Studied by 1 person
ased on the contents of Brunner & Suddarth's Textbook of Medical-Surgical Nursing,
What is hypoproliferative anemia characterized by?
a) Increased destruction of erythrocytes
b) Decreased production of erythrocytes
c) Hemorrhagic loss of erythrocytes
d) Spherocytic deformation of erythrocytes
Answer: b) Decreased production of erythrocytes
Rationale: Hypoproliferative anemia occurs when the bone marrow produces an inadequate number of erythrocytes, often due to factors like bone marrow damage, lack of erythropoietin, or nutritional deficiencies .
Which type of anemia results from the premature destruction of erythrocytes?
a) Hemolytic anemia
b) Hypoproliferative anemia
c) Iron-deficiency anemia
d) Megaloblastic anemia
a) Hemolytic anemia
Rationale: Hemolytic anemia involves the destruction of erythrocytes before their normal lifespan is completed, leading to increased bilirubin and reticulocyte counts .
A patient with anemia presents with increased reticulocyte count, jaundice, and splenomegaly. What is the most likely diagnosis?
a) Iron-deficiency anemia
b) Hemolytic anemia
c) Megaloblastic anemia
d) Hypoproliferative anemia
Answer: b) Hemolytic anemia
Rationale: Hemolytic anemia leads to the destruction of red blood cells, causing jaundice and an elevated reticulocyte count as the bone marrow compensates .
In vitamin B12 deficiency anemia, what is the typical mean corpuscular volume (MCV)?
a) Decreased
b) Normal
c) Increased
d) Fluctuating
Answer: c) Increased
Rationale: Vitamin B12 deficiency is a form of megaloblastic anemia, characterized by an increased MCV due to the production of abnormally large red blood cells .
What clinical finding is expected in a patient with iron-deficiency anemia?
a) High mean corpuscular volume (MCV)
b) Low serum ferritin
c) Elevated reticulocyte count
d) Elevated erythropoietin levels
Answer: b) Low serum ferritin
Rationale: Iron-deficiency anemia is characterized by a low ferritin level, which reflects diminished iron stores in the body .
Which of the following is a common cause of neutropenia?
a) Vitamin B12 deficiency
b) Bone marrow suppression
c) Polycythemia vera
d) Hemolysis
Answer: b) Bone marrow suppression
Rationale: Neutropenia is often caused by bone marrow suppression, which may result from chemotherapy, radiation, or certain medications .
What is the primary risk for a patient with neutropenia?
a) Blood clot formation
b) Infection
c) Increased bleeding tendency
d) Anemia
Answer: b) Infection
Rationale: Neutropenia reduces the number of neutrophils, impairing the immune response and increasing the risk of infections .
What lab finding is typical of polycythemia vera?
a) Increased platelet count
b) Decreased red blood cell mass
c) Low hematocrit
d) Elevated white blood cell count
Answer: a) Increased platelet count
Rationale: Polycythemia vera often involves an elevated platelet count in addition to increased red blood cell mass .
What intervention is essential for managing secondary polycythemia?
a) Increasing dietary iron intake
b) Treating the underlying cause of hypoxia
c) Administering vitamin B12 injections
d) Prescribing corticosteroids
answer: b) Treating the underlying cause of hypoxia
Rationale: Secondary polycythemia results from chronic hypoxia, and addressing the hypoxia (e.g., through oxygen therapy) is key to managing the condition .
Which of the following is a common clinical manifestation of thrombocytopenia?
a) Jaundice
b) Petechiae
c) Hemolysis
d) Splenomegaly
Answer: b) Petechiae
Rationale: Thrombocytopenia, characterized by a low platelet count, often leads to bleeding manifestations like petechiae, which are small, pinpoint hemorrhages .
What is the most appropriate nursing intervention for a patient with disseminated intravascular coagulation (DIC)?
a) Administering anticoagulants
b) Monitoring for bleeding and clotting
c) Providing iron supplements
d) Restricting fluid intake
b) Monitoring for bleeding and clotting
Rationale: In DIC, the simultaneous risk of bleeding and clot formation requires vigilant monitoring for both signs .
Which factor is commonly associated with disseminated intravascular coagulation (DIC)?
a) Sepsis
b) Vitamin B12 deficiency
c) Hyperkalemia
d) Polycythemia vera
Answer: a) Sepsis
Rationale: DIC is often triggered by severe infections like sepsis, which can activate widespread clotting and bleeding .
A patient with hemophilia is at increased risk for which complication?
a) Hemarthrosis
b) Anemia
c) Splenomegaly
d) Jaundice
Answer: a) Hemarthrosis
Rationale: Hemophilia is associated with spontaneous bleeding into joints (hemarthrosis), leading to pain and joint damage .
What is the genetic transmission pattern for hemophilia A?
a) Autosomal dominant
b) X-linked recessive
c) Autosomal recessive
d) Mitochondrial inheritance
Answer: b) X-linked recessive
Rationale: Hemophilia A is inherited in an X-linked recessive manner, affecting males predominantly .
Aplastic anemia involves which key laboratory finding?
a) Pancytopenia
b) Elevated reticulocyte count
c) Increased erythropoietin
d) Thrombocytosis
Answer: a) Pancytopenia
Rationale: Aplastic anemia is characterized by pancytopenia, which is the reduction in all blood cell types: red blood cells, white blood cells, and platelets .
A patient with immune thrombocytopenic purpura (ITP) has a platelet count of 25,000/mm³. What is the most appropriate nursing intervention?
a) Administer platelet transfusion
b) Monitor for signs of spontaneous bleeding
c) Provide iron supplementation
d) Encourage vigorous exercise
Answer: b) Monitor for signs of spontaneous bleeding
Rationale: With a platelet count this low, the patient is at high risk for spontaneous bleeding, and careful monitoring is essential .
What is a primary clinical manifestation of megaloblastic anemia?
a) Enlarged red blood cells
b) Fragmented red blood cells
c) Decreased mean corpuscular volume (MCV)
d) Hemoglobinuria
Answer: a) Enlarged red blood cells
Rationale: Megaloblastic anemia is characterized by the production of abnormally large red blood cells due to impaired DNA synthesis .
Which of the following is a major cause of vitamin B12 deficiency anemia?
a) Dietary folate deficiency
b) Pernicious anemia
c) Chronic kidney disease
d) Hypersplenism
Answer: b) Pernicious anemia
Rationale: Pernicious anemia is an autoimmune condition that impairs the absorption of vitamin B12 due to a lack of intrinsic factor .
Which term describes the abnormal variation in the size of red blood cells?
a) Anisocytosis
b) Poikilocytosis
c) Thrombocytosis
d) Leukocytosis
a) Anisocytosis
Rationale: Anisocytosis refers to a variation in the size of red blood cells, which is often seen in various forms of anemia .
Reticulocytes are best described as:
a) Immature red blood cells
b) Spherically shaped red blood cells
c) Fragmented white blood cells
d) Platelets
Answer: a) Immature red blood cells
Rationale: Reticulocytes are immature red blood cells that are released from the bone marrow into circulation .
Which laboratory finding is most consistent with hypoproliferative anemia?
a) Increased reticulocyte count
b) Decreased mean corpuscular volume (MCV)
c) Increased hemoglobin concentration
d) Increased iron levels
Answer: b) Decreased mean corpuscular volume (MCV)
Rationale: Hypoproliferative anemias, such as iron deficiency anemia, are associated with microcytic anemia, which reflects a low MCV. Iron deficiency also results in decreased reticulocytes due to inadequate production .
In hemolytic anemia, what is the primary mechanism leading to increased bilirubin levels?
a) Inadequate dietary intake of iron
b) Destruction of erythrocytes
c) Decreased erythropoietin production
d) Bone marrow failure
Answer: b) Destruction of erythrocytes
Rationale: Hemolytic anemia is characterized by the premature destruction of red blood cells, releasing hemoglobin that is broken down into bilirubin, leading to increased serum bilirubin levels .
What differentiates hypoproliferative anemia from hemolytic anemia in terms of pathophysiology?
a) Hypoproliferative anemia involves bone marrow damage, while hemolytic anemia involves the destruction of mature RBCs.
b) Hemolytic anemia is caused by iron deficiency, while hypoproliferative anemia is caused by blood loss.
c) Hypoproliferative anemia results from excessive RBC destruction, while hemolytic anemia results from reduced production.
d) Both types of anemia result from bleeding disorders.
Answer: a) Hypoproliferative anemia involves bone marrow damage, while hemolytic anemia involves the destruction of mature RBCs.
Rationale: Hypoproliferative anemia is associated with decreased red cell production due to bone marrow failure, while hemolytic anemia is characterized by the premature destruction of red blood cells .
A patient with neutropenia is at risk for which complication?
a) Hypoxia
b) Infection
c) Thrombocytopenia
d) Polycythemia
Answer: b) Infection
Rationale: Neutropenia is defined by a decreased number of neutrophils, which play a critical role in defending the body against infections. The primary complication of neutropenia is increased susceptibility to infections .
Which medical management approach is most appropriate for a patient with lymphopenia?
a) Blood transfusion
b) Administration of erythropoietin
c) Immunosuppressive therapy
d) Administration of antiviral agents
Answer: d) Administration of antiviral agents
Rationale: Lymphopenia, a reduction in lymphocytes, may result from viral infections such as HIV. Managing the underlying infection is critical, and antiviral therapy is often required in cases where a viral cause is identified .
What is a common cause of secondary polycythemia?
a) Bone marrow failure
b) Chronic hypoxia
c) Increased platelet production
d) Immune thrombocytopenia
b) Chronic hypoxia
Rationale: Secondary polycythemia occurs in response to chronic hypoxia, which stimulates the production of erythropoietin and leads to an increased red blood cell count. Conditions such as chronic lung disease or living at high altitudes can cause this condition .
Which clinical manifestation is most likely in a patient with disseminated intravascular coagulation (DIC)?
a) Thrombosis and hemorrhage
b) Elevated hemoglobin
c) Decreased bilirubin levels
d) Hypoglycemia
Answer: a) Thrombosis and hemorrhage
Rationale: DIC is characterized by simultaneous clot formation and bleeding due to the consumption of clotting factors. This results in widespread thrombi and spontaneous hemorrhage .
In the care of a patient with sickle cell disease, what is the primary goal during a vaso-occlusive crisis?
a) Preventing infection
b) Reducing joint inflammation
c) Maintaining hydration and oxygenation
d) Administering folic acid supplements
answer: c) Maintaining hydration and oxygenation
Rationale: During a vaso-occlusive crisis, adequate hydration and oxygenation are essential to reduce the sickling of red blood cells and prevent further blockage of blood vessels .
What distinguishes neutropenia from lymphopenia in terms of pathophysiology?
a) Neutropenia results from viral infections, while lymphopenia is a complication of bacterial infections.
b) Neutropenia involves low neutrophil counts, while lymphopenia is characterized by reduced lymphocytes.
c) Both conditions result from excessive production of white blood cells.
d) Lymphopenia is always caused by bone marrow suppression, while neutropenia results from iron deficiency.
Answer: b) Neutropenia involves low neutrophil counts, while lymphopenia is characterized by reduced lymphocytes.
Rationale: Neutropenia and lymphopenia refer to the depletion of specific types of white blood cells—neutrophils and lymphocytes, respectively. Both conditions may result from infections, immunosuppressive therapy, or bone marrow failure .
Which intervention is most important for a patient with thrombocytopenia and a platelet count of 15,000/mm³?
a) Administering iron supplements
b) Educating on fall prevention and bleeding precautions
c) Encouraging weight-bearing exercise
d) Administering erythropoietin
Answer: b) Educating on fall prevention and bleeding precautions
Rationale: In patients with thrombocytopenia, the risk of bleeding is increased. Preventive education and precautions against falls or trauma are crucial to avoid spontaneous bleeding .
Which of the following laboratory findings is consistent with a diagnosis of hemolytic anemia?
a) Decreased reticulocyte count
b) Increased bilirubin levels
c) Increased haptoglobin levels
d) Decreased mean corpuscular volume (MCV)
Answer: b) Increased bilirubin levels
Rationale: Hemolytic anemia leads to the destruction of RBCs, releasing hemoglobin that is metabolized into bilirubin, thus raising bilirubin levels .
A patient with chronic kidney disease is diagnosed with anemia. What is the underlying cause of this anemia?
a) Iron deficiency
b) Decreased erythropoietin production
c) Bone marrow suppression
d) Hemolysis of red blood cells
Answer: b) Decreased erythropoietin production
Rationale: Chronic kidney disease can lead to a decrease in erythropoietin production, which is crucial for stimulating RBC production .
Which symptom would most likely be observed in a patient with hypoproliferative anemia?
a) Jaundice
b) Pallor and fatigue
c) Dark-colored urine
d) Enlarged spleen
Answer: b) Pallor and fatigue
Rationale: Hypoproliferative anemias are typically characterized by a reduction in RBC production, leading to symptoms such as pallor
What is the primary goal of medical management for a patient with hemolytic anemia?
a) Reduce iron overload
b) Prevent RBC destruction
c) Administer anticoagulants
d) Increase RBC production
Answer: b) Prevent RBC destruction
Rationale: In hemolytic anemia, the primary goal is to reduce or stop the destruction of RBCs, which can be achieved through medical interventions like immunosuppressive therapy or splenectomy .
Which clinical manifestation is common in patients with neutropenia?
a) Jaundice
b) Fever
c) Petechiae
d) Cyanosis
Answer: b) Fever
Rationale: Neutropenia is characterized by a low neutrophil count, which increases the risk of infection. Fever is often the first sign of infection in neutropenic patients .
A patient with lymphopenia is at risk for which complication?
a) Excessive bleeding
b) Recurrent infections
c) Deep vein thrombosis
d) Anemia
b) Recurrent infections
Rationale: Lymphopenia refers to a reduced lymphocyte count, which compromises the body’s ability to fight infections, leading to a higher risk of recurrent infections .
Which intervention is the most appropriate for a patient with neutropenia?
a) Administering erythropoietin
b) Initiating protective isolation
c) Starting iron supplementation
d) Administering vitamin K
b) Initiating protective isolation
Rationale: Patients with neutropenia are at high risk for infection due to their compromised immune systems. Protective isolation is important to prevent exposure to pathogens .
What is the primary cause of secondary polycythemia?
a) Bone marrow hyperplasia
b) Chronic hypoxia
c) Hemolysis
d) Iron deficiency
b) Chronic hypoxia
Rationale: Secondary polycythemia results from increased erythropoietin production in response to chronic hypoxia, often seen in patients with chronic lung diseases or living at high altitudes
Which lab result is commonly seen in a patient with disseminated intravascular coagulation (DIC)?
a) Increased platelet count
b) Increased fibrin degradation products
c) Decreased prothrombin time
d) Decreased D-dimer levels
Answer: b) Increased fibrin degradation products
Rationale: DIC leads to widespread clotting and subsequent fibrinolysis, causing elevated levels of fibrin degradation products (FDPs) .
A patient with neutropenia following chemotherapy has an absolute neutrophil count (ANC) of 450 cells/μL. What is the nurse’s priority action?
a) Administer IV antibiotics as prescribed
b) Provide the patient with iron supplements
c) Encourage high-protein meals
d) Initiate seizure precautions
Answer: a) Administer IV antibiotics as prescribed
Rationale: An ANC below 500 cells/μL places the patient at severe risk for infections. Immediate antibiotic therapy is required if the patient shows signs of infection, such as fever .
In a patient with secondary polycythemia due to chronic obstructive pulmonary disease (COPD), which clinical finding is most concerning?
a) Hematocrit of 55%
b) Decreased blood pressure
c) Oxygen saturation of 88%
d) Increased white blood cell count
Answer: c) Oxygen saturation of 88%
Rationale: Secondary polycythemia is often caused by chronic hypoxia, as seen in COPD. A low oxygen saturation indicates ongoing tissue hypoxia, requiring oxygen therapy .
Which of the following is a primary goal in the management of disseminated intravascular coagulation (DIC)?
a) Preventing further bleeding
b) Administering iron supplements
c) Increasing platelet production
d) Enhancing RBC production
Answer: a) Preventing further bleeding
Rationale: In DIC, the depletion of clotting factors and platelets leads to severe bleeding. The primary goal is to prevent and manage bleeding through platelet transfusion, fresh frozen plasma, and treating the underlying cause .
A patient with sickle cell disease is admitted for acute chest syndrome. What is the nurse's priority intervention?
a) Administer bronchodilators
b) Start blood transfusions
c) Encourage ambulation
d) Restrict fluid intake
Answer: b) Start blood transfusions
Rationale: Acute chest syndrome is a severe complication of sickle cell disease that may require blood transfusions to reduce the proportion of sickled cells and improve oxygenation .
What is the primary cause of hemolytic anemia in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency?
a) Vitamin B12 deficiency
b) Exposure to oxidative stress
c) Excessive iron intake
d) Decreased erythropoietin production
Answer: b) Exposure to oxidative stress
Rationale: G6PD deficiency causes red blood cells to become more vulnerable to oxidative stress, leading to hemolysis when exposed to triggers such as certain medications, infections, or foods (e.g., fava beans) .
Which finding is typical in a patient with hemolytic anemia?
a) Decreased reticulocyte count
b) Dark urine
c) Elevated mean corpuscular volume (MCV)
d) Bradycardia
Answer: b) Dark urine
Rationale: Hemolytic anemia leads to the destruction of RBCs, releasing hemoglobin, which is broken down into bilirubin. Dark urine occurs due to hemoglobinuria .
Which medication would be prescribed for a patient with anemia of chronic disease (ACD) due to chronic kidney disease (CKD)?
a) Folic acid supplements
b) Erythropoietin
c) Vitamin B12 injections
d) Corticosteroids
Answer: b) Erythropoietin
Rationale: In CKD, the kidneys produce insufficient erythropoietin, leading to anemia. Administering synthetic erythropoietin stimulates RBC production in the bone marrow .
A patient with neutropenia reports fever and fatigue. What is the nurse’s priority intervention?
a) Administer prophylactic antibiotics
b) Obtain a blood culture and notify the physician
c) Encourage rest and increased fluid intake
d) Administer growth factors to increase WBC count
Answer: b) Obtain a blood culture and notify the physician
Rationale: In neutropenic patients, fever can be a sign of infection. A blood culture is essential to identify the causative organism, followed by appropriate antibiotic therapy .
A patient with immune thrombocytopenic purpura (ITP) is at risk for which complication?
a) Iron overload
b) Spontaneous bleeding
c) Severe joint pain
d) Anemia
Answer: b) Spontaneous bleeding
Rationale: ITP is characterized by a low platelet count, which increases the risk of spontaneous bleeding, particularly from mucous membranes and the gastrointestinal tract .
What is the underlying cause of disseminated intravascular coagulation (DIC)?
a) Excessive production of red blood cells
b) Depletion of clotting factors and platelets
c) Excessive fibrin production
d) Overactivation of neutrophils
Answer: b) Depletion of clotting factors and platelets
Rationale: DIC occurs when the body uses up clotting factors and platelets due to widespread clotting and fibrinolysis, leading to bleeding and potential organ damage .
In a patient with secondary polycythemia, what is the primary nursing intervention?
a) Monitoring for signs of hypoxia
b) Administering anticoagulants
c) Providing vitamin B12 injections
d) Restricting fluid intake
Answer: a) Monitoring for signs of hypoxia
Rationale: Secondary polycythemia is often caused by chronic hypoxia. Monitoring oxygen levels and administering oxygen therapy are essential to prevent complications .
Which complication should the nurse monitor for in a patient with sickle cell disease who is receiving a blood transfusion?
a) Fluid overload
b) Hypertension
c) Hypoglycemia
d) Hyperkalemia
Answer: a) Fluid overload
Rationale: Blood transfusions increase the risk of fluid overload, especially in patients with compromised cardiac function. Monitoring for signs of pulmonary edema and heart failure is important .
A patient with hypoproliferative anemia is prescribed oral iron supplements. What is the most appropriate nursing intervention to enhance iron absorption?
a) Administer the supplement with milk
b) Give the iron supplement with orange juice
c) Administer the supplement after meals
d) Encourage the patient to take the supplement at bedtime
Answer: b) Give the iron supplement with orange juice
Rationale: Vitamin C (found in orange juice) enhances the absorption of iron. Iron should be taken on an empty stomach, as certain foods (e.g., dairy products) reduce its absorption .
Which clinical manifestation is most concerning in a patient with secondary polycythemia?
a) Hemoglobin of 18 g/dL
b) Hypertension
c) Tachycardia
d) Shortness of breath
Answer: d) Shortness of breath
Rationale: Secondary polycythemia can result from chronic hypoxia, which may lead to respiratory distress. Shortness of breath is a concerning symptom that warrants intervention .
What is the primary cause of sickle cell crisis in patients with sickle cell disease?
a) Dehydration
b) Hyperkalemia
c) Bone marrow suppression
d) Excessive oxygen saturation
Answer: a) Dehydration
Rationale: Dehydration reduces blood volume and increases the concentration of sickled cells, which can lead to vaso-occlusive crises. Maintaining adequate hydration is critical for prevention .
A patient with sickle cell disease is at risk for which major complication during a sickle cell crisis?
a) Hemorrhage
b) Thrombus formation
c) Tissue ischemia
d) Excessive fluid retention
Answer: c) Tissue ischemia
Rationale: In sickle cell crisis, vaso-occlusion by sickled red blood cells can lead to tissue ischemia, causing pain and possible organ damage .
What is the rationale for using hydroxyurea in patients with sickle cell disease?
a) To increase hemoglobin A production
b) To reduce the number of sickling episodes
c) To decrease red blood cell production
d) To prevent infection
b) To reduce the number of sickling episodes
Rationale: Hydroxyurea increases the level of fetal hemoglobin (HbF), which reduces the frequency of sickling episodes and painful crises in sickle cell patients .
A patient with hemolytic anemia presents with dark urine and jaundice. What laboratory finding would the nurse expect?
a) Decreased bilirubin
b) Increased reticulocyte count
c) Decreased hemoglobin
d) Increased creatinine
Answer: b) Increased reticulocyte count
Rationale: In hemolytic anemia, the destruction of RBCs stimulates the bone marrow to increase RBC production, leading to an elevated reticulocyte count .
What is the most important nursing intervention for a patient with neutropenia?
a) Frequent handwashing
b) Administering vitamin supplements
c) Monitoring hemoglobin levels
d) Encouraging weight-bearing exercises
a) Frequent handwashing
Rationale: Patients with neutropenia are at high risk for infections due to their low neutrophil count. Hand hygiene is critical to prevent infection transmission .
Which clinical manifestation is commonly associated with lymphopenia?
a) Thrombosis
b) Increased risk of viral infections
c) Petechiae
d) Hypertension
Answer: b) Increased risk of viral infections
Rationale: Lymphopenia, characterized by a decreased lymphocyte count, compromises the immune system, making patients more susceptible to viral infections .
A patient with immune thrombocytopenic purpura (ITP) has a platelet count of 20,000/mm³. Which intervention is a priority?
a) Administering platelet transfusions
b) Restricting activity to prevent injury
c) Encouraging a diet high in iron
d) Administering erythropoietin
Answer: b) Restricting activity to prevent injury
Rationale: In patients with thrombocytopenia, there is an increased risk of bleeding. Preventing trauma and injury is critical to avoid spontaneous bleeding .
A patient with secondary polycythemia has elevated hematocrit and hemoglobin levels. What is the most appropriate intervention?
a) Administer diuretics
b) Encourage hydration
c) Restrict physical activity
d) Provide iron supplements
Answer: b) Encourage hydration
Rationale: In secondary polycythemia, the increased red cell mass can lead to increased blood viscosity. Adequate hydration is essential to reduce the risk of thrombotic events .
Which medication is typically used to treat patients with disseminated intravascular coagulation (DIC)?
a) Heparin
b) Warfarin
c) Fresh frozen plasma
d) Aspirin
c) Fresh frozen plasma
Rationale: Fresh frozen plasma is used in DIC to replace depleted clotting factors and manage bleeding. Heparin may be used in certain cases to prevent further clotting .
A patient with folic acid deficiency anemia is prescribed folic acid supplements. Which food would the nurse recommend to improve folic acid intake?
a) Dairy products
b) Leafy green vegetables
c) Poultry
d) Red meat
Answer: b) Leafy green vegetables
Rationale: Leafy green vegetables are rich in folate and are recommended for patients with folic acid deficiency anemia .
In a patient with hemolytic anemia, which intervention would the nurse implement to manage jaundice?
a) Provide vitamin K supplements
b) Encourage hydration
c) Administer corticosteroids
d) Increase iron intake
Answer: b) Encourage hydration
Rationale: Hydration helps to flush out the excess bilirubin produced by hemolysis, thereby reducing the severity of jaundice.
A patient with sickle cell disease asks why they need to avoid high altitudes. What is the best response by the nurse?
a) "High altitudes increase your risk of infection."
b) "The lower oxygen levels can trigger a sickle cell crisis."
c) "The air pressure causes red blood cell breakdown."
d) "High altitudes increase the risk of dehydration."
: b) "The lower oxygen levels can trigger a sickle cell crisis."
Rationale: At high altitudes, the reduced oxygen levels can cause sickling of red blood cells, leading to a vaso-occlusive crisis .
A patient with anemia has a hemoglobin level of 6.5 g/dL. What is the priority nursing intervention?
a) Administer packed red blood cells
b) Provide vitamin B12 injections
c) Start oral iron supplements
d) Administer corticosteroids
Answer: a) Administer packed red blood cells
Rationale: A hemoglobin level below 7 g/dL often requires a blood transfusion to improve oxygen-carrying capacity and prevent tissue hypoxia .
A patient with polycythemia vera reports severe itching. What is the best nursing intervention?
a) Administer antihistamines as prescribed
b) Encourage increased fluid intake
c) Provide iron supplements
d) Apply cold compresses to the skin
Answer: a) Administer antihistamines as prescribed
Rationale: Severe itching is a common symptom of polycythemia vera due to histamine release from an increased number of basophils. Antihistamines can help relieve the itching .
Which finding is most concerning in a patient with disseminated intravascular coagulation (DIC)?
a) Bruising on the arms
b) Blood in the urine
c) Decreased heart rate
d) Low-grade fever
Answer: b) Blood in the urine
Rationale: Hematuria (blood in the urine) is a sign of bleeding in DIC, indicating that clotting factors are being consumed and the patient is at risk for severe hemorrhage .
In a patient with sickle cell disease, what is the most effective way to prevent vaso-occlusive crises?
a) Avoid cold temperatures
b) Provide vitamin C supplements
c) Administer blood transfusions regularly
d) Encourage daily exercise
Answer: a) Avoid cold temperatures
Rationale: Cold temperatures can cause vasoconstriction, which reduces blood flow and can trigger a vaso-occlusive crisis in patients with sickle cell disease .
A patient with immune thrombocytopenic purpura (ITP) presents with petechiae and nosebleeds. What is the most appropriate nursing action?
a) Administer corticosteroids
b) Start iron supplementation
c) Provide antihistamines
d) Administer erythropoietin
a) Administer corticosteroids
Rationale: Corticosteroids are often used in ITP to suppress the immune system and increase platelet counts, which helps reduce bleeding episodes
What should the nurse monitor for in a patient receiving frequent blood transfusions for anemia?
a) Hypocalcemia
b) Iron overload
c) Hypokalemia
d) Vitamin B12 deficiency
b) Iron overload
Rationale: Frequent blood transfusions can lead to iron overload, a condition where excess iron accumulates in the body and may cause organ damage .
A patient with sickle cell disease asks why they need to stay hydrated. What is the best response by the nurse?
a) "Hydration helps reduce your risk of infections."
b) "Staying hydrated prevents your blood from becoming too thick."
c) "Hydration will improve your red blood cell production."
d) "Drinking water reduces pain during a sickle cell crisis."
Answer: b) "Staying hydrated prevents your blood from becoming too thick."
Rationale: Adequate hydration prevents the blood from becoming more viscous, reducing the risk of vaso-occlusive episodes in patients with sickle cell disease .
Which complication is most likely in a patient with polycythemia vera?
a) Hemorrhage
b) Stroke
c) Anemia
d) Neutropenia
b) Stroke
Rationale: Polycythemia vera increases the risk of thrombotic events such as stroke due to elevated red blood cell mass and increased blood viscosity .
In a patient with hemolytic anemia, which clinical finding indicates a severe complication?
a) Splenomegaly
b) Bradycardia
c) Elevated blood pressure
d) Cyanosis
Answer: a) Splenomegaly
Rationale: Hemolytic anemia can lead to splenomegaly as the spleen works to remove the destroyed red blood cells, and severe cases may require splenectomy .
A patient with disseminated intravascular coagulation (DIC) is receiving heparin therapy. What is the goal of this therapy?
a) To increase red blood cell production
b) To prevent further clot formation
c) To increase platelet count
d) To prevent infection
b) To prevent further clot formation
Rationale: In DIC, heparin is used to prevent further clot formation and stop the consumption of clotting factors, which can help manage the underlying condition .
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