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HEMA CA MIDTERM PART 1 Flashcards | StudBud
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HEMA CA MIDTERM PART 1
HEMA CA MIDTERM PART 1
100 terms
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1
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Your patient is at fall risk due to his anemia
Your patient is at risk for bleeding.
Your patient has an infection.
Your patient is neutropenic.
2
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Abdominal distention
Constipation
Puffiness around the eyes
Yellowing of the skin
3
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Excess fluid volume related to infection
Ineffective coping related to the presence of a life-threatening disease
Pain related to tissue anoxia
Decreased cardiac output related to abnormal hemoglobin formation
4
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Assessment of the client for signs of infection caused by GVHD
Infusion of D5.45% normal saline at 125 mL/hour to the client
Education of the client about ways to prevent infection
Administration of methotrexate and cyclosporine to the client
5
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Cooks tomato-based foods in iron pots
Adds vitamin C to all meals
Drinks coffee or tea with meals
Adds dried fruit to cereal and baked goods
6
48. Which of the following cells is the precursor to the red blood cell (RBC)?
T cell
Stem cell
B cell
Macrophage
7
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Red blood cells that are microcytic and hypochromic
An elevated RBC count
A decreased reticulocyte count
An elevated hemoglobin level
8
A white cell with non-specific granules is a
Myeloblast
Metamyelocyte
Lymphocyte
Band neutrophil
9
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Citrus fruits
Eggs
Cheese
Lettuce
10
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She waits 20 mins after obtaining the PRBCs before starting the infusion.
She tells the pt. that the PRBCs may cause a serious transfusion reaction.
She starts an intravenous line for the transfusion using a 22 G catheter.
She primes the transfusion set using D5 in lactated Ringer’s solution.
11
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Fluid overload
Stress
Infection
Trauma
12
?
B
C
A
D
13
Significant information obtained from the patient's health history that relates to the hematologic system includes
jaundice.
bladder surgery.
early menopause.
multiple pregnancies.
14
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Transfuse Factor VII concentrate.
Transport to radiology for C-spine x-rays.
Infuse normal saline at 250 mL/hour.
Transfuse Factor VII concentrate.
15
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The client admits to occasional marijuana use.
The client has an oral temperature of 99.7o F
The client has abdominal pain with light palpation.
The client engages in unprotected sex.
16
A nurse is caring for a client who has DIC. Which of the ff. medications should the nurse anticipate administering?
Mefoxin
Vitamin K
Heparin
Simvastatin
17
Which of the following diagnostic findings are most likely for a client with aplastic anemia?
Reed-Sternberg cells and lymph node enlargement
Increased levels of WBCs, RBCs, and platelets
Decreased production of T-helper cells
Decreased levels of white blood cells, red blood cells, and platelets
18
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17.3 x 10 to the 9th/L
16.5 x 10 to the 9th/L
15.5 x 10 to the 9th/L
18.2 x 10 to the 9th/L
19
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I am always careful not to break open the capsule.
My wife says I should take my medicine with orange juice.
It tastes better when I take my medicine with milk.
I usually take my iron with my whole-grain toast during breakfast.
20
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“Take the medication with an antacid.”
“Take the medication with cereal.”
“Take the medication with a glass of milk.”
“Take the medication on an empty stomach.”
21
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Pulse rate increased by 20 bpm immediately after the activity
Diastolic blood pressure increased by 7 mm Hg
Pulse rate within 6 bpm of resting phase after 3 minutes of rest.
Respiratory rate decreased by 5 breaths/minute
22
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Check the dressing and drains for frank bleeding
Start oxygen at 2L/min per NC
Call the physician
Continue to monitor vital signs
23
A Pt. with acute myelogenous leukemia is receiving induction phase chemo.Which assessment info is of most concern?
Serum potassium level of 7.8 mEq/L
Inflammation and redness of oral mucosa
Urine output less than intake by 400 mL
Ecchymoses present on anterior trunk
24
52. Which of the following disorders results from a deficiency of factor VIII?
Hemophilia A
Hemophilia B
Sickle cell disease
Christmas disease
25
?
A,B
A,C
C,E
B,C
26
When obtaining assessment data from a pt. w/ a microcytic, hypochromic anemia,the nurse would question the patient about
dietary intake of iron.
folic acid intake.
a history of sickle cell anemia
a history of gastric surgery.
27
The primary purpose of the Schilling test is to measure the client’s ability to:
Store vitamin B12
Produce vitamin B12
Digest vitamin B12
Absorb vitamin B12
28
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Serum creatinine, 0.5 mg/dL
Total bilirubin, 0.3 mg/dL
Hemoglobin, 16 g/dL
Folate, 1.5 ng/mL
29
Types of Blood component that responsible for fighting against tumor and viruses.
Lymphocytes
Neutrophils
Basophils
Monocytes
30
When caring for a patient with thrombocytopenia, the nurse instructs the patient to
avoid aspirin bcoz it may mask the fever that occurs with thrombocytopenia.
dab his or her nose instead of blowing.
be careful when shaving with a safety razor.
continue with physical activities to stimulate thrombopoiesis.
31
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Males inherit hemophilia from their fathers
Females inherit hemophilia from their mothers
Hemophilia is a Y linked hereditary disorder
Hemophilia A results from a deficiency of factor VIII
32
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The LPN positions cold packs on the client’s knees.
The LPN places a “No Visitors” sign on the client’s door.
The LPN checks the client’s temperature every 2 hours.
The LPN encourages the client to use the ordered PCA.
33
A white cell with lysosomes containing histamine, peroxidase, and acid hydrolases is a/an:
Eosinophil
Monocyte
Basophil
Neutrophil
34
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What activities were you able to do 6 months ago compared with the present?
“Are you more tired now than you used to be?”
“How long have you had this problem?”
“Have you been able to keep up with all your usual activities?”
35
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The blood uric acid level is very elevated.
The 24 hour urine shows Bence-Jones protein.
The client is unable to plantarflex the feet.
The client complains of chronic bone pain.
36
Because of a deficiency of iron, the person with iron deficiency anemia is unable to make sufficient:
WBCs.
plasma.
hemoglobin.
antibodies.
37
Malignant disorders that arise from granulocytic cells in the bone marrow will have the primary effect of causing
risk for hemorrhage.
decreased phagocytosis of bacteria.
decreased production of antibodies.
altered oxygenation.
38
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Hematocrit level
Reticulocyte count
Hemoglobin level
Platelet count
39
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Bleeding of the gums while brushing the teeth
Numbness and tingling of the feet
Occasional nausea after taking the medication
Non-tender swelling in the right groin
40
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I will receive general anesthesia for the test."
"I will need to stay in bed for about an hour after the test."
"This test will determine which antibiotic I should take for treatment."
"This test will be performed while I am lying flat on my back."
41
Multiple drugs are often used in combinations to treat leukemia and lymphoma because
there are fewer toxic and side effects.
the drugs work by diff. mechanisms to maximize killing of malignant cells.
the chance that one drug will be effective is increased.
the drugs are more effective without causing side effects.
42
47. A client with anemia may be tired due to a tissue deficiency of which of the following substances?
Oxygen
Carbon dioxide
T-cell antibodies
Factor VIII
43
?
Check for allergies to contrast dye or shellfish.
Use Hemoccult slides to obtain stool specimens.
Administer PEG-ES (GoLYTELY) bowel preparation.
Have the client sign a colonoscopy consent form.
44
?
C
D
A
B
45
?
D
A
B
C
46
The nurse evaluates a need for further instruction to the patient with sickle cell anemia when he says:
I am looking forward to my annual ski trip to Colorado
I walk every day rather than doing other strenuous exercise.
I know Im not supposed to drink iced drinks.
I surely do miss my three beers in the afternoon.
47
A RN in a clinic is caring for a pt. who has suspected anemia. Which of the ff. lab test results should the RN expect?
Iron 90 mcg/dL
Hgb 10 g/dL
RBC 6.5 million/uL
WBC 4,800 mm3
48
?
Check the skin for signs of redness or peeling.
Explain good skin care to the client and family.
Apply alcohol-free lotion to the area after cleaning.
Clean the skin over daily with a mild soap.
49
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“Coumadin makes me feel a little nauseated unless I take it with food.”
“I have started to eat more healthy foods like green salads and fruit.”
“I will need to have some blood testing done once or twice a week.”
“The doctor said that it is important to avoid becoming constipated.”
50
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Lack of oxygen in the red blood cells
Autoimmune reaction complicated by hypoxia
Elevated serum bilirubin concentration.
Obstruction to circulation
51
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Explain the transfusionprocedure to the client
Obtain consent from theclient for the transfusion.
Obtain blood culture specimens to send to the lab
Assess for an acutehemolytic reaction.
52
Which of the following blood components is decreased in anemia?
Platelets
Leukocytes
Erythrocytes
Granulocytes
53
A complication of the hyperviscosity of polycythemia is
thrombosis.
pulmonary edema.
disseminated intravascular coagulation (DIC).
cardiomyopathy.
54
?
D
A
C
B
55
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Evaluate the client’s response to normal activities of daily living.
Check the client’s blood pressure and pulse rate after ambulation.
Determine which self-care activities the client can do independently.
Assist the client in choosing a diet that will improve strength.
56
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Encourage the client to cough, turn, and deep breath every 2 hr.
Plan for the client to take rest periods throughout the day.
Assess temperature every 4 hr.
Monitor platelet counts
57
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Egg yolks
Tea
Vegetables
Brown rice
58
The nurse instructs the 20-year-old female patient with sickle cell trait that:
the condition will evolve into sickle cell anemia as she ages.
the trait can be passed on to all children.
all of her children will have sickle cell anemia.
the trait will be transmitted to male children only.
59
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Assess for potential abuse
Clean and dress the area
Check for diminished sensations
Document the findings
60
?
D,E
B,C
A,B,D,E
A,B
61
A pt. is to receive epoetin (Epogen) injections. What lab value should the nurse assess before giving the injection?
Prothrombin time
Partial thromboplastin time
Hematocrit
Hemoglobin concentration
62
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Get 8 hours of sleep at night and take naps during the day
Eat animal protein and dark leafy vegetables each day
Practice yoga and meditation to decrease stress and anxiety
Avoid exposure to others with acute infection
63
When reviewing laboratory results of an 83-year-old patient with an infection, the nurse would expect to find
minimal leukocytosis.
increased hemoglobin and hematocrit levels.
decreased erythrocyte sedimentation rate (ESR).
decreased platelet count.
64
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Hypertension
Xerostomia
Bradycardia
Epistaxis
65
?
B,C,D,E
B,D,E,F
A,B,C,D
A,B,E,D
66
?
Check the client’s oral temperature.
Obtain a warm blanket for the client.
Stop the medication.
Administer oxygen
67
?
Clot retraction test
Bleeding time
Partial thromboplastin time (PTT)
Tourniquet test
68
?
Warfarin therapy for atrial fibrillation
Placental abruption
Heparin therapy for deep‑vein thrombosis
Systemic lupus erythematosus
69
?
The client with shingles
The client with cellulitis
The client with digoxin toxicity
The client with viral pneumonia
70
?
Hematocrit 33%
White blood cell count 16,000/mm3
Hemoglobin 10.9 g/dL
Platelet count 426,000/ mm3
71
?
An LPN who has floated from the same-day-surgery unit
An LPN with 2 years of experience on the oncology unit
An RN from the float pool who usually works on the surgical unit
An RN who transferred recently from the ED
72
?
“Vitamin B12 may cause a very mild skin rash initially.”
Vitamin B12 will cause ringing in the eats before a toxic level is reached.
“Vitamin B12 may cause mild nausea but nothing toxic.”
“Vitamin B12 is generally free of toxicity because it is water soluble.”
73
The nurse is conscientious in the care of the feet and legs of a patient with sickle cell anemia because:
stasis ulcers are a constant threat.
toenails must be kept short to avoid ingrown nails
edema of the feet increases activity intolerance.
bleeding may occur on the soles of the feet.
74
Nursing interventions for a patient with severe anemia related to peptic ulcer disease include (select all that apply)
B,C
C,D
A,B
D,E
75
Which of the following foods would the nurse encourage the mother to offer to her child with iron deficiency anemia?
Pudding, green vegetables, and rice
Potato, peas, and chicken
Rice cereal, whole milk, and yellow vegetables
Macaroni, cheese, and ham
76
The nurse anticipates that the patient with iron deficiency anemia will have red cells that are:
hypochromic and microcytic.
normochromic and microcytic.
normochromic and normocytic.
hyperchromic and macrocytic.
77
Types of Blood component that responsible for fighting against bacterial infection?
Eosinophils
Basophils
Neutrophils
Granulocytes
78
?
Immunize with Pneumovax and Haemophilus influenzae vaccines.
Give morphine sulfate 4-8 mg IV every hour as needed.
Administer oxygen at an F102 of 100% per non-rebreather mask.
Start a large-gauge IV line and infuse normal saline at 200 mL/hour.
79
?
Bowel function
Bleeding tendencies
Intake and output
Peripheral sensation
80
Which of the following assessments in a child with hemophilia would lead the nurse to suspect early hemarthrosis?
Eccymosis formation around a joint
Instability of a long bone in passive movement
Cool, pale, clammy extremity
Child’s reluctance to move a body part
81
In a severely anemic patient, the nurse would expect to find??
cyanosis and pulmonary edema.
ventricular dysrhythmias and wheezing.
dyspnea and tachycardia.
cardiomegaly and pulmonary fibrosis.
82
?
Severe headache
Hypotension
Petechiae on the upper chest
Cyanotic nail beds
83
?
There is no palpable radial or pedal pulse.
There is mottling of the hands and feet.
The client complains of chest pain.
The O2 Sat is 87%.
84
An anticoagulant warfarin (Coumadin) that interferes w/ prothrombin production will alter the clotting mechanism during
the release of tissue thromboplastin.
stimulation of factor activation comple
platelet aggregation.
activation of thrombin.
85
The nurse would instruct the client to eat which of the following foods to obtain the best supply of vitamin B
12
?
Meats and dairy products
Broccoli and Brussels sprouts
Whole grains
Green leafy vegetables
86
The nursing management of a patient in sickle cell crisis includes (select all that apply)
A,B,C
A,B,C,D,E
A,B,C,D
B,C,D
87
43. Which of the following nursing assessments is a late symptom of polycythemia vera?
Headache
Dizziness
Shortness of breath
Pruritus
88
?
“My appetite has decreased since the chemotherapy strated.”
“My bowel movements are soft and dark brown in color.”
“I take one aspirin every morning because of my history of angina.”
“I’ve noticed that I bruise more easily since the chemotherapy started.”
89
?
“Most people with stage I Hodgkin’s disease survive.”
“Perhaps you should ask the doctor about medication.”
“Tell me a little bit more about your fear of dying.”
“Many individuals with this diagnosis have some fears.”
90
Which cardiac chamber's failure is most commonly associated with the onset of pulmonary edema?
The left ventricle.
The right atrium.
The left atrium.
The right ventricle.
91
?
maintain adequate fluid intake.
take iron supplements daily.
maintain adequate fluid intake.
maintain adequate fluid intake.
92
Which of the following is/are the component of Blood?
WBC
AOTA
Plasma
RBC
93
The nurse understands that the client with pernicious anemia will have which distinguishing laboratory findings?
RBCs 5.0 million
Intrinsic factor, absent.
Sedimentation rate, 16 mm/hour
Schilling’s test, elevated
94
The most common type of leukemia in older adults is
chronic lymphocytic leukemia.
acute myelocytic leukemia.
chronic myelocytic leukemia.
acute lymphocytic leukemia.
95
49. Which of the following symptoms is expected with hemoglobin of 10 g/dl?
Palpitations
NOTA
Shortness of breath
Pallor
96
?
There has been a 20-pound weight loss over the past year
The Philadelphia chromosome is present in the blood smear
The client’s chemotherapy has resulted in neutropenia
Glucose is elevated as a result of prednisone therapy
97
An individual who lives at a high altitude may normally have an increased RBC count because
function of the spleen in removing old RBCs is impaired at high altitudes.
hypoxia caused by decreased atmospheric oxygen stimulates erythropoiesis.
impaired production of wbc and platelets leads to inc rbc counts.
high altitudes cause vascular fluid loss, leading to hemoconcentration.
98
The nurse implements which of the following for the client who is starting a Schilling test?
Maintaining NPO status
Starting a 72-hour stool specimen collection
Starting a 24- to 48 hour urine specimen collection
Administering methylcellulose (Citrucel)
99
?
“I have 3 to 4 loose stools per day.”
“I have been drinking plenty of fluids.”
“I have been gargling with warm salt water for my sore tongue.”
“I take a vitamin B12 tablet every day.”
100
A pt. with pernicious anemia asks why she must take Vit B12 injections for life. What is the nurse’s best response?
C
A
D
B
