Hematologic Nursing
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1. The nurse is admitting a 3. 4. 5. 6.
client suspected of
having sickle cell anemia. The client with sickle cell anemia develops
The client has a fever skin ulcers on the lower extremities from the
of 38.9°C or 102°F, faint yel- vaso-occlusive aspects of the disease. The client
low-tinged sclera, would have shortness of breath and be fatigued
and is complaining of ab- and pale. The client may have swollen fingers.
dominal pain. Which The hemolysis of red blood cells results in
of the following clinical man- bilirubinuria. The client's urine is dark colored.
ifestations further
support this diagnosis?
Select all that apply:
[ ] 1. Rapid but regular
breathing
[ ] 2. Pale, dilute urine
[ ] 3. Skin ulcers on the lower
extremities
[ ] 4. Swollen fingers
[ ] 5. Pallor
[ ] 6. Fatigue
2. The nurse making a care plan 3
for a client with
severe thrombocytopenia Severe thrombocytopenia is a platelet count of
should include which <10,000 to 20,000/mm3. The client with this
of the following? low number of platelets is at great risk of
1. Careful examination of bleeding from any invasive procedure. Intramuscular injections
spinal fluid obtained can cause a hematoma
by lumbar puncture in the muscle and should be avoided if possible. A lumbar
2. A private room with re- puncture would put the client at an unnecessary risk of bleeding.
verse isolation A private room is not indicated unless there are other reasons
precautions
, Hematologic Nursing
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3. Avoid intramuscular ad- for isolation (infection, neutropenia). Furosemide is a diuretic
ministration of and not used as therapy for thrombocytopenia.
medications
4. Careful monitoring of uri-
nary output while
titrating the dosage of
furosemide (Lasix)
3. The nurse is performing an C is correct.
assessment on a client with
possible A red, beefy tongue is characteristic of the client with pernicious
pernicious anemia. Which anemia. Answer A, a weight loss of 10 pounds in 2 weeks, is
data would support this diag- abnormal but is not seen in pernicious anemia. Numbness and
nosis? tingling, in answer B, can be associated with anemia but are not
particular to pernicious anemia. This is more likely associated
A. A weight loss of 10 pounds with peripheral vascular diseases involving vasculature. In an-
in 2 weeks swer D, the hemoglobin is below normal.
B. Complaints of numbness
and tingling in the extremi-
ties
C. A red, beefy tongue
D. A hemoglobin level of
12.0gm/dL
4. A client with lung cancer is 2.
admitted with a
new diagnosis of acute dis- Acute disseminated intravascular coagulation
seminated (DIC) is a serious disorder resulting in bleeding
intravascular coagulation and clotting. It is a priority that the client must
(DIC). Which of the be assessed frequently by the nurse for
following actions is a priori- bleeding. After ensuring that there is no active
ty? bleeding, the nurse may obtain a detailed diet
, Hematologic Nursing
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1. Obtain a diet history from history or implement family teaching. A delay
the client for the to do family teaching away from the client or to
last 3 days dwell on diet history would not be appropriate.
2. Assess the client for any Some clients with chronic DIC may eventually
indications of require dialysis.
internal or external bleeding
3. Take the family to the fam-
ily lounge and
discuss home care for a client
with DIC
4. Call the dialysis unit to de-
termine when the
client may be transferred
5. A client has been receiving Answer D is correct.
cyanocobalamine (B12) injec-
tions for Cyanocolamine is a B12 medication that is used for pernicious
the past 6 weeks. Which lab- anemia, and a reticulocyte count of 1% indicates that it is having
oratory finding indicates that the desired effect.
the medication is having the Answers A, B, and C are white blood cells and have nothing to
desired effect? do with this medication.
A. Neutrophil count of 60%
B. Basophil count of 0.5%
C. Monocyte count of 2%
D. Reticulocyte count of 1%
6. A client with sickle cell ane- Answer A is correct.
mia is admitted to the labor
and delivery Clients with sickle cell crises are treated with heat, hydration,
unit during the first phase of oxygen, and pain relief. Fluids are increased, not decreased,
labor. The nurse should antic- so answer B is incorrect. Answer C is incorrect because blood
ipate
, Hematologic Nursing
Study online at https://quizlet.com/_a8sy5v
the client's need for: transfusions are usually not required. Answer D is incorrect
A. Supplemental oxygen because these clients can be delivered vaginally.
B. Fluid restriction
C. Blood transfusion
D. Delivery by Caesarean sec-
tion
7. A client with rheuma- Answer D is correct.
toid arthritis is receiving
Methotrexate. After Methotrexate is a folic acid antagonist. Leucovorin is the drug
reviewing the client's chart, given for toxicity to this drug. Answers A, B, and C are incorrect
the physician orders Well- because the drug is not used to treat iron-deficiency anemia,
covorin (leucovorin calcium). create a synergistic effects, or increase the number of circulating
The rationale for adminis- neutrophils.
tering leucovorin calcium to
a client receiving Methotrex-
ate is to:
MA. Treat iron-deficiency ane-
mia caused by chemothera-
peutic
agents
MB. Create a synergistic ef-
fect that shortens treatment
time
MC. Increase the number of
circulating neutrophils
MD. Reverse drug toxicity and
prevent tissue damage
8. The nurse is providing di- Answer A is correct.
etary instructions for a client
Study online at https://quizlet.com/_a8sy5v
1. The nurse is admitting a 3. 4. 5. 6.
client suspected of
having sickle cell anemia. The client with sickle cell anemia develops
The client has a fever skin ulcers on the lower extremities from the
of 38.9°C or 102°F, faint yel- vaso-occlusive aspects of the disease. The client
low-tinged sclera, would have shortness of breath and be fatigued
and is complaining of ab- and pale. The client may have swollen fingers.
dominal pain. Which The hemolysis of red blood cells results in
of the following clinical man- bilirubinuria. The client's urine is dark colored.
ifestations further
support this diagnosis?
Select all that apply:
[ ] 1. Rapid but regular
breathing
[ ] 2. Pale, dilute urine
[ ] 3. Skin ulcers on the lower
extremities
[ ] 4. Swollen fingers
[ ] 5. Pallor
[ ] 6. Fatigue
2. The nurse making a care plan 3
for a client with
severe thrombocytopenia Severe thrombocytopenia is a platelet count of
should include which <10,000 to 20,000/mm3. The client with this
of the following? low number of platelets is at great risk of
1. Careful examination of bleeding from any invasive procedure. Intramuscular injections
spinal fluid obtained can cause a hematoma
by lumbar puncture in the muscle and should be avoided if possible. A lumbar
2. A private room with re- puncture would put the client at an unnecessary risk of bleeding.
verse isolation A private room is not indicated unless there are other reasons
precautions
, Hematologic Nursing
Study online at https://quizlet.com/_a8sy5v
3. Avoid intramuscular ad- for isolation (infection, neutropenia). Furosemide is a diuretic
ministration of and not used as therapy for thrombocytopenia.
medications
4. Careful monitoring of uri-
nary output while
titrating the dosage of
furosemide (Lasix)
3. The nurse is performing an C is correct.
assessment on a client with
possible A red, beefy tongue is characteristic of the client with pernicious
pernicious anemia. Which anemia. Answer A, a weight loss of 10 pounds in 2 weeks, is
data would support this diag- abnormal but is not seen in pernicious anemia. Numbness and
nosis? tingling, in answer B, can be associated with anemia but are not
particular to pernicious anemia. This is more likely associated
A. A weight loss of 10 pounds with peripheral vascular diseases involving vasculature. In an-
in 2 weeks swer D, the hemoglobin is below normal.
B. Complaints of numbness
and tingling in the extremi-
ties
C. A red, beefy tongue
D. A hemoglobin level of
12.0gm/dL
4. A client with lung cancer is 2.
admitted with a
new diagnosis of acute dis- Acute disseminated intravascular coagulation
seminated (DIC) is a serious disorder resulting in bleeding
intravascular coagulation and clotting. It is a priority that the client must
(DIC). Which of the be assessed frequently by the nurse for
following actions is a priori- bleeding. After ensuring that there is no active
ty? bleeding, the nurse may obtain a detailed diet
, Hematologic Nursing
Study online at https://quizlet.com/_a8sy5v
1. Obtain a diet history from history or implement family teaching. A delay
the client for the to do family teaching away from the client or to
last 3 days dwell on diet history would not be appropriate.
2. Assess the client for any Some clients with chronic DIC may eventually
indications of require dialysis.
internal or external bleeding
3. Take the family to the fam-
ily lounge and
discuss home care for a client
with DIC
4. Call the dialysis unit to de-
termine when the
client may be transferred
5. A client has been receiving Answer D is correct.
cyanocobalamine (B12) injec-
tions for Cyanocolamine is a B12 medication that is used for pernicious
the past 6 weeks. Which lab- anemia, and a reticulocyte count of 1% indicates that it is having
oratory finding indicates that the desired effect.
the medication is having the Answers A, B, and C are white blood cells and have nothing to
desired effect? do with this medication.
A. Neutrophil count of 60%
B. Basophil count of 0.5%
C. Monocyte count of 2%
D. Reticulocyte count of 1%
6. A client with sickle cell ane- Answer A is correct.
mia is admitted to the labor
and delivery Clients with sickle cell crises are treated with heat, hydration,
unit during the first phase of oxygen, and pain relief. Fluids are increased, not decreased,
labor. The nurse should antic- so answer B is incorrect. Answer C is incorrect because blood
ipate
, Hematologic Nursing
Study online at https://quizlet.com/_a8sy5v
the client's need for: transfusions are usually not required. Answer D is incorrect
A. Supplemental oxygen because these clients can be delivered vaginally.
B. Fluid restriction
C. Blood transfusion
D. Delivery by Caesarean sec-
tion
7. A client with rheuma- Answer D is correct.
toid arthritis is receiving
Methotrexate. After Methotrexate is a folic acid antagonist. Leucovorin is the drug
reviewing the client's chart, given for toxicity to this drug. Answers A, B, and C are incorrect
the physician orders Well- because the drug is not used to treat iron-deficiency anemia,
covorin (leucovorin calcium). create a synergistic effects, or increase the number of circulating
The rationale for adminis- neutrophils.
tering leucovorin calcium to
a client receiving Methotrex-
ate is to:
MA. Treat iron-deficiency ane-
mia caused by chemothera-
peutic
agents
MB. Create a synergistic ef-
fect that shortens treatment
time
MC. Increase the number of
circulating neutrophils
MD. Reverse drug toxicity and
prevent tissue damage
8. The nurse is providing di- Answer A is correct.
etary instructions for a client
