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RN Nursing School · Med-Surg · 253 questions

Hematological Disorders practice questions

Every question below is free to read with its full rationale. For timed sets, the rest of the bank and progress tracking on Hematological Disorders, practise in the app.

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  1. 1A nurse is assessing a client who reports fatigue, low blood cell count, and pallor, which risk factor most likely contributes to the client's iron deficiency anemia?Answer →
  2. 2A client is admitted to the medical unit with an absolute neutrophil count of 470 cells/uL. What are appropriate nursing considerations? Select all that apply.Answer →
  3. 3A patient is to receive a subcutaneous injection of Heparin 3000 units. On hand the vial label reads Heparin 5000 units/1 mL. How many mL will the nurse administer? (Provide answer as number only, round to the nearest tenth)Answer →
  4. 4Shortly after starting the transfusion of red blood cells, the patient complains of anxiety, urticaria and wheezing. The patient's blood pressure drops quickly. Which condition should the nurse plan care?Answer →
  5. 5A nurse is preparing to administer heparin 2,000 units by IV bolus. Available is heparin injection 5,000 units/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)Answer →
  6. 6A nurse is providing care to a child diagnosed with chronic immune thrombocytopenia. Which intervention should take priority?Answer →
  7. 7A patient with chronic iron-deficiency anemia develops chest pain and tachycardia during minimal exertion. What is the nurse's priority assessment?Answer →
  8. 8An adult patient with thalassemia presents to the clinic reporting increased fatigue, shortness of breath on exertion, and palpitations. Vital signs are BP 110/70 mm Hg, HR 120/min, RR 22/min, and oxygen saturation 95% on room air. Laboratory results reveal a hemoglobin level of 6.5 g/dL (normal 12-16 g/dL). Which nursing action should be prioritized to address the patient's current condition?Answer →
  9. 9Which of the following statements indicate the client understands the instructions? Select the 3 statements that apply.Answer →
  10. 10A nurse is preparing to administer a continuous heparin infusion at 1600 units/hr. Available is heparin 25,000 units in dextrose 5% in water (DW) 500 mL. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)Answer →
  11. 11A patient diagnosed with polycythemia vera reports headache, dizziness, and blurred vision. The hematocrit is 62%. Which complication is the nurse most concerned about?Answer →
  12. 12A nurse is reviewing the laboratory values of a client with bone marrow suppression and is receiving epoetin alfa. Which of the following values would indicate an improvement in the client's condition?Answer →
  13. 13A 35-year-old woman presents with fatigue, pale skin, and brittle nails. Laboratory tests indicate low hemoglobin, hematocrit, and serum ferritin levels. What is the primary pathophysiological mechanism underlying her symptoms in iron deficiency anemia?Answer →
  14. 14A client undergoing a blood transfusion suddenly develops dark urine and a significant drop in blood pressure. Which immediate nursing action best addresses this clinical situation?Answer →
  15. 15A nurse is monitoring a client who reports having chills and back pain during a blood transfusion. Which of the following actions is nurse's priority?Answer →
  16. 16For each potential provider's prescription, click to specify if the potential prescription is anticipated, nonessential, or contraindicated for the client.Answer →
  17. 17Which of the following instructions should the nurse include? Select all that apply.Answer →
  18. 18A 33-year-old client with a history of sickle cell disease had an emergent open reduction and internal fixation of the right femur after a car crash. Which nursing intervention is the priority following surgery?Answer →
  19. 19A client is s/p total gastrectomy. The nurse is providing education regarding follow-up care specific to medication regimen. The nurse includes in the instruction the importance of taking which of the following medications to prevent pernicious anemia?Answer →
  20. 20During handoff report, the nurse is informed that the patient has been scheduled to receive one unit of packed red blood cells (PRBCs) due to a hemoglobin level of 6.2 g/dL (normal: 12-16 g/dL) and a hematocrit level of 21% (normal: 36-48%). Which actions must the nurse complete before initiating the transfusion?Answer →
  21. 21A nurse is assessing a 2-year-old child with suspected iron-deficiency anemia. Which assessment finding would most strongly indicate iron-deficiency anemia?Answer →
  22. 22The nurse assesses a client with acute lymphocytic leukemia (ALL) admitted to the telemetry unit with pancytopenia. What assessment finding requires immediate intervention by the nurse?Answer →
  23. 23A patient treated for HIT starts on Argatroban. aPTT result returns higher than normal. What should the nurse do?Answer →
  24. 24A patient with aplastic anemia has ANC 400. Which is highest priority?Answer →
  25. 25A nurse is reviewing the laboratory values of a client with bone marrow suppression and is receiving filgrastim. Which of the following values would indicate an improvement in the client's condition?Answer →
  26. 26A nurse is caring for a client who has acute myeloid leukemia (AML). Which of the following treatments should the nurse anticipate?Answer →
  27. 27A patient with sickle cell disease presents with chest pain, fever, and oxygen saturation 87%. Chest x-ray shows lungs infiltrates. What is the priority intervention?Answer →
  28. 28A patient with aplastic anemia has pancytopenia: WBC 1.2, platelets 18,000, Hgb 7.1. The patient reports severe headaches and confusion. What is the nurse's priority?Answer →
  29. 29A nurse is caring for a client who has thrombocytopenia due to chemotherapy treatment. Which of the following actions should the nurse take?Answer →
  30. 30The Pyxis on your floor stocks 10 mL vials of heparin that are concentrated at 1,000 units per mL. The order reads to administer 4,000 units of heparin IV push now. How many mL will be administered?Answer →
  31. 31Which occurrences are the most common cause of life-threatening infections in clients with bone marrow suppression? Select all that apply.Answer →
  32. 32A nurse is preparing to perform crossmatching before a blood transfusion for a client with anemia. The nurse understands that crossmatching is essential becauseAnswer →
  33. 33What is often the first indication that an individual has anemia of chronic disease (ACD)?Answer →
  34. 34Which nursing intervention may have caused hyperkalemia in a client after receiving packed red blood cells transfusion therapy?Answer →
  35. 35A nurse is discharging a child who has sickle cell anemia after an acute crisis episode. Which of the following instructions should the nurse include in the teaching?Answer →
  36. 36For each potential provider's prescription, click to specify if the potential prescription is anticipated, nonessential, or contraindicated for the client.Answer →
  37. 37A nurse is caring for a client who has thrombocytopenia due to chemotherapy treatment. Which of the following actions should the nurse take?Answer →
  38. 38A nurse is assessing a client who is receiving a unit of packed RBCs. Which of the following findings indicates the client is having a hemolytic transfusion reaction?Answer →
  39. 39A patient presents with fatigue, weakness, shortness of breath, and a sore, red tongue. These symptoms are indicative of:Answer →
  40. 40A patient in sickle cell crisis has oxygen saturation of 88% on room air. What is the priority intervention?Answer →
  41. 41Which lab abnormality and risk are correctly matched?Answer →
  42. 42An example of a single hormone that can exert effects in different tissues is erythropoietin. Erythropoietin is made in the kidneys and stimulates the bone marrow to produce which of the following?Answer →
  43. 43The nurse is caring for a client with pernicious anemia related to a recent gastric bypass surgery who reports numbness in the hands and feet. What action should the nurse take in the care of this client?Answer →
  44. 44Complete the following sentence: A person is at risk for iron-deficiency anemia due to [1] and decreased [2].Answer →
  45. 45What can cause an alloimmune phenomenon?Answer →
  46. 46A nurse is preparing to infuse a 250-mL unit of packed RBCs over 2 hr. The drop factor of the manual IV tubing is 15 gtts/ml. The nurse should adjust the flow rate to deliver how many drops per minute? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)Answer →
  47. 47A nurse is teaching a client who has septic shock about the development of disseminated intravascular coagulation (DIC). Which of the following statements should the nurse make?Answer →
  48. 48The nurse instructs a client who is taking clozapine to obtain weekly labs. Which potential condition must be monitored when a client is prescribed this medication?Answer →
  49. 49A nurse monitors a client 10 minutes after starting a blood transfusion. The client reports chills, back pain, and dyspnea. What is the priority action?Answer →
  50. 50The nurse is caring for a client diagnosed with septic shock. Which finding would lead the nurse to suspect the client is developing disseminated intravascular coagulation (DIC)?Answer →
  51. 51A nurse prepares to administer gentamicin 800 mg in 100 mL of dextrose 5% in water (D5W) to infuse over 1 hour. The drop factor of the tubing is 20 gtt/ml. At what rate will the nurse set the infusion? ___ gtt/min (If needed, round the answer to the nearest whole number.)Answer →
  52. 52An older adult client is to receive 2 units of packed red blood cells at 125 mL/hour. During the transfusion of the first unit, the client reports shortness of breath 30 minutes into the process. The client exhibits the vital signs shown in the accompanying table. What is the nurse's best intervention?Answer →
  53. 53A patient with sickle cell disease is dehydrated. Why does this worsen vaso-occlusion?Answer →
  54. 54Complete the following sentence by using the lists of options. The first action the nurse should take is [blank1] followed by [blank2].Answer →
  55. 55A patient with DIC initially has digital cyanosis from microthrombi, followed by bleeding gums. What explains this progression?Answer →
  56. 56A charge nurse is reviewing the patient assignments on a medical-surgical unit. Which of the following assignments requires immediate attention due to the scope of practice and patient acuity?Answer →
  57. 57A client with suspected hematologic malignancy undergoes a bone marrow biopsy and is preparing for discharge later the same day. When providing post procedure teaching to the client and family, which instruction should the nurse prioritize to minimize the risk of the most common and potentially serious complication associated with this procedure?Answer →
  58. 58A patient on warfarin presents with active epistaxis and an INR of 6.1. What is the priority nursing action?Answer →
  59. 59Which of the following risk factors is most strongly associated with the development of thalassemia?Answer →
  60. 60In which of the following anemias will a complete blood count (CBC) show a low hematocrit and hemoglobin?Answer →
  61. 61A nurse is assisting with the admission of a client who has leukemia. Which of the following transmission-based precautions should the nurse implement?Answer →
  62. 62A patient receiving warfarin therapy has an INR (International Normalized Ratio) of 5.2 (Range: 1) without signs of bleeding. What is the priority nursing action?Answer →
  63. 63Based on the clinical findings, indicate which assessment findings are consistent with each diagnosis by completing the matrix.Answer →
  64. 64Which blood types can the nurse safely administer to the patient with type AB negative blood? Select all that applyAnswer →
  65. 65A patient with iron deficiency anemia does not improve after 3 months of therapy. What is the most likely explanation?Answer →
  66. 66A patient is to receive a subcutaneous injection of Heparin 3000 units. On hand the vial label reads Heparin 5000 units/1mL. How many ml. will the nurse administer? (Provide answer as number only, round answer to the nearest tenth) _______Answer →
  67. 67The nurse is providing education to a client with thrombocytopenia about what to do if a nosebleed occurs. What statement by the client indicates a need for additional teaching?Answer →
  68. 68A nurse is obtaining a health history from a client. Which of the following findings should the nurse identify as possible risk factors for iron deficiency anemia? (Select All that Apply.)Answer →
  69. 69Which disorder would the nurse anticipate in clients with a high red blood cell count (RBC), hemoglobin (Hgb), and hematocrit (Hct)?Answer →
  70. 70A hospitalized patient on postoperative day 6 has been receiving unfractionated heparin for DVT prophylaxis. The platelet count has decreased from 240,000/με tο 68,000/μL over 48 hours. The patient now reports new right calf tenderness and mild swelling. Which nursing action is NOT appropriate at this time?Answer →
  71. 71A nurse is assessing a client newly admitted with suspected bone marrow cancer. The client reports increasing fatigue and frequent bruising over the past month. Which set of laboratory findings best correlates with the nurse's assessment findings?Answer →
  72. 72A client newly diagnosed with leukemia is admitted with a white blood cell count of 1,200/mm³. Which nursing intervention is the priority?Answer →
  73. 73A competent adult patient refuses a blood transfusion due to religious beliefs despite the nurse believing the transfusion is necessary. Which nursing action best demonstrates respect for the patient's autonomy while ensuring ethical care?Answer →
  74. 74Which type of tissue synthesizes red blood cells?Answer →
  75. 75A patient with pernicious anemia asks why injections are lifelong. Best explanation?Answer →
  76. 76A high protein diet is prescribed for an adolescent client who is anemic. Which lunch is best for this client?Answer →
  77. 77A patient with iron deficiency anemia does not improve after 3 months of therapy. What is the most likely explanation?Answer →
  78. 78A nurse is assessing a child who is in sickle cell crisis. Which of the following findings should the nurse expect?Answer →
  79. 79A client receives a blood transfusion and develops a fever, shortness of breath, and bilateral crackles. The nurse stops the transfusion. Which action should the nurse take next?Answer →
  80. 80A patient with severe thrombocytopenia reports severe headache. Why is this concerning?Answer →
  81. 81A patient with sickle cell crisis develops hypotension and enlarged spleen with rapid hemoglobin drop. What is occurring?Answer →
  82. 82A nurse is reviewing discharge instructions with a client who underwent a bone marrow biopsy. Which statement by the client indicates the need for further teaching to prevent postprocedure complications?Answer →
  83. 83A patient with sickle cell disease is dehydrated. Why does this worsen vaso-occlusion?Answer →
  84. 84A client with hypovolemic shock following a traumatic injury has ongoing significant blood loss despite initial fluid resuscitation. Vital signs show tachycardia, hypotension, and low urine output. Laboratory results reveal a hemoglobin of 6.5 g/dL and a hematocrit of 20%. Which nursing action best indicates the need to initiate the massive transfusion protocol?Answer →
  85. 85A nurse is planning care for a client who has leukemia and a platelet count of 130,000/mm³ (150,000-450,000). Which of the following interventions should the nurse include in the plan of care?Answer →
  86. 86Which manifestations alert the nurse to fluid overload in the patient receiving a whole blood transfusion? Select all that apply.Answer →
  87. 87A patient with aplastic anemia has ANC 400. Which is highest priority?Answer →
  88. 88A nurse is caring for a client who has leukemia. Which of the following findings should the nurse anticipate when reviewing the client laboratory results?Answer →
  89. 89A nurse is reinforcing teaching about pernicious anemia with a client following a total gastrectomy. Which of the following dietary supplements should the nurse include in the teaching as the treatment for pernicious anemia?Answer →
  90. 90Drag words from the choices below to fill in each blank in the following sentence. The client is at risk for developing [blank1] and [blank2].Answer →
  91. 91The nurse is assessing a patient diagnosed with anemia. What symptoms does the nurse expect to assess in the patient? (Select all that apply.)Answer →
  92. 92A patient treated for HIT starts on Argatroban (Medication use as alternative for Heparin). aPTT result returns higher than normal. What should the nurse do?Answer →
  93. 93A patient with DIC initially has digital cyanosis from microthrombi, followed by bleeding gums. What explains this progression?Answer →
  94. 94A patient admitted in sickle cell crisis reports pain 10/10 and has tachycardia. The nurse must prioritize which intervention?Answer →
  95. 95A nurse is assessing a client who has disseminated intravascular coagulation. Which of the following findings should the nurse expect?Answer →
  96. 96The nurse cares for a client receiving a unit of packed red blood cells (PRBCs). After the start of the transfusion, the client reports a headache and chills, and the client's temperature is 101.9 F (38.8 C). What transfusion reaction should the nurse suspect?Answer →
  97. 97The nurse is assigned four patients with hematologic conditions. Which patient requires immediate assessment?Answer →
  98. 98A patient with DIC has both bleeding and clotting. What best describes this condition?Answer →
  99. 99A patient with hemoglobin 6.9 g/dL is hypotensive and pale. What is the priority intervention?Answer →
  100. 100A nurse is administering a unit of RBC 350 mL over 3 hr to a client who has anemia. The nurse should set the IV pump to deliver how many ml/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) mL/hrAnswer →
  101. 101What is the primary pathophysiological mechanism underlying beta-thalassemia?Answer →
  102. 102A hospitalized patient receiving heparin therapy for DVT (Deep Vein Thrombosis) prophylaxis develops platelet count of 68,000/µL and reports new unilateral calf pain. What is the nurse's priority action?Answer →
  103. 103A nurse is caring for a client with acute leukemia undergoing chemotherapy who develops a fever of 101.5°F, tachycardia, and hypotension. Laboratory results reveal neutropenia. Which nursing intervention should be prioritized to prevent life-threatening complications?Answer →
  104. 104A 70-year-old patient with septic shock develops bleeding from IV sites, petechiae, hypotension (BP 80/44), and decreasing urine output. Labs: platelets 30,000/µl, prolonged PT and aPTT, low fibrinogen, elevated D-dimer. What is the priority nursing intervention?Answer →
  105. 105For each client's finding click to specify if the assessment finding is consistent with sickle cell disease, iron deficiency anemia, and/or pernicious anemia. Each finding may support more than 1 disease process.Answer →
  106. 106A nurse is preparing to administer a unit of packed RBCs to a client. Which of the following actions should the nurse plan to take?Answer →
  107. 107A patient with sickle cell disease presents with chest pain, fever, and oxygen saturation 87%. Chest x-ray shows lungs infiltrates. What is the priority intervention?Answer →
  108. 108A client is scheduled for a bone marrow aspiration to evaluate suspected leukemia. Which nursing action is most appropriate following the procedure?Answer →
  109. 109A nurse is caring for a client with a platelet count of 20,000 platelets/mcL. Which action(s) should the nurse take? Select all that apply.Answer →
  110. 110A nurse is caring for a client who has sickle cell anemia. The client asks, "Why do I feel so tired and fatigued all of the time?" Which of the following information should the nurse provide?Answer →
  111. 111A patient who suffers of chronic anemia today he comes to the ER complaining of chest pain on the monitor you find ST depression. Which nursing actions are appropriate? Select all that apply.Answer →
  112. 112A 42-year-old patient with immune thrombocytopenic purpura (ITP) is admitted with a platelet count of 18,000/uL. The patient reports bleeding gums when brushing teeth and scattered petechiae on the lower extremities. Vital signs are stable. Which nursing intervention is the priority?Answer →
  113. 113A hospitalized patient receiving heparin therapy for DVT (Deep Vein Thrombosis) prophylaxis develops platelet count of 68,000/µl and reports new unilateral calf pain. What is the nurse's priority action?Answer →
  114. 114The nurse is preparing to administer IV Heparin drip at 16 units/kg/hr. Pharmacy has on hand Heparin 12,500 units/250 mL. The patient weighs 198 lbs. What is the flow rate you will set the IV pump in ml/hr? Only answers with numbers, abbreviated units of measurement and time will be considered for credit. Round the answer to the nearest tenths position.Answer →
  115. 115A charge nurse (RN) is overseeing a nurse graduate nurse (GN) administering packed red blood cells (PRBC) to the patient with anemia Which action by the GN requires intervention by the RN?Answer →
  116. 116Fifteen minutes after initiation of a packed RBC transfusion, the patient develops chills, flank pain, hypotension, and anxiety. What is the nurse's first action?Answer →
  117. 117When preparing to administer a blood transfusion, which of the following actions is essential for the nurse to take to ensure client safety?Answer →
  118. 118Which of the following findings require follow-up? Select all that apply.Answer →
  119. 119A client is admitted to the hospital experiencing a vaso-occlusive crisis related to sickle cell disease. The nurse identifies priority interventions aimed at preventing complications associated with impaired oxygen delivery. Which nursing actions address the priority physiological need for this client? Select all that apply.Answer →
  120. 120Which action should the nurse take to safely administer packed red blood cells (RBC's)?Answer →
  121. 121A critically ill patient with DIC develops decreasing urine output despite adequate IV fluids. What is the primary concern?Answer →
  122. 122A patient with iron deficiency anemia (Hgb 7.8 g/dL) reports chest pain and tachycardia. What is the priority nursing action?Answer →
  123. 123A critically ill patient with DIC develops decreasing urine output despite adequate IV fluids. What is the primary concern?Answer →
  124. 124A postoperative patient receiving heparin for 5 days experiences a platelet drop from 250,000 to 90,000 and reports new shortness of breath. What is the nurse's priority action?Answer →
  125. 125Ordered: One unit of packed red blood cells (PRBC) 500 mLs is to be infused over 4 hours. Infuse 60 mLs for the first 15 minutes. What is the pump rate for the BALANCE of the transfusion?Answer →
  126. 126A nurse is caring for a client who is receiving a unit of packed red blood cells. Fifteen minutes following the start of the transfusion, the nurse notes that the client is febrile, with chills and red-tinged urine. Which of the following transfusion reactions should the nurse suspect?Answer →
  127. 127Complete the following sentence by using the lists of options. The first action the nurse should take is [A] followed by [B].Answer →
  128. 128During a medication review the nurse notes a client is prescribed apixaban and has elected to take melatonin for sleep. The nurse teaches this combination can put the client at increased risk for which complication?Answer →
  129. 129The nurse is caring for a group of clients on a hematology unit. What client should the nurse assess first?Answer →
  130. 130The nurse is conducting a nutrition class for a group of high school athletes. Which recommendation is best for the nurse to provide for the athletes before playing sports?Answer →
  131. 131Which task is appropriate to delegate to UAP for a stable patient with chronic anemia?Answer →
  132. 132A patient with hemoglobin 6.9 g/dL is hypotensive and pale. What is the priority intervention?Answer →
  133. 133Which of the following is a primary treatment modality for individuals with severe forms of thalassemia?Answer →
  134. 134Which task is appropriate to delegate to UAP for a stable patient with chronic anemia?Answer →
  135. 135A nurse is providing care to an adolescent who has disseminated intravascular coagulation (DIC) and asks the nurse what is causing their manifestations. Which of the following statements should the nurse make?Answer →
  136. 136A nurse is preparing to discharge a client who has undergone a splenectomy Which instruction should the nurse prioritize to minimize the client's risk of serious infections?Answer →
  137. 137A nurse is preparing to administer one unit of packed red blood cells (PRBCs) to a client with acute blood loss anemia. Which action by the nurse requires immediate correction?Answer →
  138. 138A patient with pernicious anemia asks why injections are lifelong. Best explanation?Answer →
  139. 139A patient with sickle cell crisis develops hypotension and enlarged spleen with rapid hemoglobin drop. What is occurring?Answer →
  140. 140Which of the following is the function of blood? Select all that apply.Answer →
  141. 141A patient with DIC and hypotension has rising creatinine. Why?Answer →
  142. 142Which of the following instructions should the nurse include? Select all that apply.Answer →
  143. 143For each client's finding, click to specify if the assessment finding is consistent with sickle cell disease, iron deficiency anemia, and/or pernicious anemia. Each finding may support more than one disease process.Answer →
  144. 144A Medical Surgical RN is prioritizing her assignment for the day upon hand off report. Which of the following patients should the nurse prioritize for immediate assessment?Answer →
  145. 145A nurse is reviewing the laboratory values of a client with bone marrow suppression and is receiving oprelvekin. Which of the following values would indicate an improvement in the client's condition?Answer →
  146. 146Which action is the most important for the nurse to implement to prevent a transfusion reaction when administering packed red blood cells to the patient with anemia?Answer →
  147. 147Which statement describes the etiology (cause) of aplastic anemia?Answer →
  148. 148A patient with iron deficiency anemia has spoon-shaped nails and pica. What is the underlying cause?Answer →
  149. 149A patient with vitamin B12 deficiency anemia reports numbness in the feet and difficulty walking. Which assessment finding requires urgent attention?Answer →
  150. 150A patient with acute leukemia develops a temperature of 38.6°C (101.5°F). What is the priority nursing action?Answer →
  151. 151A patient with iron deficiency anemia (Hgb 7.8 g/dL) reports chest pain and tachycardia. What is the priority nursing action?Answer →
  152. 152What is the priority nursing intervention when caring for an older client with a history of diverticular disease and pernicious anemia?Answer →
  153. 153What action should a person with sickle cell anemia take to prevent a sickling crisis?Answer →
  154. 154A client in the oncologist's office has leukemia. As the client and family are leaving the office, the parent says to the nurse, "I didn't quite get it when the doctor explained it. What exactly is happening in my son's body with this leukemia?" What is an appropriate response by the nurse?Answer →
  155. 155A nurse is assessing a client who is receiving a unit of packed RBCs. Which of the following findings indicates the client is having a hemolytic transfusion reaction?Answer →
  156. 156A nurse is assessing a client with thrombocytopenia after childbirth. Which laboratory finding would be most indicative of this condition?Answer →
  157. 157What is the role of hemoglobin in gas exchange?Answer →
  158. 158Which of the following statements indicate the client understands the instructions? Select the 3 statements that apply.Answer →
  159. 159A nurse is caring for a client diagnosed with disseminated intravascular coagulation (DIC). The nurse reviews the laboratory results and clinical signs to prioritize interventions. Which finding most accurately indicates the progression from the hypercoagulable phase to the bleeding phase of DIC, necessitating immediate nursing action?Answer →
  160. 160A child presents with symptoms characteristic of lymphoma. Which combination of manifestations would most likely indicate the presence of this condition?Answer →
  161. 161A nurse is reviewing the medical record of a client who is in active labor. Which of the following conditions increases the client's risk for postpartum hemorrhage (PPH)?Answer →
  162. 162Which component of the blood is essential in transporting oxygen to body cells?Answer →
  163. 163Inadequate consumption of which nutrient causes the most common nutrient deficiency in young children?Answer →
  164. 164A patient with DIC has both bleeding and clotting. What best describes this condition?Answer →
  165. 165An older adult client with unintentional weight loss and a decline in physical health reports skipping meals to save money for prescribed medications. Which action is best for the home health nurse to take?Answer →
  166. 166The nurse plans care for a client admitted with neutropenia. For each action click to specify whether the action is anticipated or not anticipated in the plan of care for this client.Answer →
  167. 167A nurse remains with a client to observe for any adverse reactions after initiating a transfusion of packed RBCs. The client becomes apprehensive and tachycardic, reporting headache and low back pain. The nurse should recognize that these findings indicate which of the following transfusion reactions?Answer →
  168. 168The nurse cares for a client with thrombocytopenia. The client tripped and fell on a cord while ambulating. The client has a laceration to the scalp and moderate bleeding is noted. What action should the nurse take first?Answer →
  169. 169Why is a person with sickle cell anemia at a high risk for developing frequent infections?Answer →
  170. 170A nurse in a provider's office is caring for a client. Based on the exhibits provided, which of the following findings require follow-up? (Select all that apply.)Answer →
  171. 171The nurse is assigned four patients with hematologic conditions. Which patient requires immediate assessment?Answer →
  172. 172Fifteen minutes after initiation of a packed RBC transfusion, the patient develops chills, flank pain, hypotension, and anxiety. What is the nurse's first action?Answer →
  173. 173A nurse is caring for a client receiving a blood transfusion who suddenly develops chills, a headache, and an elevated temperature of 2°F above baseline. After notifying the provider, which nursing intervention should the nurse perform first?Answer →
  174. 174After bone marrow biopsy, persistent bleeding is noted at the site. First action?Answer →
  175. 175A nurse is reinforcing teaching about pernicious anemia with a client following a total gastrectomy. Which of the following dietary supplements should the nurse include in the teaching as the treatment for pernicious anemia?Answer →
  176. 176The nurse preparing discharge education for a client with a white blood cell count of 2,100 cells/mcL. What instruction should the nurse plan to include in the teaching?Answer →
  177. 177A 42-year-old patient with immune thrombocytopenic purpura (ITP) is admitted with a platelet count of 18,000/µL. The patient reports bleeding gums when brushing teeth and scattered petechiae on the lower extremities. Vital signs are stable. Which nursing intervention is the priority?Answer →
  178. 178A patient with a history of alcohol abuse presents with weakness, fatigue, and difficulty concentrating. Laboratory tests show an elevated mean corpuscular volume (MCV) and low vitamin B-12 levels. What type of anemia is likely present?Answer →
  179. 179A hospitalized patient on postoperative day 6 has been receiving unfractionated heparin for DVT prophylaxis. The platelet count has decreased from 240,000/µL to 68,000/µL over 48 hours. The patient now reports new right calf tenderness and mild swelling. Which nursing action is NOT appropriate at this time?Answer →
  180. 180A patient with acute leukemia develops a temperature of 38.6°C (101.5°F). What is the priority nursing action?Answer →
  181. 181A client who is taking an antibiotic develops diarrhea. As the client resumes a regular diet, the nurse offers yogurt and buttermilk, but also observes that the client has several small bruises. Which additional dietary change should the nurse offer?Answer →
  182. 182A patient with iron deficiency anemia has spoon-shaped nails and pica. What is the underlying cause?Answer →
  183. 183A patient newly diagnosed with leukemia reports several symptoms during the nursing assessment. Which of the following clinical manifestations should the nurse recognize as typical systemic symptoms associated with leukemia? (Select all that apply)Answer →
  184. 184A patient admitted in sickle cell crisis reports pain 10/10 and has tachycardia. The nurse must prioritize which intervention?Answer →
  185. 185A patient diagnosed with polycythemia vera reports headache, dizziness, and blurred vision. The hematocrit is 62%. Which complication is the nurse most concerned about?Answer →
  186. 186A nurse is caring for a client who has a prescription for one unit of packed RBCs. The nurse should plan to remain in the room with the client at which of the following times during the infusion to observe for a transfusion reaction?Answer →
  187. 187A patient in sickle cell crisis has oxygen saturation of 88% on room air. What is the priority intervention?Answer →
  188. 188The nurse explains to a client with anemia why kidney function is routinely monitored. Which statement by the nurse correctly describes the kidney's role related to anemia?Answer →
  189. 189A nurse is caring for a client with a WBC count of 18,000/mm² and notes a left shift on the differential indicating an increased number of immature neutrophils. Which nursing action is the priority based on this data?Answer →
  190. 190An adult female client arrives at the clinic for an annual physical exam expressing an interest in becoming pregnant and requests information about preventing neural tube defects during pregnancy. Which food should the nurse encourage the client to include in her diet?Answer →
  191. 191A client is brought to the ED reporting fatigue, large amounts of bruising on the extremities, and abdominal pain localized in the left upper quadrant. A health history reveals the client has been treated for a sore throat three times in the past 2 months. Laboratory tests indicate severe anemia, significant neutropenia, and thrombocytopenia. Based on the symptoms, what could be the client's diagnosis?Answer →
  192. 192A 75-year-old patient is receiving a blood transfusion and suddenly develops dyspnea, jugular venous distention, tachycardia, increased blood pressure, and crackles on lung auscultation. Which transfusion reaction should the nurse suspect and prioritize interventions for?Answer →
  193. 193A patient with severe thrombocytopenia reports severe headache. Why is this concerning?Answer →
  194. 194The nurse provides the prescribed packed red blood cell (PRBC) transfusion to a client with leukemia and severe anemia. What assessment finding(s) should the nurse recognize as indicating effective treatment? Select all that apply.Answer →
  195. 195When teaching a client with sickle cell disease about strategies to prevent crises, what measures should the nurse recommend?Answer →
  196. 196Which physiological change is the primary reason that adolescent females require a higher daily intake of iron than adolescent males?Answer →
  197. 197Which laboratory test is crucial for the diagnosis of sickle cell anemia?Answer →
  198. 198A nurse is preparing to administer heparin 2,000 units by IV bolus. Available is heparin injection 5,000 units/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)Answer →
  199. 199When conducting diet teaching for a client who has iron-deficiency anemia, which food(s) should the nurse encourage the client to eat? Select all that apply.Answer →
  200. 200A patient with aplastic anemia has pancytopenia: WBC 1.2, platelets 18,000, Hgb 7.1. The patient reports severe headaches and confusion. What is the nurse's priority?Answer →
  201. 201A patient who suffers of chronic anemia today he comes to the ER complaining of chest pain on the monitor you find ST depression. Which nursing actions are appropriate? Select all that apply.Answer →
  202. 202A nurse is providing discharge teaching for a client with neutropenia. Which statement by the client indicates an understanding of the teaching?Answer →
  203. 203A client is undergoing a massive blood transfusion. The client reports of muscle cramps. The nurse understands to check for Chevastek's sign because of which of the following possible effects of a large volume blood transfusion?Answer →
  204. 204A pregnant woman develops anemia with a normal mean corpuscular volume (MCV). What is the likely cause of her anemia?Answer →
  205. 205A nurse is planning care for several clients. Which client(s) is/are at an increased risk for malnutrition? Select all that apply.Answer →
  206. 206The nurse has received handoff shift report on a group of clients. Which client should the nurse see first?Answer →
  207. 207prevalence of anemia among different populations. Which individual is most likely to have anemia?Answer →
  208. 208A nurse is caring for an antepartum client who has iron-deficiency anemia. When teaching the client about nutrition, the nurse should emphasize the need for an increased intake of which of the following foods?Answer →
  209. 209A nurse monitors a client 10 minutes after starting a blood transfusion. The client reports chills, back pain, and dyspnea. What is the priority action?Answer →
  210. 210What is the primary clinical value of obtaining a serum ferritin level in patients with suspected iron deficiency?Answer →
  211. 211A nurse is preparing to infuse a 100-mL unit of packed RBCs over 1 hr. The drop factor of the manual IV tubing is 15 gtts/mL. The nurse should adjust the flow rate to deliver how many drops per minute? (Only answers with numbers, units of measurement and time will be considered for credit. Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)Answer →
  212. 212If a patient has O- blood, which type can be the donor?Answer →
  213. 213A nurse is caring for a client who is receiving an iron transfusion. The patient suddenly complains of abdominal pain, severe abdominal cramping, and weakness. Which of the following would the nurse expect the provider to order?Answer →
  214. 214After bone marrow biopsy, persistent bleeding is noted at the site. First action?Answer →
  215. 215What is the oxygen-carrying protein found in red blood cells called?Answer →
  216. 216A nurse in a provider's office is caring for a client. The nurse is reviewing the client's History and Physical and Diagnostic Results. Click to highlight the findings that require follow-up.Answer →
  217. 217A nurse is caring for a client who is receiving a unit of packed red blood cells. Fifteen minutes into the transfusion, the client develops chills, a fever of 101.8°F (38.8°C), and complains of chest tightness and low back pain. Which of the following actions should the nurse take? (Select all that apply)Answer →
  218. 218A nurse is caring for an adult patient newly diagnosed with aplastic anemia. Which statement by a newly licensed nurse demonstrates correct understanding of the condition and appropriate nursing care?Answer →
  219. 219A patient with DIC and hypotension has rising creatinine. Why?Answer →
  220. 220A postoperative patient receiving heparin for 5 days experiences a platelet drop from 250,000 to 90,000 and reports new shortness of breath. What is the nurse's priority action?Answer →
  221. 221The nurse enters the room of a client who is receiving a blood transfusion. Which finding would require the nurse to intervene?Answer →
  222. 222A client with iron deficiency anemia has been taking ferrous sulfate for four weeks. What finding indicates the treatment is effective?Answer →
  223. 223A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?Answer →
  224. 224A nurse is caring for a client diagnosed with aplastic anemia. When analyzing the laboratory results, which combination of findings most accurately reflects the expected pancytopenia characteristic of this condition? WBC Reference Range: 5,000 to 10,000/mm³ High Reference Range: 12 to 18 g/dL Platelets Reference Range: 150,000 to 400,000 mm³Answer →
  225. 225A nurse is caring for a client diagnosed with disseminated intravascular coagulation (DIC). The client exhibits tachycardia, hypotension, and bleeding from the gums and nose. Laboratory results show decreased platelets and fibrinogen, increased fibrin degradation products, and prolonged PTT. Which nursing action should the nurse prioritize to address this client's condition?Answer →
  226. 226A nurse begins a packed RBC transfusion. Five minutes later, the client reports warmth and mild tachycardia. What is the priority action?Answer →
  227. 227The nurse is caring for a client with a central venous catheter who has an order for heparin flushes. What action by the nurse is appropriate?Answer →
  228. 228A nurse is evaluating a client with suspected immune thrombocytopenia (ITP) whose lab results show a platelet count of 22,000/mm³ and peripheral blood smear revealing large, immature platelets. The client reports recent fatigue and new bruising. Which priority nursing action best addresses the clinical findings and ensures patient safety?Answer →
  229. 229A 70-year-old patient with septic shock develops bleeding from IV sites, petechiae, hypotension (BP 80/44), and decreasing urine output. Labs: platelets 30,000/uL, prolonged PT and aPTT, low fibrinogen, elevated D-dimer. What is the priority nursing intervention?Answer →
  230. 230Which laboratory parameter should the nurse monitor in a patient taking linezolid (Zyvox) to prevent a serious complication of therapy?Answer →
  231. 231A nurse is preparing to administer a transfusion of packed red blood cells (RBCs) to an older adult client who has heart failure. Which of the following manifestations should the nurse recognize as signs of fluid volume overload?Answer →
  232. 232Breastfed infants are at risk for iron deficiency anemia and also deficiencies of what other nutrient?Answer →
  233. 233A 3-year-old child has been diagnosed with beta thalassemia major. As the nurse, which of the following clinical manifestations should you anticipate assessing in this child? (Select all that apply.)Answer →
  234. 234A nurse is assessing a client who has disseminated intravascular coagulation (DIC). Which of the following findings should the nurse expect?Answer →
  235. 235A patient with chronic iron-deficiency anemia develops chest pain and tachycardia during minimal exertion. What is the nurse's priority assessment?Answer →
  236. 236A nurse begins a packed RBC transfusion. Five minutes later, the client reports warmth and mild tachycardia. What is the priority action?Answer →
  237. 237Review the electronic health record. Based on the client's laboratory findings, which action(s) should the nurse take? Select all that apply.Answer →
  238. 238A nurse is caring for a client who has manifestations of aplastic anemia. The nurse should recognize that which of the following is a diagnostic and/or laboratory test used for aplastic anemia? (Select All that Apply.)Answer →
  239. 239A nurse is assessing a patient diagnosed with iron deficiency anemia. Based on the clinical manifestations of this condition, which of the following symptoms should the nurse expect to find? Select all that apply)Answer →
  240. 240For each client finding, click to specify if the finding is consistent with sickle cell disease, iron deficiency anemia, or leukemia. Each finding may support more than 1 disease process.Answer →
  241. 241A nurse assesses a patient who reports feeling well but notices several enlarged lymph nodes on the neck that are not tender or painful. Based on this finding, what is the most appropriate nursing action?Answer →
  242. 242A pediatric patient has been diagnosed with non-Hodgkin's lymphoma. Which of the following nursing interventions is most critical to prioritize in the care of this patient?Answer →
  243. 243A nurse is preparing to administer a blood transfusion to an older adult client with a history of heart failure. Which intervention should the nurse prioritize to ensure safe transfusion management?Answer →
  244. 244A patient weighing 78 kilograms is to receive a heparin infusion. The protocol for heparin infusion is 18 units/kg/hour. How many units per hour will the patient receive? (Provide answer as a number only, round answer to the nearest whole number)Answer →
  245. 245The nurse is preparing to administer 1 unit of packed red blood cells to a patient. The nurse understands the patient's peripheral intravenous access device must be at least an (1) peripheral access device to administer the product safely. 1. Select answer choiceAnswer →
  246. 246A young client has a genetic disorder of the red blood cells (RBC), where the RBCs and hemoglobin synthesis are abnormal. Based on this information, which type of anemia will the nurse educate the client and parents about?Answer →
  247. 247Which of the following conditions or situations is most closely associated with an increased risk for developing anemia of chronic disease (ACD)?Answer →
  248. 248A patient receiving warfarin therapy has an INR (International Normalized Ratio) of 5.2 (Range: 1) without signs of bleeding. What is the priority nursing action?Answer →
  249. 249A client is being transitioned from IV heparin to oral warfarin. Which laboratory finding does the nurse identify confirming that warfarin treatment is effective?Answer →
  250. 250A patient with vitamin B12 deficiency anemia reports numbness in the feet and difficulty walking. Which assessment finding requires urgent attention?Answer →
  251. 251A nurse is caring for an adolescent diagnosed with disseminated intravascular coagulation (DIC). The adolescent asks what is causing their symptoms of bleeding and bruising. Which explanation should the nurse provide?Answer →
  252. 252A nurse is preparing to administer blood to a client. The unit of blood on hand is type B, and the client has type AB blood. Which of the following actions should the nurse take?Answer →
  253. 253Order 1 unit (400 mL) Packed RBC's infused over 2 hours. The drop factor is 10 gtt/ml. Calculate the rate in gtt/min. Round the answer at the end to the nearest whole number.Answer →