SOLVED

Chapter 28 Question 1 A patient diagnosed with chronic renal insufficiency has a hemoglobin level of 8.6 mg/dL. The nurse plans care for a patient with which level of anemia? 1. Grade 1 or mild 2. Grade 3 or severe 3. Grade 4 or life threatening 4. Grade 2 or moderate Question 2 A patient with rheumatoid arthritis has a hemoglobin level of 10.0 g/dL. The nurse would consider this anemia to be related to inflammation if which other findings are present? 1. The patient has low vitamin B12 levels. 2. Laboratory testing shows low hepcidin level. 3. Increased destruction of erythrocytes is occurring. 4. Serum iron levels are low. 5. The patient’s stools are guaiac positive. Question 3 A patient receiving chemotherapy for cancer is diagnosed with anemia secondary to bone marrow depression. The nurse would expect which intervention? 1. Recombinant erythropoietin therapy 2. Iron supplements 3. Fresh frozen plasma 4. Hematopoietic stem-cell transplantation Question 4 A patient with sickle cell disease tells the nurse that she knows when the disease is going to flare because she has pain in her arms and legs. Which explanation would the nurse provide? 1. “The shape of your blood cells blocks the small capillaries in your arms and legs.” 2. “The pain is really due to your history of malaria along with having sickle cell anemia.” 3. “Your spleen is destroying all the malformed red blood cells which makes you anemic and causes arm and leg pain.” 4. “The chronic blood loss associated with sickle cell anemia causes pain in the arms and legs.” Question 5 The nurse is planning to instruct a patient with sickle cell disease on ways to avoid a painful crisis. What should the nurse include in this instruction? 1. Do not drink alcohol. 2. Eat a diet low in protein. 3. Avoid tiring exercise. 4. Avoid carbohydrates. 5. Do not smoke. Question 6 A 25-year-old patient with sickle cell disease says, “My sister is having a baby. I can’t wait until I have kids of my own.” Which nursing response is indicated? 1. “You should use barrier protection until you are ready to have a child.” 2. “Have you thought about adopting children?” 3. “Genetic counseling will be important for you and your partner.” 4. “I hope that infertility does not cause problems for you.” Question 7 A patient is admitted with the tentative diagnosis of polycythemia vera. Which assessment findings would the nurse evaluate as supporting that diagnosis? 1. Plethora 2. Fingers that are dark and cool to touch 3. Report of night sweats 4. Complaint of shortness of breath 5. Hypotension Question 8 A patient with a 40-pack-year smoking history has increased hemoglobin and hematocrit. The nurse expects that which test will be done to assess for erythrocytosis? 1. Serum electrolytes 2. Sedimentation rate 3. Platelet count 4. Carboxyhemoglobin level Question 9 The nurse is providing care for a patient diagnosed with secondary polycythemia. Which finding is most significant for the nurse to discuss with the primary health care provider immediately? 1. The patient becomes short of breath on exertion. 2. The patient has had no appetite for the last two days. 3. The patient is confused. 4. The patient’s fingers are red and warm to touch. Question 10 The nurse is providing care for a young woman diagnosed with idiopathic thrombocytopenia. Which information should the nurse provide? 1. Take a low-dose aspirin daily. 2. Use pads during menstrual cycle instead of tampons. 3. Brush and floss teeth carefully. 4. Use glycerin suppositories to prevent constipation.