Chapter 33 Assessment and Management of Patients With Hematologic Disorders

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Chapter 33  Assessment and Management of Patients With Hematologic Disorders

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

Multiple Choice

1. You are caring for a patient with a hematologic disorder. The patient asks you where the body forms blood cells. Where would you tell the patient that blood cells are formed?
A) In the spleen
B) In the kidneys

C) In the bone marrow D) In the liver

Ans: C
Chapter: 33
Client Needs: D-1
Cognitive Level: Comprehension
Difficulty: Easy
Integrated Process: Nursing Process
Objective: 1
Page and Header: 904, Anatomic and Physiologic Overview

Feedback: Bone marrow is the primary site for hematopoiesis. The liver and spleen may be involved during embryonic development or when marrow is destroyed. The kidneys release erythropoietin, which stimulates the marrow to increase production of RBCs. Blood cells are not formed in the spleen, kidneys, or liver.

2. An elderly man trips over his dog and receives an injury to the skin, which causes minor blood loss. Primary hemostasis is activated in this patient. What occurs in primary hemostasis? A) Severed blood vessels constrict.
B) Thromboplastin is released.

C) Prothrombin is converted to thrombin. D) Fibrin is lysed.

Ans: A
Chapter: 33
Client Needs: D-4
Cognitive Level: Comprehension
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 2
Page and Header: 908, Anatomic and Physiologic Overview

Feedback: Primary hemostasis involves the severed vessel constricting and platelets collecting at the injury site. Secondary hemostasis occurs when thromboplastin is released, prothrombin converts to thrombin, and fibrin is lysed.

3. A patient has come to the OB/GYN clinic with complaints of a heavy menstrual flow. The nurse knows that red blood cell production will be increased in the patient’s body. Because of this, the nurse is aware that the patient may need to increase her daily intake of what?
A) Vitamin C

B) Vitamin D C) Iron
D) Magnesium

Ans: C
Chapter: 33
Client Needs: D-4
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 2
Page and Header: 905, Anatomic and Physiologic Overview

Feedback: To replace blood loss, the rate of red cell production increases. Iron is incorporated into hemoglobin. Vitamins C and D and magnesium do not need to be increased when red blood

cell production is increased.

4. You are caring for a patient with a diagnosis of hypoproliferative anemia. You are aware that this type of anemia is due to what?
A) Lack of production of RBCs
B) Loss of RBCs

C) Injury to the RBCs in circulation D) Abnormality of RBCs

Ans: A
Chapter: 33
Client Needs: D-4
Cognitive Level: Comprehension Difficulty: Easy
Integrated Process: Nursing Process Objective: 3
Page and Header: 910, Anemia

Feedback: Hypoproliferative anemia is usually a result of inadequate numbers of RBCs being produced by the bone marrow. Loss of RBCs is usually a result of blood loss. Hemolytic anemia can be a result of injury to the RBCs in circulation, possibly due to heart valve hemolysis. Abnormality of RBCs can occur in sickle cell anemia.

5. A nurse is caring for a 16-year-old who has sickle cell anemia. The nurse is concerned about substance abuse in this patient. What would the nurse encourage the patient to do to prevent substance abuse of analgesics in this patient?
A) Seek care from a variety of sources for pain relief.

B) Seek care from a single provider for pain relief.
C) Accept chronic pain being continually present as a fact of the disease.
D) Limit the reporting of emergency department visits to the primary health care provider.

Ans: B
Chapter: 33
Client Needs: D-3
Cognitive Level: Application
Difficulty: Easy
Integrated Process: Teaching/Learning Objective: 4
Page and Header: 924, Hemolytic Anemias

Feedback: The patient should be encouraged to use a single primary health care provider to address health care concerns. Emergency department visits should be reported to the primary health care provider to achieve optimal management of the disease.

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