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WorksheetsCH 31 clients with Disorders of the Hematopoietic Syste
Total questions: 35
Worksheet time: 18mins
Your Client Was Admitted To The Emergency Department After An Accident With A Chain Saw. The Client Is Exhibiting Signs And Symptoms Of Acute Hypovolemic Anemia From Severe Blood Loss. What Signs And Symptoms Would You Assess For?
Malabsorption Disorders
Postural Hypotension
Fatigue
Reduced Urine Output
A Client With A Diagnosis Of Pernicious Anemia Comes To The Clinic Complaining Of Numbness And Tingling In His Arms And Legs. What Do These Symptoms Indicate?
Loss Of Vibratory And Position Senses
Neurologic Involvement
Severity Of The Disease
Insufficient Intake Of Dietary Nutrients
The Nurse Caring For An Older Adult With A Diagnosis Of Leukemia Would Encourage The Client To Use An Electric Razor. Why?
Trauma And Microabrasions May Contribute To Anemia.
Fragile Tissues And Altered Clotting Mechanisms May Result In Hemorrhage.
The Client Is At Risk For Spontaneous And Uncontrolled Bleeding.
The Client Is At Risk For Infection From Microorganisms.
You Are Caring For An 87-Year-Old Female Who Has Been Admitted To Your Unit With Anemia. What Would You Suspect?
Excessive Consumption Of Coffee Or Tea
Elimination Of Iron By The Body
Decrease In The Total Body Iron Stores With Age
Blood Loss From The Gastrointestinal Or Genitourinary Tract
A Client Diagnosed With Polycythemia Vera Has Come Into The Clinic Because He Has Developed A Nighttime Cough, Fatigue, And Shortness Of Breath. What Complication Would You Suspect In This Client?
Stroke
Tissue Infarction
Congestive Heart Failure
Pulmonary Embolus
You Are Caring For A Client With Multiple Myeloma. Why Would It Be Important To Assess This Client For Fractures?
Osteopathic Tumors Destroy Bone Causing Fractures.
Osteoclasts Break Down Bone Cells So Pathologic Fractures Occur.
Osteolytic Activating Factor Weakens Bones Producing Fractures.
Osteosarcomas Form Producing Pathologic Fractures.
The Nursing Instructor Is Talking With Her Clinical Group About Coagulopathies. How Should The Instructor Define Coagulopathies?
Coagulopathies Are Bleeding Disorders That Are Characterized By Abnormalities In The Numbers And Types Of Red Blood Cells In The Body.
Coagulopathies Are Bleeding Disorders That Involve Platelets Or Clotting Factors.
Coagulopathies Are Bleeding Disorders That Are Characterized By A Deficiency Of Globulins In The Plasma.
Coagulopathies Are Bleeding Disorders That Involve The Destruction Of Stem Cells In The Bone Marrow.
A Client Comes To The Walk-In Clinic Complaining Of Weakness And Fatigue. While Assessing This Client, You Find Evidence Of Petechiae And Ecchymoses. You Note That The Spleen Appears Enlarged. What Would You Suspect Is Wrong With This Client?
Aplastic Anemia
Pernicious Anemia
Iron-Deficiency Anemia
Agranulocytosis
You Are Assisting Your Client With Multiple Myeloma To Ambulate. What Is The Most Important Nursing Diagnosis To Help Prevent Fractures In This Client?
Increased Mobility
Adequate Hydration
Safety
Adequate Nutrition
The Nursing Instructor Is Discussing Disorders Of The Hematopoietic System With The Pre-Nursing Pathophysiology Class. What Disease Would The Instructor List With A Primary Characteristic Of Erythrocytosis?
Polycythemia Vera
Sickle Cell Disease
Aplastic Anemia
Pernicious Anemia
A Client Is Found To Have A Low Hemoglobin And Hematocrit When Laboratory Work Was Performed. What Does The Nurse Understand The Anemia May Have Resulted From? Select All That Apply.
Infection
Blood Loss
Abnormal Erythrocyte Production
Destruction Of Normally Formed Red Blood Cells
Inadequate Formed White Blood Cells
A Client Is Experiencing Chronic Hypovolemic Anemia As Evidenced By Laboratory Results. What Symptoms Does The Nurse Expect To Find For This Client When Collecting Objective Data?
Postural Hypotension
Urinary Output Of 10 Ml/Hr
Altered Consciousness
Extreme Pallor
A Client Is Being Treated In The Hospital For Hypovolemia Related To A Bleeding Peptic Ulcer. The Nurse Obtains A Blood Pressure Reading Of 88/62 Mm Hg, Heart Rate Of 112 Beats/Minute, And A Respiratory Rate Of 24 Breaths/Minute. What Is The First Action By The Nurse?
Administer Blood.
Notify The Physician.
Insert Two Large-Bore Intravenous Catheters.
Administer A Colloid Solution.
The Nurse Is Caring For A Client With Hypovolemic Anemia Who Is Now In Hypovolemic Shock. What Indication Does The Nurse Have That The Client Is Having Inadequate Renal Perfusion?
Hematuria
Blood Pressure Of 90/60 Mm Hg
Jaundice Of The Sclera
Urine Output Of 15 Ml/Hour
The Nurse Is Caring For A Client Who Is Developing Hypovolemic Shock From A Duodenal Ulcer Bleed. What Is The First Intervention The Nurse Can Provide To Facilitate Blood Flow To The Brain?
Prepare The Client For An Endoscopy.
Administer A Crystalloid Solution.
Place The Client In A Modified Trendelenburg Position.
Test The Client For Blood In The Stool.
The Lpn Is Following A Plan Of Care For A Client Who Is Being Treated For Hypovolemic Anemia And Is At Risk For Hypovolemic Shock. The Nurse Assesses Vital Signs And O2 Saturation And Observes The Saturation At 89% For 3 Minutes. What Should The First Action By The Nurse Be?
Notify The Charge Nurse.
Prepare To Assist With Intubation.
Give Oxygen Per Nasal Cannula
Place The Client In The Supine Position.
The Registered Nurse (Rn) And Licensed Practical Nurse (Lpn) Are Preparing An Educational Program For Clients Who May Be At Risk For The Development Of Iron-Deficiency Anemia. Which Clients Would Receive The Greatest Benefit From This Program? Select All That Apply.
A Young Female Client With Bulimia Nervosa
An Older Adult Client On A Fixed Income
A Client With Crohn's Disease
A Client Who Lives In A Nursing Home
A Client Who Is A Vegetarian
The Nurse Is Caring For An Older Adult Client Who Has A Hemoglobin Of 9.6 G/Dl And A Hematocrit Of 34%. To Determine Where The Blood Loss Is Coming From, What Intervention Can The Nurse Provide?
Observe Stools For Blood.
Observe The Gums For Bleeding After The Client Brushes Teeth.
Observe The Sputum For Signs Of Blood
Observe Client For Facial Droop.
The Nurse Is Collecting Data For A Patient Who Has Been Diagnosed With Iron Deficiency Anemia. What Subjective Findings Does The Nurse Recognize As Symptoms Related To This Type Of Anemia?
“I Feel Hot All Of The Time.”
“I Have A Difficult Time Falling Asleep At Night.”
“I Have An Increase In My Appetite.”
“I Have Difficulty Breathing When Walking 30 Feet.”
The Nurse Observes The Laboratory Studies For A Client In The Hospital With Fatigue, Feeling Cold All Of The Time, And Hemoglobin Of 8.6 G/Dl And A Hematocrit Of 28%. What Finding Would Be An Indicator Of Iron-Deficiency Anemia?
Erythrocytes That Are Microcytic And Hypochromic
Erythrocytes That Are Macrocytic And Hyperchromic
Clustering Of Platelets With Sickled Red Blood Cells
An Increased Number Of Erythrocytes
The Nurse Is Instructing A Client About Taking A Liquid Iron Preparation For The Treatment Of Iron-Deficiency Anemia. What Should The Nurse Include In The Instructions?
Do Not Take Medication With Orange Juice Because It Will Delay Absorption Of The Iron.
Iron May Cause Indigestion And Should Be Taken With An Antacid Such As Mylanta.
Dilute The Liquid Preparation With Another Liquid Such As Juice And Drink With A Straw.
Discontinue The Use Of Iron If Your Stool Turns Black.
The Nurse Is Caring For Four Clients On The Medical-Surgical Unit Of The Hospital. What Client Is Mostly Likely To Be Receiving Treatment For Sickle Cell Crisis?
A 29-Year-Old Caucasian Female
A 19-Year-Old African American Male
A 24-Year-Old Native American Female
A 36-Year-Old Eastern European Female
A Client Is Seen In The Emergency Department With Severe Pain Related To A Sickle Cell Crisis. What Does The Nurse Understand Is Occurring With This Client?
The Client Has A Decreased Tolerance Of Pain Related To The Chronic Nature Of The Illness.
Bone Marrow Decreases The Erythrocyte Production Causing Decrease In Hypoxia.
Overhydration Enlarges The Red Blood Cells.
Vascular Occlusion In Small Vessels Decreasing Blood And Oxygen To The Tissues.
A Client With Sickle Cell Disease Informs The Nurse That He Is Having Chest Pain. The Nurse Hears The Client Coughing, Wheezing, And Breathing Rapidly. What Does The Nurse Suspect Is Occurring With This Client?
Vaso-Occlusive Crisis
Pneumocystis Pneumonia
Acute Chest Syndrome
Acute Muscular Strain
Parents Arrive To The Clinic With Their 5-Year-Old Child And Inform The Nurse The Child Has Just Been Diagnosed With Sickle Cell Disease. The Parents Ask The Nurse How This Could Have Happened And Which One Of Them Is The Carrier. What Is The Best Response By The Nurse?
“Most Likely, The Father Is The Carrier Of The Gene.”
“The Trait Is Passed Down Through The Mother.”
“The Child Must Inherit Two Defective Genes, One From Each Parent.”
“It Is An Acquired, Not A Hereditary Disorder.”
The Nurse Is Instructing The Client With Sickle Cell Disease About The Use Of An Inhaled Vasodilator That May Reduce Sickling. What Medication Is The Nurse Instructing The Client About?
Nitrous Oxide
Nitric Oxide
Betamethasone
Terbutaline (Brethine)
The Nurse Is Caring For A Client Who Is Having A Sickle Cell Crisis. Which Order For Analgesia Should The Nurse Consult With The Physician?
Meperedine (Demerol)
Morphine Sulfate
Sublimaze (Fentanyl)
Buprenorphine (Buprenex)
The Nurse Is Caring For An Older Adult Client With Hemolytic Anemia. What Does The Nurse Understand About The Reason This Client Is Most Susceptible To This Disorder?
The Client Is Older And Is Probably Noncompliant With Medications.
Older Adult Clients Often Take More Medications Than Younger People.
Older Adult Clients Have More Incidences Of Coagulation Disorders.
The Older Adult Client Does Not Follow Up With Physician Appointments.
The Nurse Is Admitting A Client With Cooley's Anemia To The Hospital With A Hemoglobin Of 6.2 G/Dl And Hematocrit Of 26%. What Does The Nurse Document About The Client's Skin?
Bronzing Of The Skin
Jaundice Of The Skin And Mucous Membranes
Ruddy Complexion
Pale Skin And Mucous Membranes
The Nurse Is Assigned To Care For A Client With Polycythemia Vera. When The Nurse Encourages The Client To Drink 3 L Of Fluid Per Day, The Client States, “Why Do I Have To Drink So Much?” What Is The Best Response By The Nurse?
“We Don't Want You To Get Dehydrated.”
“It Helps Adequately Hydrate You And Ensures A Sufficient Urine Production.”
“It Will Help Your Heart Beat Regularly And Effectively.”
“It Will Help Restrict Blood Circulation.”
The Nurse Is Instructing The Client With Polycythemia Vera How To Perform Isometric Exercises Such As Contracting And Relaxing The Quadriceps And Gluteal Muscle During Periods Of Inactivity. What Does The Nurse Understand Is The Rationale For This Type Of Exercise?
Isometric Exercise Programs Are Inclusive Of All Muscle Groups And Have An Aerobic Effect To Increase The Heart Rate.
Isometric Exercise Decreases The Workload Of The Heart And Restores Oxygenated Blood Flow.
This Type Of Exercise Increases Arterial Circulation As It Returns To The Heart.
Contraction Of Skeletal Muscle Compresses The Walls Of Veins And Increases The Circulation Of Venous Blood As It Returns To The Heart.
A Client Is Suspected Of Having Leukemia And Is Having A Series Of Laboratory And Diagnostic Studies Performed. What Does The Nurse Recognize As The Hallmark Signs Of Leukemia? Select All That Apply.
Diarrhea
Nausea And Vomiting
Frequent Infections
Fatigue From Anemia
Easy Bruising
A Client Was Admitted To The Hospital With A Pathologic Pelvic Fracture. The Client Informs The Nurse That He Has Been Having A Strange Pain In The Pelvic Area For A Couple Of Weeks That Was Getting Worse With Activity Prior To The Fracture. What Does The Nurse Suspect May Be Occurring Based On These Symptoms?
Hemolytic Anemia
Polycythemia Vera
Leukemia
Multiple Myeloma
A Client With Multiple Myeloma Is Complaining Of Severe Pain When The Nurse Comes In To Give A Bath And Change Position. What Is The Priority Intervention By The Nurse?
Inform The Client That The Position Must Be Changed, And Then You Will Give Her Pain Medication And Omit The Bath.
Inform The Client That She Will Feel Better After Receiving A Bath And Clean Sheets.
Obtain The Pain Medication And Delay The Bath And Position Change Until The Medication Reaches Its Peak.
Inform The Client That The Bath And Positioning Is An Important Part Of Client Care And Will Be Done Right After Pain Medication Administration.
A 15-Year-Old Client With Hemophilia Sustains A Leg Laceration After Falling Off Of His Skateboard And Is Brought To The Emergency Department. The Laceration Is Bleeding Profusely Even With Direct Pressure To The Site. What Does The Nurse Anticipate Will Be Ordered For Administration To Control Bleeding?
Fresh Frozen Plasma
A Colloid Solution Such As Hetastarch (Hespan)
A Crystalloid Solution Such As Lactated Ringer's
Albumin
