Coordinating Care for Patients With Hematological Disorders Multiple Choice

Coordinating Care for Patients With Hematological Disorders
Multiple Choice
Identify the choice that best completes the statement or answers the question.

____ 1. The home healthcare nurse is preparing a care plan for a patient with severe anemia. The patient currently lives
alone and states, “I can’t even walk to the kitchen without getting winded.” What would be the priority nursing
diagnosis for this patient?
1 Hopelessness
)
2 Activity Intolerance
)
3 Altered Nutrition, Less than Body Requirements
)
4 Anxiety
)

____ 2. A nurse is providing discharge teaching for a patient with iron-deficiency anemia. The patient has been prescribed
ferrous sulfate and has been told to increase the intake of foods that are naturally high in iron. Which patient
statement indicates correct understanding?
1 “I will decrease my intake of green leafy vegetables while taking my ferrous sulfate tab-
) let.”
2 “I will increase my fluid intake while I am taking my ferrous sulfate.”
)
3 “I will take my ferrous sulfate tablet on an empty stomach.”
)
4 “I will decrease milk intake while taking my ferrous sulfate tablet.”
)

____ 3. The nurse is evaluating a patient’s understanding of dietary needs to treat anemia. Which patient statement
indicates a need for additional teaching?
1 “I will eat more fruits and vegetables, especially green leafy ones, to get more iron in my
) diet.”
2 “I will need to include more protein foods in my diet such as meats, dried beans, and
) whole-grain breads.”
3 “I will decrease foods high in vitamin C, as they decrease my absorption of iron.”
)
4 “I will take vitamins with extra iron in addition to eating a balanced diet with meat to
) correct my anemia.”

____ 4. The nurse is instructing a patient with iron-deficiency anemia about appropriate menu choices. Which diet choice
indicates that teaching has been effective?
1 Tofu with mixed vegetables in curry, milk, whole-wheat bun
)
2 Broiled fish, lettuce salad, grapefruit half, carrot sticks
)
3 Pork chop, mashed potatoes and gravy, cauliflower, tea
)
4 Roast beef, steamed spinach, tomato soup, orange juice

, )

____ 5. A nurse is providing discharge instructions to a patient with iron-deficiency anemia who is experiencing glossitis.
Which patient statement indicates the need for further education?
1 “I will monitor my lips and tongue daily.”
)
2 “I will use an alcohol-based mouthwash twice per day.”
)
3 “I will apply a petroleum-based lubricating ointment to my lips.”
)
4 “I will use a soft toothbrush when brushing my teeth each day.”
)

____ 6. The nurse is planning care for a patient with acute myeloid leukemia (AML). Which is the priority nursing
diagnosis to minimize the risk of complications associated with AML?
1 Risk for Bleeding
)
2 Ineffective Thermoregulation
)
3 Imbalanced Nutrition
)
4 Fluid Volume Excess
)

____ 7. A pediatric patient being treated for acute lymphocytic leukemia (ALL) has a white blood cell count of
1,000/mm3. Which nursing diagnosis would be a priority for this patient?
1 Readiness for Enhanced Immunization Status
)
2 Impaired Gas Exchange
)
3 Risk for Infection
)
4 Activity Intolerance
)

____ 8. A pediatric nurse is caring for a child with acute lymphoblastic leukemia (ALL). When providing education to the
child’s parents regarding this disease, which topic should the nurse include?
1 ALL is characterized by abnormal proliferation of all bone marrow elements.
)
2 This form of leukemia is the most common type among children and adolescents.
)
3 This form of leukemia is very rarely seen in children.
)
4 The onset of ALL is usually gradual.
)

____ 9. A nurse is planning care for a patient with leukemia. The nurse chooses Risk for Bleeding as the nursing
diagnosis. Which intervention supports this nursing diagnosis?
1 Educate patient in use of soft toothbrush for oral care
)

, 2 Limit parenteral injections
)
3 Apply pressure to arterial puncture sites for five minutes
)
4 Encourage patient to deep breathe and huff cough
)

____ 10. A patient in sickle cell crisis reports taking a recent skiing trip that caused a respiratory infection from the cold
weather. Which nursing diagnosis is a priority for this patient?
1 Fluid Volume Excess
)
2 Risk for Self-Mutilation
)
3 Knowledge Deficit
)
4 Acute Pain
)

____ 11. A patient is admitted to the emergency department in a sickle cell crisis. The nurse assesses the patient and
documents the following clinical findings: temperature 102°F, O2 saturation of 89%, and complaints of severe
abdominal pain. Based on the assessment findings, which intervention is the greatest priority?
1 Apply oxygen per nasal cannula at 3 L/minute.
)
2 Assess and document peripheral pulses.
)
3 Administer morphine sulfate 10 mg IM.
)
4 Administer Tylenol 650 mg by mouth.
)

____ 12. The nurse is caring for a patient who was admitted to a medical-surgical unit in a sickle cell crisis. Which
medication should the nurse expect to administer to this patient?
1 Acetaminophen
)
2 Ibuprofen
)
3 Meperidine
)
4 Hydroxyurea
)

____ 13. The nurse is providing care to a patient who is receiving treatment for sickle cell disease. The patient is at risk for
infection. Which medication does the nurse expect to administer to this patient?
1 Acetaminophen
)
2 Penicillin
)
3 Morphine sulfate
)
4 Tamoxifen

, )

____ 14. An emergency department nurse is caring for a child in a sickle cell crisis. The nurse suspects the etiology of the
crisis as being thrombotic in nature due to which clinical manifestations?
1 The patient has profound pallor and fatigue.
)
2 The patient is in extreme pain.
)
3 The patient has profound hypotension and shock.
)
4 The patient’s chest CT reveals a pulmonary infarct.
)

____ 15. A nurse is planning care for a patient with sickle cell disease and chooses Acute Pain as the nursing diagnosis.
Which intervention is inappropriate for the nurse to include in this plan of care?
1 Administer ordered analgesic medications around the clock
)
2 Place patient in position of comfort
)
3 Use heat or cold packs as tolerated
)
4 Support the patient’s joints and extremities with pillows
)

____ 16. A child who has polycythemia is prescribed radiation. The child’s parents ask why this is necessary since the child
does not have cancer. Which response by the nurse is accurate?
1 “It stimulates red blood cell production.”
)
2 “It suppresses the bone marrow.”
)
3 “It provides vitamin supplementation.”
)
4 “It decreases the risk of transfusion reactions.”
)

____ 17. A child diagnosed with aplastic anemia is admitted to the hospital. The parents ask the nurse what aplastic anemia
is. Which response by the nurse is accurate?
1 “Aplastic anemia causes a proliferation of white blood cells.”
)
2 “Aplastic anemia is characterized by abnormally shaped red blood cells.”
)
3 “Aplastic anemia is caused by the bone marrow producing inadequate cells.”
)
4 “Aplastic anemia is a disorder that occurs after a viral illness.”
)

____ 18. Which is the priority nursing diagnosis for the child diagnosed with idiopathic thrombocytopenic purpura (ITP)?
1 Ineffective Breathing Pattern
)
2 Nausea