Adult Health - Hematological

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Author:
nursedaisy98
ID:
256682
Filename:
Adult Health - Hematological
Updated:
2014-04-20 10:55:27
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NCLEX RN
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Adult Health
Description:
Hematological
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  1. A client enters the hospital emergency department with a nosebleed. On assessment the client tells the nurse that the nosebleed just suddenly began. The nurse notes no obvious facial injury. Which is the initial nursing action? 
    1. Insert nasal packing. 
    2. Prepare a nasal balloon for insertion. 
    3. Place the client in a semi-Fowler's position, and apply ice packs to the nose. 
    4. Sit the client down, ask the client to lean forward slightly, and apply pressure to the nose for 5 to 10 minutes.
    4. Sit the client down, ask the client to lean forward slightly, and apply pressure to the nose for 5 to 10 minutes.
  2. The nurse is performing an assessment on a client with a diagnosis of pernicious anemia. Which finding would the nurse expect to note in this client? 
    1. Dyspnea 
    2. Dusky mucous membranes 
    3. Shortness of breath on exertion
    4. Red tongue that is smooth and sore
    4. Red tongue that is smooth and sore
  3. The nurse has provided instructions to a client with sickle cell disease regarding measures that will prevent a sickle cell crisis. Which statement, if made by the client, indicates an understanding of these measures? 
    1. "I need to avoid any exercise." 
    2. "I need to avoid increasing my fluid intake." 
    3. "I need to avoid going outdoors in warm weather." 
    4. "I need to avoid situations that may lead to an infection."
    4. "I need to avoid situations that may lead to an infection."
  4. The nurse is preparing to perform an assessment on a client being admitted to the hospital with a diagnosis of sickle cell crisis, vaso-occlusive crisis. Which findings should the nurse expect to note on assessment of the client? Select all that apply. 
    1. Pallor 
    2. Fever 
    3. Joint swelling 
    4. Blurred vision 
    5. Abdominal pain
    • 1. Pallor 
    • 2. Fever 
    • 3. Joint swelling 
    • 5. Abdominal pain
  5. The nurse is preparing a plan of care for a client with sickle cell crisis who will be admitted to the nursing unit. The nurse should include which intervention as a priority in the plan of care for the client? 
    1. Initiate an intravenous (IV) line for the administration of fluids. 
    2. Consult with the psychiatric department regarding genetic counseling. 
    3. Call the blood bank and request preparation of a unit of packed red blood cells. 
    4. Call the respiratory department to prepare for intubation and mechanical ventilation.
    1. Initiate an intravenous (IV) line for the administration of fluids.
  6. The nurse is performing an assessment on a client with a diagnosis of anemia that developed as a result of blood loss after a traumatic injury. The nurse should expect to note which sign or symptom in the client as a result of the anemia? 
    1. Bradycardia 
    2. Muscle cramps 
    3. Increased respiratory rate 
    4. Shortness of breath with activity
    4. Shortness of breath with activity
  7. The nurse has provided medication instructions to a client with an iron deficiency anemia who will be taking iron supplements. Which statement, if made by the client, indicates an understanding of this medication? 
    1. "I need to increase my fluid intake." 
    2. "I should eliminate fiber foods from my diet." 
    3. "I need to take the medication with water before a meal." 
    4. "I should be sure to chew the tablet thoroughly before swallowing it."
    1. "I need to increase my fluid intake."
  8. A client who was diagnosed with toxic shock syndrome (TSS) now exhibits petechiae, oozing from puncture sites, and coolness of the digits of the hands and feet. Clotting times determined for this client are prolonged. The nurse interprets these clinical signs as being most compatible with which condition? 
    1. Heparin overdose 
    2. Vitamin K deficiency 
    3. Factor VIII deficiency 
    4. Disseminated intravascular coagulopathy (DIC)
    4. Disseminated intravascular coagulopathy (DIC)
  9. The nurse in a health care clinic is reviewing the record of a client with diabetes mellitus who was just seen by the health care provider (HCP). The nurse notes that the HCP has prescribed acarbose (Precose). Which preexisting disorder, if noted in the client's record, would indicate a contraindication to the use of this medication? 
    1. Hypothyroidism 
    2. Renal insufficiency 
    3. Arterial insufficiency 
    4. Coronary artery disease
    2. Renal insufficiency
  10. The nurse is reviewing the health care provider's prescriptions for a client admitted to the hospital with a diagnosis of idiopathic autoimmune hemolytic anemia. The nurse prepares the client for treatment of this disorder, understanding that which may be recommended? Select all that apply. 
    1. Transfusions 
    2. Splenectomy 
    3. Radiation therapy 
    4. Corticosteroid medication 
    5. Immunosuppressive agents
    • 1. Transfusions 
    • 2. Splenectomy 
    • 4. Corticosteroid medication 
    • 5. Immunosuppressive agents
  11. A client with chronic kidney disease is anemic. The nurse plans care, knowing that this problem is caused by the client's insufficient production of which substance? 
    1. Renin 
    2. Aldosterone 
    3. Angiotensin I 
    4. Erythropoietin
    4. Erythropoietin
  12. When obtaining assessment data from a client with a microcytic normochromic anemia, which should the nurse question the client about? 
    1. Folic acid intake 
    2. Dietary intake of iron 
    3. A history of gastric surgery 
    4. A history of sickle cell anemia
    2. Dietary intake of iron
  13. A client is seen by the nurse in the health care clinic with a diagnosis of mild anemia. The anemia is believed to be a result of her menstrual period. The client asks the nurse how much blood is lost during a menstrual period. What is the nurse's best response? 
    1. 40 mL 
    2. 50 mL 
    3. 60 mL 
    4. 70 mL
    1. 40 mL

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