Chapter 30: Hematologic Problems

Multiple Choice

1. Question: A 62-year old man with chronic anemia is experiencing increased fatigue and occasional palpitations at rest.
2. Question: The nurse would expect the patients laboratory findings to include
3. Question: Which menu choice indicates that the patient understands the nurses teaching about best dietary choices for iron-deficiency anemia?
4. Question: A patient who is receiving methotrexate for severe rheumatoid arthritis develops a megaloblastic anemia.
5. Question: The nurse will anticipate teaching the patient about increasing oral intake of
6. Question: A 52-year-old patient has a new diagnosis of pernicious anemia. The nurse determines that the patient understands the teaching about the disorder when the patient states, I
7. Question: An appropriate nursing intervention for a hospitalized patient with severe hemolytic anemia is to
8. Question: Which patient statement to the nurse indicates a need for additional instruction about taking oral ferrous sulfate?
9. Question: Which collaborative problem will the nurse include in a care plan for a patient admitted to the hospital with idiopathic aplastic anemia?
10. Question: It is important for the nurse providing care for a patient with sickle cell crisis to
11. Question: Which statement by a patient indicates good understanding of the nurses teaching about prevention of sickle cell crisis?
12. Question: Which instruction will the nurse plan to include in discharge teaching for the patient admitted with a sickle cell crisis?
13. Question: The nurse notes scleral jaundice in a patient being admitted with hemolytic anemia. The nurse will plan to check the laboratory results for the
14. Question: A patient who has been receiving a heparin infusion and warfarin (Coumadin) for a deep vein thrombosis (DVT) is diagnosed with heparin-induced thrombocytopenia (HIT) when her platelet level drops to 110,000/L. Which action will the nurse include in the plan of care?
15. Question: A critical action by the nurse caring for a patient with an acute exacerbation of polycythemia vera is to
16. Question: Which intervention will be included in the nursing care plan for a patient with immune thrombocytopenic purpura (ITP)?
17. Question: Which laboratory result will the nurse expect to show a decreased value if a patient develops heparin- induced thrombocytopenia (HIT)?
18. Question: The nurse caring for a patient with type A hemophilia being admitted to the hospital with severe pain and swelling in the right knee will
19. Question: A 28-year-old man with von Willebrand disease is admitted to the hospital for minor knee surgery. The nurse will review the coagulation survey to check the
20. Question: A routine complete blood count indicates that an active 80-year-old man may have myelodysplastic syndrome. The nurse will plan to teach the patient about
21. Question: Which action will the admitting nurse include in the care plan for a 30-year old woman who is neutropenic?
22. Question: Which laboratory test will the nurse use to determine whether filgrastim (Neupogen) is effective for a patient with acute lymphocytic leukemia who is receiving chemotherapy?
23. Question: A 68-year-old woman with acute myelogenous leukemia (AML) asks the nurse whether the planned chemotherapy will be worth undergoing. Which response by the nurse is appropriate?
24. Question: A patient with a history of a transfusion-related acute lung injury (TRALI) is to receive a transfusion of packed red blood cells (PRBCs). Which action by the nurse will decrease the risk for TRALI for this patient?
25. Question: A 54-year-old woman with acute myelogenous leukemia (AML) is considering treatment with a hematopoietic stem cell transplant (HSCT). The best approach for the nurse to assist the patient with a treatment decision is to
26. Question: Which action will the nurse include in the plan of care for a 72-year-old woman admitted with multiple myeloma?
27. Question: An appropriate nursing intervention for a patient with non-Hodgkins lymphoma whose platelet count drops to 18,000/L during chemotherapy is to
28. Question: A 30-year-old man with acute myelogenous leukemia develops an absolute neutrophil count of 850/L while receiving outpatient chemotherapy. Which action by the outpatient clinic nurse is most appropriate?
29. Question: Which information obtained by the nurse caring for a patient with thrombocytopenia should be

immediately communicated to the health care provider?

30. Question: The nurse is planning to administer a transfusion of packed red blood cells (PRBCs) to a patient with blood loss from gastrointestinal hemorrhage. Which action can the nurse delegate to unlicensed assistive personnel (UAP)?
31. Question: A postoperative patient receiving a transfusion of packed red blood cells develops chills, fever, headache, and anxiety 35 minutes after the transfusion is started. After stopping the transfusion, what action should the nurse take?
32. Question: A patient in the emergency department complains of back pain and difficulty breathing 15 minutes after a transfusion of packed red blood cells is started. The nurses first action should be to
33. Question: Which patient should the nurse assign as the roommate for a patient who has aplastic anemia?
34. Question: Which patient requires the most rapid assessment and care by the emergency department nurse?
35. Question: A 19-year-old woman with immune thrombocytopenic purpura (ITP) has an order for a platelet transfusion Which information indicates that the nurse should consult with the health care provider before obtaining and administering platelets?
36. Question: Which problem reported by a patient with hemophilia is most important for the nurse to communicate to the physician?
37. Question: A patient with septicemia develops prolonged bleeding from venipuncture sites and blood in the stools. Which action is most important for the nurse to take?
38. Question: A patient with possible disseminated intravascular coagulation arrives in the emergency department with a blood pressure of 82/40, temperature 102 F (38.9 C), and severe back pain. Which physician order will the nurse implement first?
39. Question: Which action for a patient with neutropenia is appropriate for the registered nurse (RN) to delegate to a licensed practical/vocational nurse (LPN/LVN)?
40. Question: Several patients call the outpatient clinic and ask to make an appointment as soon as possible. Which patient should the nurse schedule to be seen first?
41. Question: After receiving change-of-shift report for several patients with neutropenia, which patient should the nurse assess first?
42. Question: Which action will the nurse include in the plan of care for a patient who has thalassemia major?
43. Question: Which patient information is most important for the nurse to monitor when evaluating the effectiveness of deferoxamine (Desferal) for a patient with hemochromatosis?
44. Question: Which finding about a patient with polycythemia vera is most important for the nurse to report to the health care provider?
45. Question: Following successful treatment of Hodgkins lymphoma for a 55-year-old woman, which topic will the nurse include in patient teaching?
46. Question: A patient who has non-Hodgkins lymphoma is receiving combination treatment with rituximab (Rituxan) and chemotherapy. Which patient assessment finding requires the most rapid action by the nurse?
47. Question: Which information obtained by the nurse assessing a patient admitted with multiple myeloma is most important to report to the health care provider?
48. Question: When a patient with splenomegaly is scheduled for splenectomy, which action will the nurse include in the preoperative plan of care?
49. Question: The nurse has obtained the health history, physical assessment data, and laboratory results shown in the accompanying figure for a patient admitted with aplastic anemia. Which information is most important to communicate to the health care provider?