Chapter 29 Management of Patients With Nonmalignant
Hematologic Disorders
1. A nurse is caring for a patient who has sickle cell anemia and the nurse's assessment reveals the
possibility of substance abuse. What is the nurse's most appropriate action? A) Encourage the
patient to rely on complementary and alternative therapies.
B) Encourage the patient to seek care from a single provider for pain relief.
C) Teach the patient to accept chronic pain as an inevitable aspect of the disease. D) Limit
the reporting of emergency department visits to the primary health care
provider. Ans: B
Feedback:
The patient should be encouraged to use a single primary health care provider to
address health care concerns. Emergency department visits should be reported to the primary
health care provider to achieve optimal management of the disease. It would inappropriate to
teach the patient to simply accept his or her pain. Complementary therapies are usually
insufficient to fully address pain in sickle cell disease.
2. A patient newly diagnosed with thrombocytopenia is admitted to the medical unit. After the
admission assessment, the patient asks the nurse to explain the disease. What should the nurse
explain to this patient?
A) There could be an attack on the platelets by antibodies.
B) There could be decreased production of platelets.
C) There could be impaired communication between platelets.
D) There could be an autoimmune process causing platelet malfunction. Ans: B
Feedback:
Thrombocytopenia can result from a decreased platelet production, increased platelet
destruction, or increased consumption of platelets. Impaired platelet communication,
antibodies, and autoimmune processes are not typical pathologies.
,3. A critical care nurse is caring for a patient with autoimmune hemolytic anemia. The patient is
not responding to conservative treatments, and his condition is now becoming life threatening.
The nurse is aware that a treatment option in this case may include what?
A) Hepatectomy
B) Vitamin K administration
C) Platelet transfusion
D) Splenectomy
Ans: D
Feedback:
A splenectomy may be the course of treatment if autoimmune hemolytic anemia does not
respond to conservative treatment. Vitamin K administration is treatment for vitamin K
deficiency and does not resolve anemia. Platelet transfusion may be the course of treatment
for some bleeding disorders. Hepatectomy would not help the patient.
, 4. A nurse is providing education to a patient with iron deficiency anemia who has been
prescribed iron supplements. What should the nurse include in health education?
A) Take the iron with dairy products to enhance absorption.
B) Increase the intake of vitamin E to enhance absorption. C) Iron will cause the stools to
darken in color.
D) Limit foods high in fiber due to the risk for diarrhea. Ans: C
Feedback:
The nurse will inform the patient that iron will cause the stools to become dark in color.
Iron should be taken on an empty stomach, as its absorption is affected by food, especially
dairy products. Patients should be instructed to increase their intake of vitamin C to enhance
iron absorption. Foods high in fiber should be consumed to minimize problems with
constipation, a common side effect associated with iron therapy.
5. The nurse is assessing a new patient with complaints of overwhelming fatigue and a sore
tongue that is visibly smooth and beefy red. This patient is demonstrating signs and symptoms
associated with what form of what hematologic disorder?
A) Sickle cell anemia
B) Hemophilia
C) Megaloblastic anemia D) Thrombocytopenia Ans: C
Feedback:
A red, smooth, sore tongue is a symptom associated with megaloblastic anemia. Sickle cell
disease, hemophilia, and thrombocytopenia do not have symptoms involving the tongue.
6. A patient with renal failure has decreased erythropoietin production. Upon analysis of the
patient's complete blood count, the nurse will expect which of the following results? A) An
increased hemoglobin and decreased hematocrit
B) A decreased hemoglobin and hematocrit
Hematologic Disorders
1. A nurse is caring for a patient who has sickle cell anemia and the nurse's assessment reveals the
possibility of substance abuse. What is the nurse's most appropriate action? A) Encourage the
patient to rely on complementary and alternative therapies.
B) Encourage the patient to seek care from a single provider for pain relief.
C) Teach the patient to accept chronic pain as an inevitable aspect of the disease. D) Limit
the reporting of emergency department visits to the primary health care
provider. Ans: B
Feedback:
The patient should be encouraged to use a single primary health care provider to
address health care concerns. Emergency department visits should be reported to the primary
health care provider to achieve optimal management of the disease. It would inappropriate to
teach the patient to simply accept his or her pain. Complementary therapies are usually
insufficient to fully address pain in sickle cell disease.
2. A patient newly diagnosed with thrombocytopenia is admitted to the medical unit. After the
admission assessment, the patient asks the nurse to explain the disease. What should the nurse
explain to this patient?
A) There could be an attack on the platelets by antibodies.
B) There could be decreased production of platelets.
C) There could be impaired communication between platelets.
D) There could be an autoimmune process causing platelet malfunction. Ans: B
Feedback:
Thrombocytopenia can result from a decreased platelet production, increased platelet
destruction, or increased consumption of platelets. Impaired platelet communication,
antibodies, and autoimmune processes are not typical pathologies.
,3. A critical care nurse is caring for a patient with autoimmune hemolytic anemia. The patient is
not responding to conservative treatments, and his condition is now becoming life threatening.
The nurse is aware that a treatment option in this case may include what?
A) Hepatectomy
B) Vitamin K administration
C) Platelet transfusion
D) Splenectomy
Ans: D
Feedback:
A splenectomy may be the course of treatment if autoimmune hemolytic anemia does not
respond to conservative treatment. Vitamin K administration is treatment for vitamin K
deficiency and does not resolve anemia. Platelet transfusion may be the course of treatment
for some bleeding disorders. Hepatectomy would not help the patient.
, 4. A nurse is providing education to a patient with iron deficiency anemia who has been
prescribed iron supplements. What should the nurse include in health education?
A) Take the iron with dairy products to enhance absorption.
B) Increase the intake of vitamin E to enhance absorption. C) Iron will cause the stools to
darken in color.
D) Limit foods high in fiber due to the risk for diarrhea. Ans: C
Feedback:
The nurse will inform the patient that iron will cause the stools to become dark in color.
Iron should be taken on an empty stomach, as its absorption is affected by food, especially
dairy products. Patients should be instructed to increase their intake of vitamin C to enhance
iron absorption. Foods high in fiber should be consumed to minimize problems with
constipation, a common side effect associated with iron therapy.
5. The nurse is assessing a new patient with complaints of overwhelming fatigue and a sore
tongue that is visibly smooth and beefy red. This patient is demonstrating signs and symptoms
associated with what form of what hematologic disorder?
A) Sickle cell anemia
B) Hemophilia
C) Megaloblastic anemia D) Thrombocytopenia Ans: C
Feedback:
A red, smooth, sore tongue is a symptom associated with megaloblastic anemia. Sickle cell
disease, hemophilia, and thrombocytopenia do not have symptoms involving the tongue.
6. A patient with renal failure has decreased erythropoietin production. Upon analysis of the
patient's complete blood count, the nurse will expect which of the following results? A) An
increased hemoglobin and decreased hematocrit
B) A decreased hemoglobin and hematocrit
