Chapter 29: Assessment:hematologic System 11 Edition

CHAPTER 29: ASSESSMENT:HEMATOLOGIC SYSTEM 11 EDITION MULTIPLE CHOICE 1. A patient is being discharged after an emergency splenectomy following a motor vehicle crash. Which instructions should the nurse include in the discharge teaching? a. Check often for swollen lymph nodes. b. Watch for excess bleeding or bruising. c. Take iron supplements to prevent anemia. d. Wash hands and avoid persons who are ill. ANS: D Splenectomy increases the risk for infection, especially with gram-positive bacteria. The risks for lymphedema, bleeding, and anemia are not increased after a person has a splenectomy. DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity 2. The nurse assesses a patient who has numerous petechiae on both arms. Which question should the nurse ask the patient? a. “Are you taking any oral contraceptives?” b. “Have you been prescribed antiseizure drugs?” c. “Do you take medication containing salicylates?” d. “How long have you taken antihypertensive drugs?” ANS: C NURSINGTB.COM Salicylates interfere with platelet function and can lead to petechiae and ecchymoses. Antiseizure drugs may cause anemia but not clotting disorders or bleeding. Oral contraceptives increase a person’s clotting risk. Antihypertensives do not usually cause problems with decreased clotting. DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity 3. A nurse reviews the laboratory data for an older adult. The nurse would be most concerned about which finding? a. Hematocrit of 35% b. Hemoglobin of 11.8 g/dL c. Platelet count of 400,000/µL d. White blood cell count of 2800/µL ANS: D Because the total white blood cell (WBC) count is not usually affected by aging, the low WBC count in this patient would indicate that the patient’s immune function may be compromised, and the underlying cause of the problem needs to be investigated. The platelet count is normal. The slight decrease in hemoglobin and hematocrit are not unusual for an older patient. DIF: Cognitive Level: Analyze (analysis) TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity