Question 1

The nurse is teaching a patient with sickle cell anemia how to prevent crises.Which foods should the nurse teach the patient to avoid?

Accepted Answer

A)  Citrus fruits 
B)  Alcoholic beverages 
C)  Chocolates and colas 
D)  Whole grain products

Question 2

A patient with aplastic anemia is to receive an injection of erythropoietin (Epogen).The patient asks what the injection is intended to do.Which should the nurse respond to the patient?

Accepted Answer

A)  "It will inhibit the protein that is attacking your blood cells." 
B)  "It works like a blood transfusion to give you extra red blood cells." 
C)  "It will stimulate your body to produce more of its own red blood cells." 
D)  "It will increase your energy while your body is recovering from the anemia."

Question 3

The recommended dose of filgrastim (Neupogen)is 10 mcg/kg/day.It is supplied as 300 mcg/mL.A patient who weighs 132 lb should receive ____________________ mL.

Accepted Answer

The answer of The recommended dose of filgrastim (Neupogen)is 10...

Question 4

A patient is admitted to the hospital with hypertension and vertigo related to polycythemia vera (PV).For which treatment should the nurse prepare the patient?

Accepted Answer

A)  Myelogram 
B)  Splenectomy 
C)  Therapeutic phlebotomy 
D)  Injection of colony-stimulating factors

Question 5

The nurse is planning discharge teaching for a patient with polycythemia.Which nursing intervention should the nurse consider to help prevent complications in this patient?

Accepted Answer

A)  Monitor intake and output. 
B)  Avoid use of injections for pain. 
C)  Maintain bedrest during treatment. 
D)  Encourage 3 L of water intake daily.

Question 6

A patient with multiple myeloma is being cared for at home.Which nursing diagnosis should guide the nurse when teaching the family how to provide care for the patient?

Accepted Answer

A)  Risk for Injury related to compromised bone integrity 
B)  Ineffective Tissue Perfusion related to vascular occlusion 
C)  Risk for Deficient Fluid Volume related to bleeding disorder 
D)  Ineffective Airway Clearance related to cervical lymphadenopathy

Question 7

The nurse is preparing teaching materials for a patient with PV.How many liters of fluid should the nurse instruct the patient to consume each day?

Accepted Answer

A)  1 
B)  2 
C)  3 
D)  4

Question 8

The nurse is assessing a patient with a bleeding disorder and finds large purplish areas in the skin and oral mucosa.Which term should the nurse use to document this finding?

Accepted Answer

A)  Purpura 
B)  Bleeding 
C)  Petechiae 
D)  Hemorrhage

Question 9

A comatose patient is admitted to the emergency department after an automobile accident.The nurse notes a Medic-Alert identification bracelet that states the patient has hemophilia.What should the nurse do first?

Accepted Answer

A)  Notify the physician of the bracelet. 
B)  Tape the bracelet to the patient's arm. 
C)  Call the phone number on the bracelet. 
D)  Remove the bracelet, and give it to the patient's family member.

Question 10

A patient receiving chemotherapy for chronic myelocytic leukemia has irritated mucous membranes.Which mouth care intervention should the nurse include in the plan of care?

Accepted Answer

A)  Brush teeth twice a day with a firm toothbrush. 
B)  Use waxed floss between meals and at bedtime. 
C)  Use sponge Toothettes to clean teeth after meals. 
D)  Swab teeth and mucous membranes four times daily with lemon-glycerin swabs.

Question 11

The nurse is caring for a patient with thrombocytopenia.Which activity should be avoided?

Accepted Answer

A)  Ambulation 
B)  Intramuscular injections 
C)  Visits from family members 
D)  Eating fresh fruits and vegetables

Question 12

A nurse is assisting with data collection on a newly admitted patient with a history of hemophilia.Which assessment finding indicates that the patient has experienced some severe episodes of bleeding in the past?

Accepted Answer

A)  Joint deformities 
B)  Distended abdomen 
C)  Ecchymoses on the extremities 
D)  Elevated WBC count

Question 13

The nurse is collecting information about sickle cell disease for an upcoming seminar.What should the nurse include as common triggers for a sickle cell crisis? (Select all that apply.)

Accepted Answer

A)  Anesthesia 
B)  Chemotherapy 
C)  Severe infection 
D)  Strenuous exercise 
E)  Use of nasal oxygen
F) Blood loss during surgery

Question 14

A patient with anemia and a nursing diagnosis of activity intolerance due to tissue hypoxia and dyspnea is attempting to increase activity tolerance.What percentage of increase in pulse and respiratory rate should the nurse use to determine if the activity is too strenuous for the patient?

Accepted Answer

A)  5% 
B)  10% 
C)  20% 
D)  30%

Question 15

The nurse is emptying the bedside commode of a patient with chronic leukemia and notes that the stool is very dark.Which assumption should guide the nurse's action?

Accepted Answer

A)  The patient may be bleeding. 
B)  The patient may be dehydrated. 
C)  The patient is most likely on iron supplements. 
D)  The patient ate something that turned the stool a dark color.

Question 16

During a home visit,the nurse becomes concerned that a patient recovering from a splenectomy is at risk for infection.What did the nurse observe to come to this conclusion? (Select all that apply.)

Accepted Answer

A)  Received a manicure and pedicure 
B)  Washed hands before preparing lunch 
C)  Poured a cup of tea after petting the cat 
D)  Had a hot tub installed on the back patio 
E)  Planting tomato plants in an outside garden

Question 17

The nurse is assisting in the development of a care plan for a patient with anemia.Which nursing diagnosis is most common in a patient with anemia?

Accepted Answer

A)  Activity Intolerance related to tissue hypoxia 
B)  Ineffective Airway Clearance related to dyspnea 
C)  Chronic Pain related to bone marrow dysfunction 
D)  Risk for Infection related to reduction in circulating WBCs

Question 18

A patient is diagnosed with a folic acid deficiency.On what dietary changes should the nurse instruct this patient? (Select all that apply.)

Accepted Answer

A)  Snack on peanuts. 
B)  Eat breads fortified with folic acid. 
C)  Add green leafy vegetables to meals. 
D)  Increase the intake of milk each day. 
E)  Prepare soups with dried peas and beans.

Exam 28: Nursing Care of Patients With Hematologic and Lymphatic Disorders