Chapter 47 Care of the Patient with Blood or Lymphatic Disorder

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

c. Phagocytosis

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?

d. differential

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

c. an infection or stress.

4. B cells and T cells fit under which classification?

c. Lymphocytes

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

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

a. shift to the left.

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

b. Lack of the intrinsic factor

8. Erythropoiesis is the term referring to which process?

d. Production of new red blood cells in the bone marrow

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

b. Allergy

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

c. Alternating activity with rest periods

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

c. 500 mL

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

b. lightweight blanket.

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

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

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

c. Pain relief measures

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

d. Prevention of infectious diseases

16. Which must a patient undergo before a bone marrow transplant?

b. Chemotherapy to eradicate malignant bone marrow cells

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?"

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

b. an annual influenza vaccine.

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

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?

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

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?

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?

b. Closely supervise and assist when ambulating

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?

b. stage II.

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

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

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

c. examines the shape and structure of cells

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

b. Reduce blood viscosity

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

c. Acute lymphocytic leukemia (ALL)

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

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

31. Which is the average lifespan of an erythrocyte?

c. 120 days

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?

b. iron-deficiency anemia.

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

c. Prophylactic use of factors VIII and IX.

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?

c. Posterior iliac crest

35. Which is the first step in the process of hemostasis?

f. Release of thromboplastin from platelets

36. Which event causes the kidney to produce erythropoetin?

b. Decreased oxygen levels

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

b. Aplastic anemia

c. Leukemia

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.

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.

f. hemoglobin.

40. Which is a necessary factor that supports healthy erythropoiesis? (Select all that apply.)

a. Dietary magnesium

b. Healthy bone marrow and kidney function

d. Vitamin B12

e. Amino acids

f. Vitamin Bo

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? (Select all that apply.)

ANS: A, B, E, F

a. irritability.

b. restlessness.

e. pallor.

f. hypotension.

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

ANS: B, E

b. Night sweats

f. Persistent dry cough