Hematologic Problems Medical-Surgical Nursing 2nd Edition February latest update with questions correct and verified answers

Hematologic Problems Medical-Surgical Nursing 2nd Edition February latest update with questions correct and verified answers 1. A 62-year old man with chronic anemia is experiencing increased fatigue and occasional palpitations at rest. The nurse would expect the patient’s laboratory test findings to include a. An RBC count of 4,500,000/µL. b. A hematocrit (Hct) value of 38%. c. Normal red blood cell (RBC) indices. d. A hemoglobin (Hgb) of 8.6 g/dL (86 g/L). ANS: D 2. Which menu choice indicates that the patient understands the nurse’s teaching about recommended dietary choices for iron-deficiency anemia? a. Omelet and whole wheat toast c. Strawberry and banana fruit plate b. Cantaloupe and cottage cheese d. Cornmeal muffin and orange juice ANS: A 3. A patient who is receiving methotrexate for severe rheumatoid arthritis develops a megaloblastic anemia. The nurse will anticipate teaching the patient about increasing oral intake of a. Iron. C. cobalamin (vitamin B12). b. Folic acid. D. ascorbic acid (vitamin C). ANS: B 4. A 52-yr-old patient has a new diagnosis of pernicious anemia. The nurse determines that the patient understands the teaching about the disorder when the patient states, a. “I need to start eating more red meat and liver.” b. “I will stop having a glass of wine with dinner.” c. “I could choose nasal spray rather than injections of vitamin B12.” d. “I will need to take a proton pump inhibitor such as omeprazole (Prilosec).” ANS: C 5. An appropriate nursing intervention for a hospitalized patient with severe hemolytic anemia is to a. Provide a diet high in vitamin K. b. Alternate periods of rest and activity. c. Teach the patient how to avoid injury. d. Place the patient on protective isolation. ANS: B 6. Which patient statement to the nurse indicates a need for additional instruction about taking oral ferrous sulfate? a. “I will call my health care provider if my stools turn black.” b. “I will take a stool softener if I feel constipated occasionally.” c. “I should take the iron with orange juice about an hour before eating.” d. “I should increase my fluid and fiber intake while I am taking iron tablets.” ANS: A 7. Which collaborative problem will the nurse include in a care plan for a patient admitted to the hospital with idiopathic aplastic anemia? a. Potential complication: seizures b. Potential complication: infection c. Potential complication: neurogenic shock d. Potential complication: pulmonary edema ANS: B 8. It is important for the nurse providing care for a patient with sickle cell crisis to a. Limit the patient’s intake of oral and IV fluids. b. Evaluate the effectiveness of opioid analgesics. c. Encourage the patient to ambulate as much as tolerated. d. Teach the patient about high-protein, high-calorie foods. ANS: B 9. Which statement by a patient indicates good understanding of the nurse’s teaching about prevention of sickle cell crisis? a. “Home oxygen therapy is frequently used to decrease sickling.” b. “There are no effective medications that can help prevent sickling.” c. “Routine continuous dosage narcotics are prescribed to prevent a crisis.” d. “Risk for a crisis is decreased by having an annual influenza vaccination.” ANS: D 10. Which instruction will the nurse plan to include in discharge teaching for a patient admitted with a sickle cell crisis? a. Take a daily multivitamin with iron. b. Limit fluids to 2 to 3 quarts per day. c. Avoid exposure to crowds when possible. d. Drink only two caffeinated beverages daily. ANS: C 11. The nurse notes scleral jaundice in a patient being admitted with hemolytic anemia. The nurse will plan to check the laboratory results for the a. Schilling test. C. gastric analysis. b. Bilirubin level. D. stool occult blood. ANS: B 12. A patient who has been receiving IV heparin infusion and oral warfarin (Coumadin) for a deep vein thrombosis (DVT) is diagnosed with heparin-induced thrombocytopenia (HIT) when the platelet level drops to 110,000/µL. Which action will the nurse include in the plan of care? a. Prepare for platelet transfusion. b. Discontinue the heparin infusion. c. Administer prescribed warfarin (Coumadin). d. Use low-molecular-weight heparin (LMWH). ANS: B 13. An expected action by the nurse caring for a patient who has an acute exacerbation of polycythemia Vera is to a. Place the patient on bed rest. c. avoid use of aspirin products. b. Administer iron supplements. d. monitor fluid intake and output. ANS: D 14. Which intervention will be included in the nursing care plan for a patient with immune thrombocytopenic purpura? a. Assign the patient to a private room. b. Avoid intramuscular (IM) injections. c. Use rinses rather than a soft toothbrush for oral care. d. Restrict activity to passive and active range of motion.