemia that the child should have which vaccine?

a)

the series for prevention of hepatitis B.

b)

an annual influenza vaccine.

c)

an annual pneumococcal vaccine.

d)

vitamin B12 shots.

19.

Which patient statement from a 15-year-old girl with thrombocytopenia would require more assessment to report to the charge nurse?

a)

I think these red spots on my skin are going away.

b)

I am so bored lying in bed I could scream.

c)

I can’t tell if the corticosteroids are helping.

d)

I started my menstrual period this morning.

20.

A 23-year-old male patient with hemophilia A says, “How can I keep my children from having hemophilia A?” Which is the most informative response?

a)

You need to select a very dependable mode of birth control.

b)

You can only pass hemophilia B to your sons.

c)

Your daughter may be a carrier and her children may have hemophilia A.

d)

Your sons should have coagulation studies.

21.

A child with hemophilia is hospitalized with hemarthrosis. Which should the nurse caring for that child expect to implement when following the plan of care?

a)

Use analgesia sparingly.

b)

Apply warm compresses to reduce hemorrhages in the joint.

c)

Encourage vigorous joint movement exercises to keep the joints flexible.

d)

Reinforce instructions to receive factor VIII infusions prophylactically.

22.

In caring for a patient with multiple myeloma, which should the prioritize from the plan of care?

a)

Limit fluid intake to less than 1000 mL/day

b)

Closely supervise and assist when ambulating

c)

Strain all urine for kidney crystals

d)

Limit the use of an analgesic

23.

The nurse is aware that a person with Hodgkin disease, who has two or more abnormal lymph nodes on the same side of the diaphragm and cancer extending locally from one lymph node area into a nearby organ, would be in which stage?

a)

stage I.

b)

stage II.

c)

stage III.

d)

stage IV.

24.

The nurse explains to a patient with Non-Hodgkin’s lymphoma that a positron emission tomography (PET) has been ordered for which reason?

a)

assess bone marrow depression.

b)

measure bone density.

c)

radiate and destroy diseased lymph nodes.

d)

determine the extent of possible metastasis.

25.

Which food would the nurse recommend to a person with iron-deficiency anemia as an excellent meat source for erythropoiesis?

a)

Dark meat of chicken

b)

Cured ham

c)

Pork chops

d)

Processed meat

26.

The peripheral smear is a diagnostic test performed for which reason?

a)

assesses the level of hemoglobin.

b)

measures antibody production.

c)

examines the shape and structure of cells.

d)

identifies possible sources of infection

27.

The typical medical treatment of polycythemia vera involves repeated phlebotomies for which intended benefit?

a)

stimulate bone marrow.

b)

Reduce blood viscosity

c)

increase hemoglobin.

d)

reduce symptoms of gout.

28.

Which would the nurse explain as a type of leukemia that affects noticeably more children and teens than adults?

a)

Chronic lymphocytic leukemia (CLL)

b)

Acute myeloid leukemia (AML)

c)

Acute lymphocytic leukemia (ALL)

d)

Chronic myeloid leukemia (CML)

29.

The nurse is aware that some persons of the Jehovah’s Witness faith accept which types of blood transfusions?

a)

No type of blood transfusion

b)

Blood that has been blessed by their religious leader

c)

Transfusions only for persons who have not yet been baptized

d)

Autologous blood transfusions

30.

Which mandatory practice is the most effective and significant nursing practice to prevent the spread of infection for a patient with agranulocytosis?

a)

Strict and frequent hand washing by all people having contact with the patient

b)

Placement of patients in private rooms with high-efficiency particulate air (HEPA) filtration

c)

Administration of combinations of prophylactic antibiotics

d)

Creation of a “sterile” environment for the patient with the use of laminar airflow rooms

31.

Which is the average lifespan of an erythrocyte?

a)

7 days

b)

60 days

c)

120 days

d)

Up to several years

32.

Because older adults suffer from conditions such as colonic diverticula, hiatal hernia, and ulcerations that can cause occult bleeding, the nurse should assess for symptoms of which blood disorder?

a)

leukemia.

b)

iron-deficiency anemia.

c)

sickle cell anemia.

d)

polycythemia.

33.

The nurse explains that the treatment of hemophilia has been revolutionized with the advent of the use of which medical intervention?

a)

corticosteroids.

b)

large doses of testosterone.

c)

Prophylactic use of factors VIII and IX.

d)

transfusion with packed red cells.

34.

The nurse will prepare the adult patient who will be undergoing bone marrow sampling by explaining the sample will be obtained from which site?

a)

Sternum

b)

Posterior superior iliac crest

c)

Posterior iliac crest

d)

Femur

35.

Which is the first step in the process of hemostasis?

a)

Formation of fibrin

b)

Release of thromboplastin from platelets

c)

Prothrombin converts to thrombin

d)

Trapping of RBC and platelets

e)

Formation of thrombin

36.

Which event causes the kidney to produce erythropoietin?

a)

Decreased erythrocytes

b)

Decreased oxygen levels

c)

Extensive systemic infection

d)

Excessive circulating clotting factor

37.

The hematopoietic stem cell transplant (Bone marrow transplant) is used for a patient with which disease? (Select all that apply.)

a)

Iron deficiency anemia

b)

Aplastic anemia

c)

Leukemia

d)

Pernicious anemia

e)

Myelodysplastic syndrome

38.

The spleen is a highly vascularized organ located in the left upper quadrant of the abdominal cavity. Which is the main function of the spleen? (Select all that apply.)

a)

Serve as reservoir for blood.

b)

Destroy worn-out RBCs.

c)

Promote phagocytosis.

d)

Responsible for development of T lymphocytes.

e)

Continuously produce RBCs during lifetime.

39.

The nurse examines the complete blood count (CBC) to assess which level? (Select all that apply.)

a)

hematocrit

b)

red cell count

c)

differential white blood cell count

d)

plasma level

e)

hemoglobin

40.

Which is a necessary factor that supports healthy erythropoiesis?

a)

Healthy bone marrow and kidney function

b)

Vitamin B6

c)

Amino acids

d)

Vitamin B12

e)

Dietary magnesium

41.

The nurse caring for a patient in the emergency room with suspected internal injuries will assess for hypovolemic shock, which is evidenced by which symptom?

a)

hypotension.

b)

restlessness.

c)

irritability.

d)

pallor.

e)

slow bounding pulse.

42.

Which of the following are “B” symptoms of a patient with Hodgkin disease? (Select all that apply.)

a)

Severe diarrhea

b)

Weight gain from edema

c)

Fever

d)

Night sweats

e)

Hematuria

43.

(a)   are leukocytes that destroy and remove cellular waste, bacteria, and solid particles.

44.

The person with aplastic anemia is said to have (a)   because all three major blood elements (RBCs, WBCs, and platelets) are diminished or absent.

45.

The nurse clarifies that ferrous (a)   replaces iron stores to treat iron deficiency anemia.

46.

Neutrophils release (a)   , an enzyme that destroys certain bacteria.

47.

The Reed-Sternberg cell is the hallmark diagnostic indicator for (a)   disease.