Medsurg Blood, Lymph & Immune
- 1.
Which of the following is NOT part of the lymphatic system
- A.
Lymph nodes
- B.
Spleen
- C.
Hypothalamus
- D.
Lymphatic vessels
Correct Answer
C. HypothalamusExplanation
Lymphatic vessels help to return tissue fluid to the circulatory system. Lymph nodes and nodules are masses of lymphatic tissue. Macrophages in the spleen phagocytize pathogens.Rate this question:
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- 2.
Chemical markers that identify cells or molecules are called?
- A.
Antigens
- B.
Antibodies
- C.
Lymphocytes
- D.
Natural Killer Cells
Correct Answer
A. AntigensExplanation
The human body has "self" antigens that identify cells belonging to the body. If antigens of foreign cells do not match, they are recognized and destroyed.Rate this question:
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- 3.
What is true about B cells and T cells.
- A.
Both are formed in the red bone marrow, with T cells maturing in the Thymus and B cells maturing in the bone marrow.
- B.
T cells are formed in the thymus
- C.
B cells are formed in the thymus
- D.
B cells and T cells are both formed in the spleen
Correct Answer
A. Both are formed in the red bone marrow, with T cells maturing in the Thymus and B cells maturing in the bone marrow.Explanation
B cells and T cells are both formed in the red bone marrow. T cells migrate to the thymus to mature before moving to the lymph nodes, nodules, and spleen. B cells remain in the bone marrow to mature and them move directly to the lymphatic tissue.Rate this question:
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- 4.
What are the functions of T cells in cell mediated immunity?
- A.
Helper T cells stimulate B cells
- B.
T cells attach to infected cells for transport to the kidneys in order to be excreted in urine
- C.
They alert WBCs of foreign objects
- D.
Helper T cells (CD4) stimulate Killer T cells (CD8) which are cytotoxic and lyse infected cells, malignant cells, or foreign tissue. Memory T cells remember for future invasion
Correct Answer
D. Helper T cells (CD4) stimulate Killer T cells (CD8) which are cytotoxic and lyse infected cells, malignant cells, or foreign tissue. Memory T cells remember for future invasionExplanation
Cell-mediated immunity only involves T cells.Rate this question:
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- 5.
What are the function of Helper T cells (CD4) in humoral immunity?
- A.
Helper T cells stimulate B cells to divide and become specialized
- B.
Helper T cells lyse infected or foreign cells
- C.
Helper T cells attach to B cells to create a super cell
- D.
Helper T cells are not involved in humoral immunity
Correct Answer
A. Helper T cells stimulate B cells to divide and become specializedExplanation
Humoral immunity involves both T cells and B cells. Killer T cells lyse foreign antigensRate this question:
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- 6.
What would be the next course of action following a positive ELISA HIV test?
- A.
Advise the patient that they should begin to see symptoms within the next 2-3 weeks
- B.
Patient is started on antiretroviral agents
- C.
Western blot test is performed
- D.
None. A positive ELISA test is good news
Correct Answer
C. Western blot test is performedExplanation
The ELISA test is used to determine if HIV antibodies are present. A positive test will then need to beconfirmed by the Western Blot test which determines if HIV antigens are present.Rate this question:
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- 7.
What would determine if a Western Blot test is positive?
- A.
Western Blot is positive only after confirmation using the ELISA test
- B.
At least one HIV antigen is present
- C.
HIV antibodies are present
- D.
The presence of two or more HIV antigens
Correct Answer
D. The presence of two or more HIV antigensExplanation
A positive Western Blot is determined if there are at least two of more HIV antigens present. Western Blot is used as a confirmation test.Rate this question:
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- 8.
What equipment would be needed for the administration of a blood transfusion? (select all that apply)
- A.
Normal Saline
- B.
Lactated Ringers
- C.
Tubing with a filter
- D.
#18 or #20 gauge IV catheter
Correct Answer(s)
A. Normal Saline
C. Tubing with a filter
D. #18 or #20 gauge IV catheterExplanation
All blood is hung with Normal Saline and special tubing containing a filter that filters out harmful particles. An #18 or #20 gauge catheter is appropriate for the viscosity and amount to be transfused.Rate this question:
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- 9.
A blood transfusion is ordered for a patient with a peripheral IV infusion located in the right forearm running Lactated ringers at 80ml/hour. The nurse begins to prepare another line in the left a/c for the ordered transfusion. The patient requests that the nurse use the existing site. Which statement made by the nurse is correct?
- A.
I will need to infuse the blood transfusion using a separate line
- B.
I will ask the doctor if he will approve it
- C.
That is a good idea since I won't have to stick you again
- D.
I will just wait to start the blood transfusion
Correct Answer
A. I will need to infuse the blood transfusion using a separate lineExplanation
Blood transfusions must be administered via a separate IV line with NS and blood tubing containing a filter that removes harmful particles.Rate this question:
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- 10.
A patient has an order for a unit of packed RBCs to be administered. At 0600 the transfusion is started. At 1000, it is noted that the IV line has clotted with only 80% of the transfusion complete. What intervention should the nurse take?
- A.
Call the blood bank and order another unit of blood
- B.
Flush the line with NS and continue to infuse the remaining 20%
- C.
Discontinue the blood infusion, notify the blood bank and document the findings
- D.
Start another IV line and continue to infuse the remaining 20%
Correct Answer
C. Discontinue the blood infusion, notify the blood bank and document the findingsExplanation
Blood must be infused within 4 hours or be discontinued. Blood and packaging should be returned to the blood bank.Rate this question:
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- 11.
Before beginning a blood transfusion what assessment of the patient will the nurse make?
- A.
Hematocrit level
- B.
Urine output
- C.
Prothrombin time
- D.
Vital signs
Correct Answer
D. Vital signsExplanation
Baseline vital signs should be taken for comparison in case of adverse reaction.Rate this question:
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- 12.
A blood transfusion is ordered for a patient. As the nurse explains the procedure, the patient advises that he has had an adverse reaction during a previous blood transfusion. What would be appropriate action for the nurse to take?
- A.
Inform the patient that the blood has been checked against his blood type and continue with the infusion
- B.
Hold the transfusion and inform the Doctor of previous reaction
- C.
Administer corticosteroids prior to giving the infusion
- D.
Flush the IV line with NS prior to administering the infusion
Correct Answer
B. Hold the transfusion and inform the Doctor of previous reactionExplanation
The appropriate action for the nurse to take would be to hold the transfusion and inform the doctor of the patient's previous adverse reaction. This is important because the patient's safety is paramount, and the doctor needs to be aware of the potential risk before proceeding with the transfusion.Rate this question:
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- 13.
An RN requests the LPNs assistance, as policy requires two nurses be involved in the administration of a blood transfusion. The LPN observes that the patient's date of birth on the blood bag is incorrect. What would be the appropriate action for the LPN?
- A.
Inform the RN, document the discrepancy, and continue with the transfusion
- B.
Advise the RN and leave her/him to administer the transfusion alone
- C.
Throw the blood bag out and request a new unit of blood from the blood bank
- D.
Notify the RN of the discrepancy and do not administer the blood. Inform the blood bank and return the blood to the bank
Correct Answer
D. Notify the RN of the discrepancy and do not administer the blood. Inform the blood bank and return the blood to the bankExplanation
Any discrepancy between the patient information and the information on the blood bag requires that the blood is not administered, the blood bank is notified, and the blood is returned.Rate this question:
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- 14.
The LPN requests that an RN assists in beginning a blood transfusion. After successfully identifying the patient and confirming that the information on the blood bag is correct the infusion is started. What would be the appropriate action for the LPN to take next?
- A.
Check on your other patients while the transfusion is running
- B.
Remain with patient and take vital signs 15 minutes into the transfusion, observing for adverse reactions
- C.
Advise the CNA to remain with the patient and notify you of any observed changes
- D.
Administer O2 at 2Lvia nasal cannula to ensure that the patient's oxygen saturation levels remain stable
Correct Answer
B. Remain with patient and take vital signs 15 minutes into the transfusion, observing for adverse reactionsExplanation
Only a small amount of blood will trigger a hemolytic transfusion reaction. Most adverse reactions occur within the first 15 minutes. Signs & symptoms include hypotension, fever, tachycardia and tachypnea which can be observed when taking vital signs. Remaining with the patient enables early detection which can minimize complicationsRate this question:
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- 15.
A patient receiving a blood transfusion begins to complain of low back pain. You observe that he begins to wheeze, has chills, and is SOB. The nurse would know that this is probably what type of reaction?
- A.
A normal reaction to receiving new blood
- B.
Hemolytic transfusion reaction
- C.
The blood is cold and needs to be warmed
- D.
Anaphylactic reaction
Correct Answer
B. Hemolytic transfusion reactionExplanation
Signs and symptoms of a hemolytic transfusion reaction are low back or chest pain, hypotension, fever, chills, tachycardia, tachypnea, wheezing, edema, cough, hives, N/V. An anaphylactic reaction would result in narrowing of the bronchial, wheezing and respiratory arrest.Rate this question:
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- 16.
A patient arrives to the emergency room and has a normal blood volume but has a decrease in RBCs and Hgb, What type of blood transfusion would they need?
- A.
Packed red blood cells
- B.
Platelets
- C.
Plasma
- D.
Frozen red blood cells
Correct Answer
A. Packed red blood cellsExplanation
Packed red blood cells contain no plasma and are used when blood volume is normal. Platelets are given to a patient with active bleeding and a low platelet count. Plasma is given to patients with bleeding disorders and are used to replace blood volume. Frozen red blood cells are taken from a patient prior to surgery.Rate this question:
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- 17.
A patient with hemophilia would receive what type of transfusion?
- A.
Frozen red blood cells
- B.
Cryoprecipitates
- C.
Platelets
- D.
Plasma
Correct Answer
B. CryoprecipitatesExplanation
Cryoprecipitates have a concentration of specific clotting factors that are used for patients with hemophiliaRate this question:
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- 18.
A patient with a scheduled surgery in which blood loss is expected would most likely receive what type of blood transfusion?
- A.
Frozen red blood cells
- B.
Packed red blood cells
- C.
Plasma
- D.
Platelets
Correct Answer
A. Frozen red blood cellsExplanation
Frozen red blood cells are taken from the patient and saved for surgery in order to help prevent hemolytic transfusion reaction. This process is called auto transfusionRate this question:
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- 19.
What are IgE antibodies responsible for?
- A.
Provides passive immunity in newborns
- B.
First antibodies produces during an infection
- C.
Provide immunity following a vaccination or illness
- D.
Response to allergic reactions and cause release of histamine which cause an inflammatory response
Correct Answer
D. Response to allergic reactions and cause release of histamine which cause an inflammatory responseExplanation
IgE antibodies are important in allergic reactions. IgG antibodies cross the placenta to provide immunity to newborns and also provide immunity after a vaccine or illness. IgM antibodies are produced first during an infection.Rate this question:
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- 20.
Which cells are responsible for producing antibodies?
- A.
T cells
- B.
B cells and T cells
- C.
Natural killer cells
- D.
B cells
Correct Answer
D. B cellsExplanation
B cells that become plasma cells are capable of producing millions of different antibodies. T cells directly attach a foreign antigen. Natural killer cells release toxins that result in cytolysis.Rate this question:
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- 21.
Many studies show that breastfeeding a newborn provides them with antibodies that help protect them against infection. What type of immunity is this?
- A.
Naturally acquired passive immunity
- B.
Artificially acquired passive immunity
- C.
Naturally acquired active immunity
- D.
Artificially acquired active immunity
Correct Answer
A. Naturally acquired passive immunityExplanation
Passive immunity occurs when antibodies are NOT produced by the person. Active immunity occurs when a person produces their own antibodies due to illness or vaccine. Naturally acquired passive immunity is a result in placental or breast milk transmission from a mother to newborn.Rate this question:
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- 22.
Exposure to a small amount of live antigens or a large number of dead antigens results in this type of immunity?
- A.
Artificially acquired passive immunity
- B.
Artificially acquired active immunity
- C.
Naturally acquired passive immunity
- D.
Naturally acquired active immunity
Correct Answer
B. Artificially acquired active immunityExplanation
Artificially acquired active immunity refers to the immunity that is developed when a person is intentionally exposed to a small amount of live antigens or a large number of dead antigens. This exposure stimulates the person's immune system to produce antibodies and memory cells, providing long-term protection against future infections. This type of immunity is different from naturally acquired active immunity, which occurs when a person is exposed to antigens through natural infection.Rate this question:
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- 23.
A 14 y/o that had chicken pox when she was 9 has developed what type of immunity?
- A.
Artificially acquired passive immunity
- B.
Naturally acquired passive immunity
- C.
Naturally acquired active immunity
- D.
Artificially acquired active immunity
Correct Answer
C. Naturally acquired active immunityExplanation
The 14-year-old who had chickenpox when she was 9 has developed naturally acquired active immunity. This means that her immune system has produced antibodies in response to the infection, providing long-term protection against future chickenpox infections.Rate this question:
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- 24.
How long does passive immunity last?
- A.
Temporary
- B.
For life
- C.
15 minutes
- D.
None of the above
Correct Answer
A. TemporaryExplanation
Passive immunity is acquired through the transfer of antibodies from another source, such as through breastfeeding or receiving a vaccine. Unlike active immunity, which is developed by the body's own immune system, passive immunity is temporary because the transferred antibodies eventually break down and are eliminated from the body. Therefore, the correct answer is "Temporary."Rate this question:
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- 25.
The ability to destroy pathogens, foreign materials, or prevent future invasion by the same organism is called?
- A.
Neutralization
- B.
Auto-sensitivity
- C.
Immunity
- D.
Inflammation
Correct Answer
C. ImmunityExplanation
Immunity refers to the body's ability to defend itself against pathogens, foreign materials, or prevent future invasion by the same organism. It involves the recognition and response to specific antigens, which can be achieved through the production of antibodies or activation of immune cells. Immunity plays a crucial role in protecting the body from infections and diseases, and can be acquired naturally or through vaccination.Rate this question:
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- 26.
A patient with AIDS has a nursing diagnosis of imbalanced nutrition: less than body requirements. The nurse plans which of the following goals with this patient?
- A.
Consume foods and beverages that are high in glucose
- B.
Plan large menus and cook meals in advance
- C.
Eat low-calorie snacks between meals
- D.
Eat small, frequent meals throughout the day
Correct Answer
D. Eat small, frequent meals throughout the dayExplanation
Patient with imbalance nutrition should eat small frequent meals throughout the day that are high calorie/high protein. Anti-emetics should be given for N/V as well as vitamin/nutritional supplementsRate this question:
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- 27.
A patient with AIDS is experiencing shortness of breath related to Pneumocystis jiroveci pneumonia. Which measure should the nurse include in the plan of care to assist the patient in performing activities of daily living?
- A.
Provide supportive care with hygiene needs
- B.
Provide meals and snakes with high-protein, high calorie, and high-nutritional value
- C.
Provide small, frequent meals
- D.
Offer low microbial foods
Correct Answer
A. Provide supportive care with hygiene needsExplanation
Providing supportive care with hygiene needs reduces the patient's physical and emotional energy demands and conserves energy resources for breathing.Rate this question:
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- 28.
A patient who was tested for HIV after a recent exposure had a negative result. During the post-test counseling session, the nurse tells the patient which of the following?
- A.
The test should be repeated in 6 months
- B.
This ensures that you are not infected with the HIV virus
- C.
You no longer need to protect yourself from sexual partners
- D.
You probably have immunity to the AIDS virus
Correct Answer
A. The test should be repeated in 6 monthsExplanation
Test should be repeated in 6 months due to a possible false-negative result early in the infectionRate this question:
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- 29.
A patient is diagnosed with late stage HIV. She and her family are extremely upset about the diagnosis. The priority psychosocial nursing intervention for the client and family is to?
- A.
Tell the client and family to stop smoking because it will predispose the client to respiratory infections
- B.
Tell the client and family that raw or improperly washed foods can produce microbes
- C.
Encourage the patient and family to discuss their feelings about the disease
- D.
Advise the patient to avoid becoming pregnant because of the risk of transmission of the infection
Correct Answer
C. Encourage the patient and family to discuss their feelings about the diseaseExplanation
Discussing feeling about the disease is a psychosocial interventionRate this question:
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- 30.
A patient is diagnosed with HIV. The nurse prepares a care plan for the patient knowing that HIV is primarily a condition in which?
- A.
Immunosuppression occurs and is indicated by a T4 lymphocyte count of less than 200/mm3
- B.
Bacterial infection occurs, causing weakness
- C.
Fungal infection occurs, causing a rash and pruritus
- D.
Protozoan infection occurs, causing a fever and non productive cough
Correct Answer
A. Immunosuppression occurs and is indicated by a T4 lymphocyte count of less than 200/mm3Explanation
HIV causes immunosuppression and is indicated by a T4 lymphocyte count of less than 200/mm3. Although bacterial, fungal, and protozoa infections can occur, these occur as opportunistic infection as a result of immunosuppressionRate this question:
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- 31.
The nurse understands that the client with pernicious anemia will have which distinguishing laboratory finding?
- A.
Schilling's test, elevated
- B.
Intrinsic factor, absent
- C.
Sedimentation rate, 16 mm/hour
- D.
RBCs 5.0 million
Correct Answer
B. Intrinsic factor, absentExplanation
Pernicious anemia is due to antibodies that destroy gastric parietal cells leading to a decreased production of intrinsic factor.Rate this question:
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- 32.
A patient with pernicious anemia asks why she must take vitamin B12 injections for the rest of her life. What is the nurse's best response?
- A.
"Your vitamin deficiency is an inability to absorb the vitamin because the stomach is not producing sufficient acid"
- B.
"Your vitamin deficiency is an inability to absorb the vitamin because the stomach is not producing sufficient intrinsic factor."
- C.
"Your vitamin deficiency is due to an excessive excretion of the vitamin because of kidney dysfunction."
- D.
"Your vitamin deficiency is due to an increased requirement for the vitamin because of rapid red blood cell production."
Correct Answer
B. "Your vitamin deficiency is an inability to absorb the vitamin because the stomach is not producing sufficient intrinsic factor."Explanation
Patients with pernicious anemia have deficient production of intrinsic factor in the stomach, which is needed for the body to absorb vitamin B12Rate this question:
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- 33.
A nurse is assisting a patient diagnosed with pernicious anemia in selecting dinner. What would supply the best source of vitamin B12?
- A.
Whole grains
- B.
Green leafy vegetables
- C.
Broccoli and Brussels sprouts
- D.
Meats and dairy products
Correct Answer
D. Meats and dairy productsExplanation
Good sources of vitamin B12 include meats and dairy products. whole grains are a good source of thiamine. Green leafy vegetables are a good source of niacin and folate. Broccoli and brussel sprouts are a good source of vitamin CRate this question:
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- 34.
The LPN is caring for a patient diagnosed with pernicious anemia. Which nursing interventions would be appropriate? (select all that apply)
- A.
Monitor O2 Sat & keep HOB elevated
- B.
Keep patient on isolation precautions
- C.
Assist with ambulation
- D.
Provide frequent rest periods
- E.
Provide iron supplements
Correct Answer(s)
A. Monitor O2 Sat & keep HOB elevated
C. Assist with ambulation
D. Provide frequent rest periodsExplanation
Patients O2 should be monitored due to lack of oxygen in the blood and tissues. Fatigue due to lack of oxygen will occur, so ensure that patient has frequent rest periods. Assisting with ambulation will help to prevent falls due to fatigue.Rate this question:
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- 35.
Which of the following is a sign or symptom of pernicious anemia?
- A.
Glossitis
- B.
Itching
- C.
Kyphosis
- D.
Lower back spasms
Correct Answer
A. GlossitisExplanation
Glossitis refers to the inflammation of the tongue, which can be a sign or symptom of pernicious anemia. Pernicious anemia is a condition characterized by a deficiency in vitamin B12, which can lead to various symptoms including glossitis. The inflammation of the tongue can cause it to appear swollen, red, and smooth. It may also be painful and can affect a person's ability to speak and eat. Therefore, glossitis is a relevant sign or symptom of pernicious anemia.Rate this question:
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- 36.
The nurse is assisting with data collection. Which of the following past surgeries found in the history may influence immune system dysfunction?
- A.
Splenectomy
- B.
Thyroidectomy
- C.
Pneumonectomy
- D.
Parathyroidectomy
Correct Answer
A. SplenectomyExplanation
Removal of the spleen results in altered lymphocyte and plasma cell production which affects the humoral ummune response.Rate this question:
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- 37.
What would be the appropriate treatment for a patient whose spleen is enlarged or whose spleen function is causing too many RBCs & Platelets to be removed from the blood would?
- A.
Increase fluid intake
- B.
Blood transfusion
- C.
Chemotherapy
- D.
Splenectomy
Correct Answer
D. SplenectomyExplanation
Splenectomy would be the appropriate treatment for a patient whose spleen is enlarged or whose spleen function is causing too many RBCs and platelets to be removed from the blood. A splenectomy is the surgical removal of the spleen, which helps to alleviate the excessive removal of red blood cells and platelets from the bloodstream. This procedure can effectively treat conditions such as an enlarged spleen, certain blood disorders, and immune system disorders.Rate this question:
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- 38.
A nurse monitoring a postoperative patient after a splenectomy notes that the patient's temperature is 102. What would be the appropriate action for the nurse to take?
- A.
Encourage TCDB
- B.
Notify the MD
- C.
Continue monitoring VS
- D.
Give the patient tylenol
Correct Answer
B. Notify the MDExplanation
MD should be notified for any temperature over 101. TCDB would be appropriate for patients with a low grade fever.Rate this question:
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- 39.
A nurse is giving discharge instruction to a patient that has had a splenectomy. What would NOT be part of the patient teaching given by the nurse?
- A.
Keep Flu & Pneumonia vaccinations current
- B.
Notify MD immediately if you have any new abdominal pain
- C.
The kidneys will now take over the functions of the spleen
- D.
You must notify the MD immediately if you have strep or flu
Correct Answer
C. The kidneys will now take over the functions of the spleenExplanation
The liver and red bone marrow will remove RBCs from circulation. A person without a spleen is not more susceptible to infections such as flu and pneumonia. Abdominal pain may be due to formation of a fistula due to pancreatitis. Overwhelming Post Splenectomy Infection (OPSI) can occur up to 20 years post op which is caused by strep & fluRate this question:
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- 40.
A 69 y/o male arrives to the emergency department with a flu-like symptoms and a fever. His wife states that he has had a splenectomy in 14 years ago. You would assess that the patient is most likely suffering from?
- A.
Overwhelming Post Splenectomy Infection
- B.
Food poisoning
- C.
Polycythemia
- D.
Hemophilia
Correct Answer
A. Overwhelming Post Splenectomy InfectionExplanation
OPSI begins with a fever and malaise and quickly progresses to sepsis and death within a few hours. Strep & Flu are the #1 causesRate this question:
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- 41.
A patient is pre-op for a splenectomy. What would most likely be administered prior to surgery?
- A.
Blood transfusion
- B.
Normal saline
- C.
Vitamin K
- D.
Both A and C
Correct Answer
D. Both A and CExplanation
Pre-op care for a patient having a splenectomy include blood transfusion if they anemic and vitamin K for bleeding.Rate this question:
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- 42.
Which of the following is NOT a function of blood?
- A.
Transportation
- B.
Filter pathogens
- C.
Body temperature regulation
- D.
Provide body protection
Correct Answer
B. Filter pathogensExplanation
The lymphatic system is responsible for filtering pathogens. Blood transports oxygen, nutrients, and waste products. Blood regulates body temperature. Blood also is involved with providing transport of WBCs and platelets for protection against foreign antigens and bleeding.Rate this question:
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- 43.
A patient's CBC results show that she has a RBC level of 3.2 million/mm3. The nurse knows that this is called?
- A.
Leukopenia
- B.
Polycythemia
- C.
Leukemia
- D.
Erythropenia
Correct Answer
D. ErythropeniaExplanation
Erythropenia is the decrease in RBC level. Leukopenia is the decrease of WBCs. Polycythemia is the excess of RBCs. Leukemia is an increase in immature WBCsRate this question:
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- 44.
A patient suffering from dehydration would be expected to have which abnormal CBC result?
- A.
63% Hematocrit level
- B.
12 g/100 mL Hemoglobin level
- C.
4.2 million/mm3 RBC level
- D.
39% Hematocrit level
Correct Answer
A. 63% Hematocrit levelExplanation
The normal Hematocrit level is 38 - 49%. An elevated percentage of hematocrit would indicate dehydration.Rate this question:
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- 45.
The nurse is preparing to teach a client with microcytic hypochromic anemia about the diet to follow after discharge. which of the following foods should be included in the diet?
- A.
Eggs
- B.
Lettuce
- C.
Citrus fruits
- D.
Cheese
Correct Answer
A. EggsExplanation
Foods high in iron include eggs, organ and muscle meats, shellfish, shrimp, tuna, whole-grain and fortified cereals and breads, legumes, nuts, dried fruits, beans, oatmeal, and sweet potatoesRate this question:
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- 46.
A nurse devises a teaching plan for a patient with aplastic anemia. Which of the following is the most important concept to teach for health maintenance?
- A.
Eat animal protein and dark leafy vegetables each day
- B.
Avoid exposure to others with acute infection
- C.
Practice yoga and meditation to decrease stress and anxiety
- D.
Get 8 hours of sleep at night and take naps during the day
Correct Answer
B. Avoid exposure to others with acute infectionExplanation
Patients with aplastic anemia are severely immunocompromised and at risk for infection and death related to bone marrow suppression. Strict aseptic technique and Isolation precautions to prevent infection are highest priorityRate this question:
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- 47.
A vegetarian patient meets with a nutritional counselor for anemia. What statement indicates that further counseling is needed?
- A.
"I can add dried fruit to cereal and baked goods."
- B.
"I should cook tomato-based foods in iron pots."
- C.
"I can drink coffee or tea with meals."
- D.
"I should add vitamin C to all my meals."
Correct Answer
C. "I can drink coffee or tea with meals."Explanation
Coffee and tea increase GI motility and inhibit absorption of nonheme iron. Dried fruits are a nonanimal iron source. Cooking acid-based foods in iron cookware adds iron to the diet. Iron absorption is increased when foods high in vitamin C are consumed.Rate this question:
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- 48.
A 3 day post-op patient has a hematocrit level of 34%. The nurse observes that the hematocrit level the prior day was 36%. RBC and hemoglobin levels have remained at 4.5 million/mm3 and 11.9 g/dL, respectively. Which intervention is appropriate?
- A.
Check the dressing and drains for bleeding
- B.
Call the physician
- C.
Continue to monitor vital signs
- D.
Start O2 at 2L/min
Correct Answer
C. Continue to monitor vital signsExplanation
The decrease in hematocrit level is a normal response. Immediately after surgery a patient's hematocrit level indicated a false high value due to the body compensating for the sudden loss of fluid. By the 3rd day post-op bleeding is not likely.Rate this question:
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- 49.
A nurse is going to administer an epogen injection. What laboratory value should the nurse assess before giving the injection?
- A.
Hematocrit
- B.
Partial thromboplastin time
- C.
Hemoglobin
- D.
Prothrombin time
Correct Answer
A. HematocritExplanation
Epogen is a form of erythropoietin, which stimulated production of RBCs which would cause the hematocrit level to rise.Rate this question:
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- 50.
Which of the following is a late symptom of polycythemia vera?
- A.
Headache
- B.
Dizziness
- C.
Pruritus
- D.
Shortness of breath
Correct Answer
C. PruritusExplanation
Pruritus is a late symptom that results from abnormal histamine metabolism. Headache, dizziness and shortness of breath are early signsRate this question:
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