Unexplained anemia in a patient with suspected idiopathic thrombocytopenic purpura should suggest all of the following EXCEPT
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Question 2 of 105
A client comes to the clinic and the nurse inspects the client's mouth and throat. The nurse documents that the tonsil size is 2+. What does this mean?
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Question 3 of 105
A nurse is assisting a client with Hodgkin's lymphoma and has assessed shallow respirations associated with enlarged cervical lymph nodes. What would be the best nursing intervention to assist the client to avoid unnecessary pressure on the trachea and provide for increased lung expansion and improved air exchange?
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Question 4 of 105
The patient's laboratory results show a marked decrease in RBCs, WBCs, and platelets. What term should the nurse use when reporting the results to the physician?
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Question 5 of 105
All the following are true regarding physiologic anemia of infancy EXCEPT
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Question 6 of 105
The most likely diagnosis for the condition described in Question 1 is
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Question 7 of 105
Which of the following is responsible for infections of mononucleosis?
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Question 8 of 105
A transfusion of PRBCs has been infusing for 5 minutes when the client becomes flushed and tachypneic and says, 'I am having chills. Please get me a blanket.' Which action should you take first?
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Question 9 of 105
Which of the following nursing interventions ensures that a client with Hodgkin's disease remains free of infection?
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Question 10 of 105
A 45-year-old woman is admitted to the surgical service with severe arterial insufficiency of the right second toe. She has no prior medical history and takes no medications. Physical examination findings are normal except for mild splenomegaly and signs of early gangrene in the right second toe. All pulses are full and equal throughout. Diagnostic testing results are shown in Table 9.Q2. Which of the following is the most likely diagnosis?
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Question 11 of 105
Iron deficiency anemia is associated with all of the following EXCEPT
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Question 12 of 105
What is the major nursing intervention in educating clients who have leukemia?
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Question 13 of 105
A teen is seen in clinic for a possible diagnosis of Hodgkin disease. Which symptom should make the physician suspect Hodgkin disease?
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Question 14 of 105
A 58-year-old woman with active rheumatoid arthritis presents with fatigue and joint pain. She received the diagnosis of rheumatoid arthritis 5 years earlier and has been taking prednisone 10 mg daily and methotrexate with folate weekly. She has had chronic fatigue and anemia. Her vital signs are normal. Her conjunctivae are pale, and she has active synovitis affecting both knees, her wrists, and elbows, with rheumatoid nodules on the extensor surface of her right forearm. The remainder of the physical examination findings are normal. Diagnostic testing results are shown in Table 9.Q7. Which of the following laboratory findings are consistent with this condition?
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Question 15 of 105
A 7-year-old apparently healthy boy presented to the outpatient clinic with mild pallor and slight yellowish discoloration of sclera since early childhood, family was reluctant to seek medical consultation. On examination, he had palpable spleen in addition to pallor and jaundice. His uncle had a history of repeated blood transfusions during childhood that was relieved with splenectomy. Of the following, the MOST likely diagnosis at this stage is
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Question 16 of 105
Matching: Hemolytic anemia - Coombs positive
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Question 17 of 105
You are going to explain the role of anti-D therapy to the parents of a 4-year-old boy with acute immune thrombocytopenia (ITP) who has several ecchymotic lesions located over extremities and trunk. There is no mucosal bleeding. An important statement that should be included during the discussion is
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Question 18 of 105
The prothrombin time, which is a test of the extrinsic tissue coagulation pathway, is abnormally prolonged in
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Question 19 of 105
After receiving the change-of-shift report, which client will you assess first?
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Question 20 of 105
An 18-month-old Caucasian male is brought to your office for a routine health maintenance visit. The mother reveals that the child always appears hungry; in fact, he drinks a quart of whole milk a day and also eats dirt. Intake of solid foods is sporadic, but the mother states that she thought all 18-month-olds were 'picky eaters.' Physical examination reveals mild pallor of the conjunctivae. He has no hepatosplenomegaly, and the rest of the examination findings are normal. Based on the information, which of the following would be the most likely to determine the diagnosis?
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Question 21 of 105
The problem in hypertrophic cardiomyopathy is diastolic dysfunction were the end diastolic volume is reduced and the stroke volume consequently is reduced also. So the role of medications is to relax the heart muscle and to slow the heart rate so that the heart can pump more efficiently (inotropes is contraindicated). Other options are good for
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Question 22 of 105
Fresh frozen plasma (FFP) transfusion is the best treatment for which of the following conditions
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Question 23 of 105
Which measure should be implemented to protect the central nervous system from the invasion of malignant cells in a child newly diagnosed with leukemia?
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Question 24 of 105
Matching: Red blood cell aplasia - Onset before age 4 months
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Question 25 of 105
A 75-year-old African American man was seen last week by his primary care physician for mild dyspnea. He has also noted intermittent peripheral edema. During the evaluation, an electrocardiogram showed low-voltage QRS complexes in the limb leads. The troponin T level was elevated (0.07 ng/mL). This finding suggested the need for a coronary angiogram, which showed no significant coronary artery disease. An echocardiogram showed diffuse left ventricular thickening with a granular texture to the myocardium and a septal thickness of 2.5 cm (normal
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Question 26 of 105
The laboratory finding that is MOST likely consistent with the diagnosis of spherocytosis is
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Question 27 of 105
Matching: Hemolytic anemia - Dactylitis
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Question 28 of 105
If a patient with blood type O Rh+ is given AB Rh+ blood, what would the nurse expect to happen?
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Question 29 of 105
Which of the following organs releases erythropoietin, a hormone determining the rate of the production of red blood cells?
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Question 30 of 105
Low platelets count may be encountered in all the following EXCEPT
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Question 31 of 105
A prolonged thrombin time with normal reptilase time is consistent with
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Question 32 of 105
You obtain the following data about a client admitted with multiple myeloma. Which information has the most immediate implications for the client's care?
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Question 33 of 105
A client admitted to the hospital with a sickle cell crisis complains of severe abdominal, hip, and knee pain. You observe an LPN accomplishing these client care tasks. Which one requires that you, as charge nurse, intervene immediately?
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Question 34 of 105
The treatment of choice for most cases of type 1 von-Willebrand disease is
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Question 35 of 105
The following factors affect the common pathway EXCEPT
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Question 36 of 105
You are reviewing the complete blood count (CBC) for a client who has been admitted for knee arthroscopy. Which value is most important to report to the physician prior to surgery?
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Question 37 of 105
One of the following features is TRUE about hemophilia inhibitors
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Question 38 of 105
A client who has been receiving cyclosporine following an organ transplant is experiencing these symptoms. Which one is of most concern?
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Question 39 of 105
How are patients with pernicious anemia treated?
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Question 40 of 105
The MOST specific test that is helpful to differentiate Diamond-Blackfan anemia from transient erythroblastopenia of childhood is
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Question 41 of 105
When teaching a patient about a bone marrow examination, what should the nurse explain?
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Question 42 of 105
After receiving change-of-shift report about all of these clients, which one will you assess first?
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Question 43 of 105
Following a car accident, a client with a Medic-Alert bracelet indicating hemophilia A is admitted to the emergency department (ED). Which physician order should you implement first?
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Question 44 of 105
To better understand her condition and its treatment Mrs. Young needs to know the relationship between
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Question 45 of 105
A client is prescribed medications that depress thrombocytes. The nurse should monitor for which of the following signs and symptoms in the client?
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Question 46 of 105
Clients with hemophilia should be taught to avoid
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Question 47 of 105
What should patients with chronic myelocytic leukemia be told about abdominal discomfort due to splenic enlargement?
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Question 48 of 105
The parent of a child with leukemia in remission reports the child has been exposed to chickenpox and has never had the infection. What should be done?
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Question 49 of 105
Under which of the following situations should a nurse notify the physician when caring for a client with lymphangitis?
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Question 50 of 105
Which component of normal hemostasis involves the processes of protein C and protein S and plasminogen?
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Question 51 of 105
The best treatment for the patient described in Questions 16 and 17 includes
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Question 52 of 105
What is the most common opportunistic infection in children infected with HIV?
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Question 53 of 105
A client with graft-versus-host disease (GVHD) after a bone marrow transplant is being cared for on the medical unit. Which of these nursing activities is best delegated to a newly graduated RN who has had a 6-week orientation to the unit?
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Question 54 of 105
The MOST prevalent anemia in the world is
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Question 55 of 105
Splenectomy in acute immune thrombocytopenia is indicated
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Question 56 of 105
When reviewing the results of an 83-year-old patient's blood tests, which finding would be of most concern to the nurse?
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Question 57 of 105
A challenging differential diagnosis of Diamond-Blackfan syndrome is
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Question 58 of 105
Which of the following children with acute immune thrombocytopenia is MOST likely to have a benefit from splenectomy?
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Question 59 of 105
Patients with ITP have an increased risk of bleeding. What would you expect careful monitoring of?
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Question 60 of 105
A client is admitted to the intensive care unit (ICU) with disseminated intravascular coagulation (DIC) associated with a gram-negative infection. Which assessment information has the most immediate implications for the client's care?
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Question 61 of 105
Severe and extensive hemolysis causes:
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Question 62 of 105
Which of the following viruses is more likely to be associated with chronic immune thrombocytopenia?
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Question 63 of 105
All the following are true regarding low molecular weight heparin (LMWH) in comparison with unfractionated heparin (UFH) EXCEPT
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Question 64 of 105
A mother called you fifteen minutes after starting blood transfusion of her 3-year- old leukemia boy for a concern of being hot, examination showed alert and vitally-stable boy with a temperature of 39.8 C, his urine color is clear. Of the following, the BEST treatment option now is
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Question 65 of 105
Which component of blood has proteins that function primarily as immunologic agents that prevent or modify some types of infectious diseases?
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Question 66 of 105
In which of the following conditions you should use a plasma that is frozen within 24 hours after collection?
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Question 67 of 105
You are evaluating a 4-year-old child with B-thalassemia major; he is on chronic transfusion therapy since the age of 1 year; you suspect transfusion-induced hemosiderosis. Of the following, the organ that is LEAST likely to be affected by iron deposition at this time is
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Question 68 of 105
Which of the following describe(s) ITP? (Select one that does not apply..)
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Question 69 of 105
All the following may cause autoimmune hemolytic anemia EXCEPT
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Question 70 of 105
Which cells are classified as granulocytes (select one that doesn't apply)?
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Question 71 of 105
Parvovirus B19 infection in sickle cell disease is associated with which type of crises?
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Question 72 of 105
The nurse's responsibility for observing the rate of flow and response to blood transfusions is highly significant, particularly for patients with
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Question 73 of 105
Leukemia is characterized by
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Question 74 of 105
Acquired factors that predispose to thrombosis include all the following EXCEPT
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Question 75 of 105
What should a patient diagnosed with iron deficiency anemia do to help correct it?
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Question 76 of 105
What signs and symptoms should the nurse teach a patient recently diagnosed with hemophilia to recognize?
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Question 77 of 105
A 10-year-old with leukemia is receiving chemotherapy and is on neutropenic precautions. Friends come to the desk asking for a vase for flowers. Which is the best response?
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Question 78 of 105
A child diagnosed with leukemia is receiving allopurinol as part of the treatment plan. The parents ask why their child is receiving this medication.
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Question 79 of 105
Matching: Regional lymphadenopathy - Sarcoidosis
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Question 80 of 105
Allogeneic bone marrow stem cell transplantation is least likely to be required in
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Question 81 of 105
A feature that signifies β-thalassemia minor is
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Question 82 of 105
Regardless of the type of anemia, what major physiologic effect underlies the resulting symptoms?
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Question 83 of 105
A patient with a hematologic disorder has a smooth, shiny, red tongue. Which laboratory result would the nurse expect to see?
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Question 84 of 105
A 32-year-old client with a history of sickle cell anemia is admitted to the hospital during a sickle cell crisis. The physician orders all of these interventions. Which order will you implement first?
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Question 85 of 105
You discover that a college-aged patient experiences intermittent nose bleeds lasting 15 to 20 minutes and has heavy menstrual bleeding every month. What condition might these symptoms suggest?
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Question 86 of 105
A 22-year-old woman is brought to the emergency department after having 1 witnessed tonic-clonic seizure. She had appeared confused for the preceding few hours. On examination, she is febrile and appears slightly confused; otherwise, neurologic and physical examination findings are normal. Laboratory testing results are shown in Table 9.Q12, and the peripheral blood smear is shown in Figure 9.Q12. What is the most appropriate next step in management?
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Question 87 of 105
Which of the following types of hemoglobin is responsible for the sickle cell crescent shape in hemoglobin under hypoxic conditions?
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Question 88 of 105
Which of the following instructions should a nurse give a client with Hodgkin's disease who is at risk of impaired skin integrity?
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Question 89 of 105
A 5-year-old boy presented with history of frequent blood transfusion since the end of the first year of life, he has a similarly affected older sibling. On examination: he is pale and jaundiced, with frontal bossing and enlarged liver and spleen. Of the following, the MOST likely diagnosis is
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Question 90 of 105
As charge nurse, you are making the daily assignments on the medical-surgical unit. Which client is best assigned to a nurse who has floated from the post-anesthesia care unit (PACU)?
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Question 91 of 105
The least common infection that may occur in a 6-year-old child with sickle cell anemia is
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Question 92 of 105
Which activities should the nurse suggest for a child diagnosed with hemophilia? (Select one that does not apply..)
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Question 93 of 105
Children being treated for leukemia may experience which complications?
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Question 94 of 105
Using light pressure with the index and middle fingers, the nurse cannot palpate any of the patient's superficial lymph nodes. How should the nurse respond to this assessment?
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Question 95 of 105
An example of macrocytic anemia is
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Question 96 of 105
The parent of a teen with Hodgkin disease asks about the prognosis. What should the nurse explain?
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Question 97 of 105
You are transferring a client with newly diagnosed chronic myeloid leukemia to a long-term-care (LTC) facility. Which information is most important to communicate to the LTC charge nurse prior to transferring the client?
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Question 98 of 105
Mr. Campbell has just received a permanent pacemaker and is returned to your unit. Which teaching needs assumes the highest priority at this time?
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Question 99 of 105
What is the period in life when the need for iron increases?
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Question 100 of 105
The primary site of hematopoiesis in the fourth week of gestational age is
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Question 101 of 105
A nurse instructs the parent of a child with sickle cell anemia about factors that might precipitate a pain crisis. Which of the following factors identified by the parent indicates a need for further instruction?
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Question 102 of 105
Hematologic disease with upper limb orthopedic congenital abnormalities with presence of thumbs is MOST likely seen in
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Question 103 of 105
Because leukemic disorders attack the immunologic system, it is important for the nurse to
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Question 104 of 105
The earliest response to oral iron, in iron deficiency anemia is
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Question 105 of 105
For a client with polycythemia vera, how can the nurse help decrease the risk for thrombus formation?
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