Immune And Hematologic Disorders

113 Questions | Total Attempts: 486

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Immune And Hematologic Disorders

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Questions and Answers
  • 1. 
    Which client is most at risk for developing disseminated intravascular coagulation (DIC)?
    • A. 

      A client admitted with suspected cocaine overdose

    • B. 

      A client with an amniotic fluid embolism

    • C. 

      A client with a stage IV pressure ulcer

    • D. 

      A client with heart failure and renal failure

  • 2. 
    A nurse is monitoring a client who developed facial edema after receiving a medication. Which white blood cells stimulated the edema?
    • A. 

      Basophils

    • B. 

      Eosinophils

    • C. 

      Monocytes

    • D. 

      Neutrophils

  • 3. 
    Which client is most likely to develop systemic lupus erythematosus (SLE)?
    • A. 

      A 25-year-old white male

    • B. 

      A 25-year-old Jewish female

    • C. 

      A 27-year-old black female

    • D. 

      A 35-year-old Hispanic male

  • 4. 
    A client with rheumatoid arthritis arrives at the clinic for a checkup. Which statement by the client refers to the most overt clinical manifestation of rheumatoid arthritis?
    • A. 

      My legs feel weak.

    • B. 

      My finger joints are oddly shaped.

    • C. 

      I have pain in my hands.

    • D. 

      I have trouble with my balance.

  • 5. 
    A nurse is caring for a child in acute sickle cell crisis. Which laboratory values does the nurse expect to see? Select all that apply.
    • A. 

      Low mean corpuscular hemoglobin (MCH)

    • B. 

      High mean corpuscle value (MCV)

    • C. 

      Positive metabisulfate test

    • D. 

      Negative Howell-Jolly bodies

    • E. 

      Positive hemoglobin (Hb) SS

  • 6. 
    A physician orders gentamicin sulfate (Garamycin), 80 mg I.V. every 8 hours for a client with Pseudomonas aeruginosa. The nurse should infuse this drug over at least:
    • A. 

      5 minutes.

    • B. 

      10 minutes.

    • C. 

      20 minutes.

    • D. 

      30 minutes.

  • 7. 
    Which iron-rich foods should a nurse encourage an anemic client requiring iron therapy to eat?
    • A. 

      Shrimp and tomatoes

    • B. 

      Lobster and squash

    • C. 

      Cheese and bananas

    • D. 

      Lamb and peaches

  • 8. 
    A client is to receive a blood transfusion of packed red blood cells (RBCs) for severe anemia. The nurse identifies the client using two client identifiers, then prepares to administer the transfusion. Place the following steps in the order the nurse should follow to administer this product. Use all options.1. Flush the I.V. Tubing and line with NSS.2. Check blood bag against the client's information.3. Watch for a transfusion reaction.4. Record vital signs.5. Put on gloves, a gown, and a face shield.6. Check packed RBCs for the date and abnormalities
  • 9. 
    A physician orders tests to determine if a client has systemic lupus erythematosus (SLE). Which test result helps to confirm an SLE diagnosis?
    • A. 

      Increased total serum complement levels

    • B. 

      Negative antinuclear antibody test

    • C. 

      Negative lupus erythematosus cell test

    • D. 

      An above-normal anti-deoxyribonucleic acid (DNA) test

  • 10. 
    A nurse is caring for a client with acquired immunodeficiency syndrome. To adhere to standard precautions, the nurse should:
    • A. 

      Maintain strict isolation.

    • B. 

      Keep the client in a private room, if possible.

    • C. 

      Wear gloves when providing mouth care.

    • D. 

      Wear a gown when delivering the client's food tray.

  • 11. 
    A nurse is planning care for a client with human immunodeficiency virus (HIV). She's being assisted by a licensed practical nurse (LPN). Which statements by the LPN indicate her understanding of HIV transmission? Select all that apply.
    • A. 

      I'll wear a gown, mask, and gloves for all client contact.

    • B. 

      I don't need to wear any personal protective equipment because nurses have a low risk of occupational exposure.

    • C. 

      I'll wear a mask if the client has a cough caused by an upper respiratory infection.

    • D. 

      I'll wear a mask, gown, and gloves when splashing of body fluids is likely.

    • E. 

      I'll wear a mask, gown, and gloves when splashing of body fluids is likely.

  • 12. 
    Which one do you like?
    • A. 

      Rinse her eyes with water, record the incident on the client's chart, and see Employee Health.

    • B. 

      Wash her hands, complete an incident report, and see a physician as soon as possible.

    • C. 

      Rinse her eyes with water, report the incident, and go to Employee Health.

    • D. 

      Rinse her eyes, contact Employee Health and document their findings.

  • 13. 
    Which nonpharmacologic interventions should a nurse include in a care plan for a client who has moderate rheumatoid arthritis (RA)? Select all that apply.
    • A. 

      Massaging inflamed joints

    • B. 

      Avoiding range-of-motion (ROM) exercises

    • C. 

      Applying splints to inflamed joints

    • D. 

      Using assistive devices at all times

    • E. 

      Selecting clothing that has Velcro fasteners

    • F. 

      Applying moist heat to joints

  • 14. 
    A client involved in a motor vehicle accident arrives at the emergency department unconscious and severely hypotensive. The nurse suspects he has several fractures in the pelvis and legs. Which parenteral fluid is the best choice for the client's current condition?
    • A. 

      Fresh frozen plasma

    • B. 

      Normal saline solution

    • C. 

      Lactated Ringer's solution

    • D. 

      Packed red blood cells (RBCs)

  • 15. 
    When a relief charge nurse posts assignments, a nurse notes that she is no longer assigned to a client whom she has cared for the previous 2 nights. How should the nurse respond to this assignment?
    • A. 

      Tell the charge nurse that she'd like to continue with the same assignment.

    • B. 

      Ask the nurse if there's a reason she changed the assignment.

    • C. 

      Accept the assignment and discuss the situation with the charge nurse at a later time.

    • D. 

      Tell the charge nurse she feels she's the best person to care for this particular client.

  • 16. 
    A client with acquired immunodeficiency syndrome is receiving zidovudine (azidothymidine, AZT [Retrovir]). Which laboratory value indicates an adverse reaction to zidovudine?
    • A. 

      Red blood cell (RBC) count of 1.8 million/μl

    • B. 

      Fasting blood glucose of 104 mg/dl

    • C. 

      Serum calcium level of 8.9 mg/dl

    • D. 

      Platelet count of 240,000/mm3

  • 17. 
    What nursing interventions should a nurse expect to implement when caring for a child in acute sickle cell crisis? Select all that apply.
    • A. 

      Maintaining adequate hydration

    • B. 

      Providing adequate pain control

    • C. 

      Assessing family education needs

    • D. 

      Encouraging healthful eating habits

    • E. 

      Frequently monitoring vital signs

    • F. 

      Anticipating play needs

  • 18. 
    A client with multiple myeloma presents to the emergency department complaining of excessive thirst and constipation. His family members report that he has been confused for the last day. Which laboratory value is most likely responsible for this client's symptoms?
    • A. 

      Platelet count 300,000/mm3

    • B. 

      Serum calcium level 13.8 mg/dl

    • C. 

      Serum sodium level of 133 mEq/L

    • D. 

      Hemoglobin of 9.8 g/dl

  • 19. 
    A nurse is caring for a client with the following laboratory values: white blood cell count (WBC) 4,500/mm3, neutrophils 15%, and bands 1%. Based on the client's absolute neutrophil count (ANC), what is the client's risk of infection?
    • A. 

      No increased risk

    • B. 

      Significant risk

    • C. 

      High risk

    • D. 

      Almost certain risk

  • 20. 
    In a client infected with human immunodeficiency virus (HIV), CD4+ levels are measured to determine the:
    • A. 

      Presence of opportunistic infections.

    • B. 

      Level of the viral load.

    • C. 

      Extent of immune system damage.

    • D. 

      Resistance to antigens.

  • 21. 
    Clients with cancer who receive multiple blood transfusions are at risk for forming antibodies against the blood. What precautions should the nurse take when administering blood to a client with a history of multiple transfusions?
    • A. 

      Use a blood filter to filter the leukocytes.

    • B. 

      Ask all clients about previous blood product administration.

    • C. 

      Administer allogeneic blood products.

    • D. 

      Make sure that leukocyte-reduced blood products are ordered.

  • 22. 
    For a client diagnosed with idiopathic thrombocytopenia purpura (ITP), which nursing intervention is appropriate?
    • A. 

      Teaching coughing and deep-breathing techniques to help prevent infection

    • B. 

      Administering platelets, as ordered, to maintain an adequate platelet count

    • C. 

      Giving aspirin, as ordered, to control body temperature

    • D. 

      Administering stool softeners, as ordered, to prevent straining during defecation

  • 23. 
    When preparing a client with acquired immunodeficiency syndrome (AIDS) for discharge to home, the nurse should be sure to include which instruction?
    • A. 

      Put on disposable gloves before bathing.

    • B. 

      Sterilize all plates and utensils in boiling water.

    • C. 

      Avoid sharing such articles as toothbrushes and razors.

    • D. 

      Avoid eating foods from serving dishes shared by other family members.

  • 24. 
    Following a splenectomy, a client has a hemoglobin (Hb) level of 7.5 g/dl and has vertigo when getting out of bed. The nurse suspects abnormal orthostatic changes. The vital sign values that most support the nurse's analysis are:
    • A. 

      Blood pressure of 150/100 mm Hg and pulse of 130 beats/minute.

    • B. 

      Blood pressure of 150/100 mm Hg and pulse of 50 beats/minute.

    • C. 

      Blood pressure of 80/40 mm Hg and pulse of 50 beats/minute.

    • D. 

      Blood pressure of 80/40 mm Hg and pulse of 130 beats/minute.

  • 25. 
    A client is admitted with a tentative diagnosis of acquired immunodeficiency syndrome (AIDS). He undergoes biopsies of facial lesions. The preliminary report indicates Kaposi's sarcoma. Which action by the nurse is most appropriate?
    • A. 

      Tell the client that Kaposi's sarcoma is common in people with AIDS.

    • B. 

      Pretend not to notice the lesions on the client's face.

    • C. 

      Inform the client of the biopsy results and support him emotionally.

    • D. 

      Explore the client's feelings about his facial disfigurement.

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