Hematologic Problems (Exam Mode) By Rnpedia.Com
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- 1.You are reviewing the complete blood count (CBC) for a client who has been admitted for knee arthroscopy. Which value is most important to report to the physician prior to surgery?
- A.
White blood cell count 16,000/mm3
- B.
Hematocrit 33%
- C.
Platelet count 426,000/ mm3
- D.
Hemoglobin 10.9 g/dL
- 2.A new RN is preparing to administer packed red blood cells (PRBCs) to a client whose anemia was caused by blood loss after surgery. Which action by the new RN requires that you, as charge nurse, intervene immediately?
- A.
The new RN waits 20 minutes after obtaining the PRBCs before starting the infusion.
- B.
The new RN starts an intravenous line for the transfusion using a 22-gauge catheter.
- C.
The new RN primes the transfusion set using 5% dextrose in lactated Ringer’s solution.
- D.
The new RN tells the client that the PRBCs may cause a serious transfusion reaction.
- 3.A 32-year-old client with a history of sickle cell anemia is admitted to the hospital during a sickle cell crisis. The physician orders all of these interventions. Which order will you implement first?
- A.
Give morphine sulfate 4-8 mg IV every hour as needed.
- B.
Start a large-gauge IV line and infuse normal saline at 200 mL/hour.
- C.
Immunize with Pneumovax and Haemophilus influenzae vaccines.
- D.
Administer oxygen at an F102 of 100% per non-rebreather mask.
- 4.A 78-year-old client admitted to the hospital with chronic anemia caused by possible gastrointestinal bleeding has all of these activities included in the care plan. Which activity is best delegated to an experienced nursing assistant (NA)?
- A.
Use Hemoccult slides to obtain stool specimens.
- B.
Have the client sign a colonoscopy consent form.
- C.
Administer PEG-ES (GoLYTELY) bowel preparation.
- D.
Check for allergies to contrast dye or shellfish.
- 5.As charge nurse, you are making the daily assignments on the medical-surgical unit. Which client is best assigned to a nurse who has floated from the post-anesthesia care unit (PACU)?
- A.
A 30-year-old client with thalassemia major who has an order for subcutaneous infusion of deferoxamine (Desferal)
- B.
A 43-year-old client with multiple myeloma who needs discharge teaching
- C.
A 52-year-old client with chronic gastrointestinal bleeding who has returned to the unit after a colonoscopy
- D.
A 65-year-old client with pernicious anemia who has just been admitted to the unit
- 6.You are making a room assignment for a newly arrived client whose laboratory testing indicates pancytopenia. All of these clients are already on the nursing unit. Which one will be the best roommate for the new client?
- A.
The client with digoxin toxicity
- B.
The client with viral pneumonia
- C.
The client with shingles
- D.
The client with cellulitis
- 7.A client admitted to the hospital with a sickle cell crisis complains of severe abdominal, hip, and knee pain. You observe an LPN accomplishing these client care tasks. Which one requires that you, as charge nurse, intervene immediately?
- A.
The LPN encourages the client to use the ordered PCA.
- B.
The LPN positions cold packs on the client’s knees.
- C.
The LPN places a “No Visitors” sign on the client’s door.
- D.
The LPN checks the client’s temperature every 2 hours.
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