Immune And Hematologic Disorders

113 Questions | Total Attempts: 1014

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Immune And Hematologic Disorders - Quiz

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Questions and Answers
  • 1. 
    A client diagnosed with acquired immunodeficiency syndrome (AIDS) is experiencing end-stage Kaposi's sarcoma. Concerned that the health care team is investing too much energy in keeping him alive, he asks that they not attempt any more interventions. How should a nurse respond to this client?
    • A. 

      You might consider consulting with a therapist to be sure this is what you really want.

    • B. 

      AIDS is no longer an automatic death sentence. You might want to reconsider.

    • C. 

      We have to make sure you've signed an advance directive.

    • D. 

      I need to get your physician to make this recommendation and write an order.

  • 2. 
    A client diagnosed with idiopathic thrombocytopenia purpura needs a peripherally inserted central catheter (PICC) placed. When explaining the catheter to the client, the nurse explains that one advantage of a catheter is that it can be used:
    • A. 

      To administer only blood products and I.V. fluids.

    • B. 

      In clients with infections in the blood.

    • C. 

      To provide long-term access to central veins.

    • D. 

      For 2 weeks without being replaced.

  • 3. 
    A nurse is teaching a female client, who is positive for human immunodeficiency virus, about pregnancy. The nurse should know more teaching is necessary when the client says:
    • A. 

      The baby can get the virus from my placenta.

    • B. 

      I'm planning on starting on birth control pills.

    • C. 

      Not everyone who has the virus gives birth to a baby who has the virus.

    • D. 

      I'll need to have a cesarean birth if I become pregnant and have a baby.

  • 4. 
    A client with acquired immunodeficiency syndrome (AIDS) is ordered zidovudine (azidothymidine, AZT [Retrovir]), 200 mg P.O. every 4 hours. When teaching the client about this drug, the nurse should provide which instruction?
    • A. 

      Take zidovudine with meals.

    • B. 

      Take zidovudine on an empty stomach.

    • C. 

      Take zidovudine every 4 hours around the clock.

    • D. 

      Take over-the-counter (OTC) drugs to treat minor adverse reactions.

  • 5. 
    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
  • 6. 
    While monitoring a client for the development of disseminated intravascular coagulation (DIC), the nurse should take note of which assessment parameters?
    • A. 

      Platelet count, prothrombin time, and partial thromboplastin time

    • B. 

      Platelet count, blood glucose levels, and white blood cell (WBC) count

    • C. 

      Thrombin time, calcium levels, and potassium levels

    • D. 

      Fibrinogen level, WBC, and platelet count

  • 7. 
    After receiving a dose of penicillin, a client develops dyspnea and hypotension. The nurse suspects the client is experiencing anaphylactic shock. What should the nurse do first?
    • A. 

      Page an anesthesiologist immediately and prepare to intubate the client.

    • B. 

      Administer epinephrine, as ordered, and prepare to intubate the client, if necessary.

    • C. 

      Administer the antidote for penicillin, as ordered, and continue to monitor the client's vital signs.

    • D. 

      Insert an indwelling urinary catheter and begin to infuse I.V. fluids, as ordered.

  • 8. 
    A female client with human immunodeficiency virus (HIV) receives family-planning counseling. Which statement about safer sex practices for persons with HIV is accurate?
    • A. 

      If the client and her sexual partners are HIV-positive, unprotected sex is permitted.

    • B. 

      A latex condom with spermicide provides the best protection against HIV transmission during sexual intercourse.

    • C. 

      Contraceptive methods, such as hormonal contraceptives, implants, and injections, are recommended to prevent HIV transmission.

    • D. 

      The intrauterine device is recommended for a client with HIV.

  • 9. 
    A client with lymphoma tells the nurse that he's found an overseas holistic physician who can cure him with coffee enemas. What should the nurse say?
    • A. 

      That unproven alternative therapy can be very dangerous.

    • B. 

      You should ask your physician if this is a helpful approach.

    • C. 

      It's illegal for unlicensed physicians to prescribe your care.

    • D. 

      This treatment is questionable. It could be dangerous.

  • 10. 
    A client with systemic lupus erythematosus (SLE) has the classic rash of lesions on the cheeks and bridge of the nose. What term should the nurse use to describe this characteristic pattern?
    • A. 

      Butterfly rash

    • B. 

      Papular rash

    • C. 

      Pustular rash

    • D. 

      Bull's eye rash

  • 11. 
    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

  • 12. 
    During chemotherapy for lymphocytic leukemia, a client develops abdominal pain, fever, and "horse barn"-smelling diarrhea. It would be most important for the nurse to advise the physician to order:
    • A. 

      An enzyme-linked immunosuppressant assay (ELISA) test.

    • B. 

      An electrolyte panel and a hemogram.

    • C. 

      Stools for a Clostridium difficile test.

    • D. 

      A flat plate X-ray of the abdomen.

  • 13. 
    A nurse on the hematology floor feels the charge nurse has been unfairly assigning complex clients to her by not dividing enough of the workload among the rest of the staff. This nurse is creating tension among the staff. What is the charge nurse's best approach?
    • A. 

      Instruct this staff member to bring her concerns to her directly.

    • B. 

      Assure the staff member that the she is being as fair as possible and that the nurse needs to pull her weight.

    • C. 

      Meet with this nurse privately and give her an opportunity to further express her concerns.

    • D. 

      Write the nurse up, then sit down to counsel her in a private setting.

  • 14. 
    A client with pernicious anemia is receiving parenteral vitamin B12 therapy. Which client statement indicates effective teaching about this therapy?
    • A. 

      I will receive parenteral vitamin B12 therapy until my signs and symptoms disappear.

    • B. 

      I will receive parenteral vitamin B12 therapy until my vitamin B12 level returns to normal.

    • C. 

      I will receive parenteral vitamin B12 therapy monthly for 6 months to a year.

    • D. 

      I will receive parenteral vitamin B12 therapy for the rest of my life.

  • 15. 
    A client diagnosed with metastatic cancer is preparing for discharge. The physician orders morphine sulfate controlled-release tablets 100 mg every 12 hours as needed after discharge. What legal rights and responsibilities should the nurse address when teaching the client about morphine sulfate use?
    • A. 

      You must avoid driving or other activities that require alertness while taking controlled-release morphine sulfate.

    • B. 

      Morphine sulfate is an opioid and you may develop tolerance. This is an expected response and isn't harmful.

    • C. 

      Federal law prevents refills of this medication. Your physician will give you a new prescription when you need more medicine.

    • D. 

      If you no longer require the morphine sulfate controlled-release tablets for your cancer pain, don't take any leftover pills for other disorders.

  • 16. 
    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.

  • 17. 
    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.

  • 18. 
    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.

  • 19. 
    A client with anemia has been admitted to the medical-surgical unit. Which assessment findings are characteristic of iron deficiency anemia?
    • A. 

      Nights sweats, weight loss, and diarrhea

    • B. 

      Dyspnea, tachycardia, and pallor

    • C. 

      Nausea, vomiting, and anorexia

    • D. 

      Itching, rash, and jaundice

  • 20. 
    A client with rheumatoid arthritis is being discharged with a prescription for aspirin (Ecotrin), 600 mg P.O. every 6 hours. Which statement by the client indicates understanding of the adverse effects of the medication?
    • A. 

      I'll call my physician if I have difficulty voiding.

    • B. 

      I'll call my physician if I have ringing in the ears.

    • C. 

      I'll call my physician if I have leg cramps.

    • D. 

      I'll call my physician if I have fewer bowel movements than normal.

  • 21. 
    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

  • 22. 
    A client has had heavy menstrual bleeding for 6 months. Her physician diagnoses microcytic hypochromic anemia and orders ferrous sulfate (Feosol), 300 mg P.O. daily. Before initiating iron therapy, the nurse reviews the client's medical history. The nurse should question this order when she notes that the client:
    • A. 

      Is pregnant.

    • B. 

      Has asthma.

    • C. 

      Has ulcerative colitis.

    • D. 

      Has severely impaired liver function.

  • 23. 
    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

  • 24. 
    The wife of a client with end-stage acquired immunodeficiency syndrome (AIDS) is caring for her husband at home. The hematologist recommends hospice care and the couple agrees. During the initial admission visit, the hospice nurse provides information to the client and his family about an advance directive. During the next day's visit, the client states that since he and his wife filled out the advance directive form, he feels abandoned by his physician. Which statement by the hospice nurse best addresses the client's concerns?
    • A. 

      Your physician will continue to care for you. The advance directive simply puts in writing the care you want, so he will be able to provide it if you can't tell him yourself.

    • B. 

      You don't need to feel that way. Your physician is required by law to sign your orders and the hospice nurses will be contacting him with updates on your condition.

    • C. 

      Many people first feel that way when they are admitted into hospice. Although the focus of your care has changed from curative to supportive, your physician will still continue directing it.

    • D. 

      It's understandable to feel that way. But clients with end-stage AIDS who have advanced directives generally experience a less painful death that those individuals who don't.

  • 25. 
    A nurse assesses a client in the physician's office. Which assessment findings support a suspicion of systemic lupus erythematosus (SLE)?
    • A. 

      Facial erythema, pericarditis, pleuritis, fever, and weight loss

    • B. 

      Photosensitivity, polyarthralgia, and painful mucous membrane ulcers

    • C. 

      Weight gain, hypervigilance, hypothermia, and edema of the legs

    • D. 

      Hypothermia, weight gain, lethargy, and edema of the arms

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