Title: Quiz: Hematological Disorders
Course: PRN 0092 Practical Nursing II > Section: Nursing Care of Clients with Cardiovascular Disorders

Q: The element that makes up 55% of the blood is
- plasma.
- RBCs.
- WBCs.
- platelets.
A: plasma.
If right: Plasma constitutes 55% of the blood’s volume; the remaining 45% is composed of the blood cells and platelets.
If wrong: Plasma constitutes 55% of the blood’s volume; the remaining 45% is composed of the blood cells and platelets.

Q: Erythrocytes are also known as
- WBCs.
- platelets.
- RBCs.
- oxygen.
A: RBCs.
If right: Erythrocytes (red blood cells) give blood its rich, red color.
If wrong: Erythrocytes (red blood cells) give blood its rich, red color.

Q: Leukocytes are also known as
- WBCs.
- platelets.
- RBCs.
- hemoglobin.
A: WBCs.
If right: Unlike the erythrocytes, the leukocytes (white blood cells) have nuclei, are colorless, and live from a few days to several years.
If wrong: Unlike the erythrocytes, the leukocytes (white blood cells) have nuclei, are colorless, and live from a few days to several years.

Q: A patient has a test ordered to determine why he is having fatigue and soreness of the tongue. A test that will measure the absorption of radioactive vitamin B_12 is
- gastric analysis.
- Schilling test.
- peripheral smear.
- red cell indices.
A: Schilling test.
If right: The Schilling test is a laboratory blood test for diagnosing pernicious anemia. The test measures the absorption of radioactive vitamin B_12.
If wrong: The Schilling test is a laboratory blood test for diagnosing pernicious anemia. The test measures the absorption of radioactive vitamin B_12.

Q: In an adult, erythrocytes are continuously produced in the
- yellow bone marrow.
- lymphatic system.
- spleen.
- red bone marrow.
A: red bone marrow.
If right: Erythrocytes are continuously produced in the red bone marrow, principally in the vertebrae, ribs, and sternum.
If wrong: Erythrocytes are continuously produced in the red bone marrow, principally in the vertebrae, ribs, and sternum.

Q: Pernicious anemia results from inadequate absorption of
- vitamin B_12.
- iron.
- vitamin K.
- protein.
A: vitamin B_12.
If right: Because the intrinsic factor is not available to combine with B_12, transport of this necessary vitamin to the ileum is prevented.
If wrong: Because the intrinsic factor is not available to combine with B_12, transport of this necessary vitamin to the ileum is prevented.

Q: Which nursing intervention does the nurse plan for a patient who has multiple myeloma?
- Maintaining fluid intake of 3 to 4 L/day to dilute calcium load
- Limiting activity to prevent pathological fractures
- Administering narcotic analgesics continuously to control bone pain
- Assessing for changes in size and characteristics of lymph nodes
A: Maintaining fluid intake of 3 to 4 L/day to dilute calcium load
If right: Increase fluid intake to 3000 to 4000 mL/day.
If wrong: Increase fluid intake to 3000 to 4000 mL/day.

Q: When developing a care plan for a patient just diagnosed with leukemia, which two nursing diagnoses are the most appropriate to use?
- Deficient knowledge and Hopelessness
- Risk for infection and Risk for injury
- Ineffective coping and Chronic pain
- Fatigue and Chronic pain
A: Ineffective coping and Chronic pain
If right: Coping mechanisms may be strained because of pain, change of body image, or fear of death.
If wrong: Coping mechanisms may be strained because of pain, change of body image, or fear of death.

Q: The patient has a history of iron deficiency anemia. The value most indicative of iron deficiency anemia is
- a hemoglobin of 8 g/dL.
- a leukocyte count of 8,000/mm^3.
- an RBC of 6 million/mm^3.
- a platelet count of 20,000/mm^3.
A: a hemoglobin of 8 g/dL.
If right: Blood studies will show RBC count and hemoglobin and hematocrit levels to be below normal. The normal hemoglobin level is 14 to 18 g/dL for males.
If wrong: Blood studies will show RBC count and hemoglobin and hematocrit levels to be below normal. The normal hemoglobin level is 14 to 18 g/dL for males.

Q: A patient is to begin taking iron supplements. The nurse evaluates the patient’s understanding of the use of this drug. Which indicates that she has an adequate knowledge base?
- Using antidiarrheal drugs if she has diarrhea
- Understanding that black stools may occur
- Checking her gums for bleeding
- Brushing her teeth with a soft-bristled brush
A: Understanding that black stools may occur
If right: An oral iron supplement may turn the stool black.
If wrong: An oral iron supplement may turn the stool black.

Q: The patient, age 35, is admitted with aplastic anemia. He asks the nurse what aplastic anemia is. An accurate response would be that
- the activity of the bone marrow is depressed.
- the bone marrow fails to produce lymphocytes.
- the bone marrow fails to produce red blood cells.
- red cells are absent as a result of chronic blood loss.
A: the activity of the bone marrow is depressed.
If right: Aplastic anemia or aplasia (a hematological term for a failure of the normal process of cell generation and development) has two etiologic classifications: congenital and acquired. All three major blood elements (RBCs, WBCs, platelets) are reduced or absent.
If wrong: Aplastic anemia or aplasia (a hematological term for a failure of the normal process of cell generation and development) has two etiologic classifications: congenital and acquired. All three major blood elements (RBCs, WBCs, platelets) are reduced or absent.

Q: A patient, an African American, is the mother of a 9-year-old child with sickle cell anemia. She asks the nurse if sickle cell anemia occurs frequently in her race. The correct response is that
- it is a very rare disease.
- approximately 1 of 500 African Americans has sickle cell anemia.
- approximately 1 of 2,500 African Americans has the disease.
- approximately 1 of 10 African Americans has the disease.
A: approximately 1 of 500 African Americans has sickle cell anemia.
If right: Approximately one of every 10 African Americans has sickle cell traits, and approximately one of every 500 has sickle cell anemia.
If wrong: Approximately one of every 10 African Americans has sickle cell traits, and approximately one of every 500 has sickle cell anemia.

Q: A patient, age 24, is admitted with idiopathic thrombocytopenic purpura and a platelet count of 18,000/mm^3. An appropriate nursing intervention would be to
- monitor the administration of cryoprecipitate.
- administer vitamin B_12.
- institute bleeding precautions.
- use the Z-track method for DexFerrum administration.
A: institute bleeding precautions.
If right: Significant risk for serious bleeding occurs when the count is below 20,000/mm^3.
If wrong: Significant risk for serious bleeding occurs when the count is below 20,000/mm^3.

Q: The nurse is caring for a 34-year-old obstetric patient who has disseminated intravascular coagulation (DIC). The nurse is aware that DIC is
- an acquired hemorrhagic syndrome of clotting cascade overstimulation and anticlotting processes.
- a hereditary coagulation disorder in which factor VIII is absent.
- a deficiency of the number of circulating platelets with thrombocytopenia present.
- a malignant disorder characterized by painless, progressive enlargement of lymphoid tissue.
A: an acquired hemorrhagic syndrome of clotting cascade overstimulation and anticlotting processes.
If right: Disseminated intravascular coagulation (DIC) is a grave coagulopathy condition resulting from the overstimulation of clotting and anticlotting processes in response to disease or injury.
If wrong: Disseminated intravascular coagulation (DIC) is a grave coagulopathy condition resulting from the overstimulation of clotting and anticlotting processes in response to disease or injury.

Q: The appropriate nursing intervention to relieve the symptom of pruritus in a patient with Hodgkin’s disease would be to
- decrease fluid intake to decrease fluid retention in the interstitial area.
- soothing bath with prescribed antipruritic medication.
- give a hot bath to decrease pruritus.
- apply warm, moist packs to the pruritic area.
A: soothing bath with prescribed antipruritic medication.
If right: Soothing baths with an antipruritic medication (as ordered) can be effective. Warmth and heat increase pruritus.
If wrong: Soothing baths with an antipruritic medication (as ordered) can be effective. Warmth and heat increase pruritus.

Q: A patient is admitted with fatigue; discomfort; enlarged, painless cervical lymph nodes; and pruritus. A lymph node biopsy yields a diagnosis of Hodgkin’s disease. The nurse is aware that the abnormal cells noted by the pathologist in Hodgkin’s disease are called
- Rodem-Lee cells.
- Bullus-Frendelenburg cells.
- Stevens-Jorgens cells.
- Reed-Sternberg cells.
A: Reed-Sternberg cells.
If right: The presence of Reed-Sternberg cells remains a hallmark of the presence of Hodgkin’s disease.
If wrong: The presence of Reed-Sternberg cells remains a hallmark of the presence of Hodgkin’s disease.

Q: Patients with pernicious anemia must receive injections of which medication for the rest of their lives?
- Ferrous sulfate
- 6-Mercaptopurine
- Vitamin B_12
- DexFerrum (iron)
A: Vitamin B_12
If right: The standard treatment includes initiating vitamin B_12 replacement therapy. Without vitamin B_12 administration, these individuals will die in 1 to 3 years. Treatment is 1,000 units of vitamin B_12 administered intramuscularly daily for weeks, then weekly for 1 month, and finally monthly for life.
If wrong: The standard treatment includes initiating vitamin B_12 replacement therapy. Without vitamin B_12 administration, these individuals will die in 1 to 3 years. Treatment is 1,000 units of vitamin B_12 administered intramuscularly daily for weeks, then weekly for 1 month, and finally monthly for life.

Q: A patient, age 52, is admitted with thrombocytopenia. The most important nursing intervention to prevent hemorrhage in this patient is to
- prevent trauma and falling.
- avoid catheterization.
- monitor vitals every hour.
- begin immunocompromised (neutropenic) precautions.
A: prevent trauma and falling.
If right: An understanding of the disease process and causative agents is necessary in forming a knowledge base for self-care and prevention of trauma and infection. Instruction on signs and symptoms, as well as preventive measures, must be given.
If wrong: An understanding of the disease process and causative agents is necessary in forming a knowledge base for self-care and prevention of trauma and infection. Instruction on signs and symptoms, as well as preventive measures, must be given.

Q: The typical medical treatment of polycythemia vera involves
- transfusion of packed cells.
- therapeutic phlebotomy.
- cryoprecipitate infusion.
- appendectomy.
A: therapeutic phlebotomy.
If right: Repeated phlebotomy decreases blood viscosity.
If wrong: Repeated phlebotomy decreases blood viscosity.

Q: The patient, age 44, has polycythemia vera. The nurse recognizes that the primary pathophysiologic feature of this disorder is
- hyperproduction of erythropoietin.
- capillary fragility and hemorrhage.
- fatty infiltration of the bone marrow.
- increase in red blood cells and hemoglobin and hyperviscosity.
A: increase in red blood cells and hemoglobin and hyperviscosity.
If right: Polycythemia vera is characterized by erythrocytosis (an abnormal increase in the number of circulating red blood cells) and also increased production of granulocytes and platelets.
If wrong: Polycythemia vera is characterized by erythrocytosis (an abnormal increase in the number of circulating red blood cells) and also increased production of granulocytes and platelets.

Q: Which should the nurse implement as the most important measure in preventing transmission of harmful pathogens to patients with depressed bone marrow function?
- Strict and frequent handwashing by all people having contact with the patient
- Placement of patients in private rooms with high-efficiency particulate air (HEPA) filtration
- Administration of combinations of prophylactic antibiotics
- Creation of a “sterile” environment for the patient with the use of laminar airflow rooms
A: Strict and frequent handwashing by all people having contact with the patient
If right: Meticulous handwashing by medical and nursing personnel and strict asepsis are mandatory.
If wrong: Meticulous handwashing by medical and nursing personnel and strict asepsis are mandatory.

Q: The average life span of an erythrocyte is
- a few days to several years.
- 120 days.
- 5 to 9 days.
- several years.
A: 120 days.
If right: The life span of an RBC is 129 days. A WBC’s life span is days to several years. Platelets live 5 to 9 days.
If wrong: The life span of an RBC is 129 days. A WBC’s life span is days to several years. Platelets live 5 to 9 days.

Q: Many older adults suffer from conditions such as colonic diverticula, hiatal hernia, and ulcerations that can cause occult bleeding. Older adults with these conditions should be observed for
- leukemia.
- iron deficiency anemia.
- sickle cell anemia.
- polycythemia.
A: iron deficiency anemia.
If right: Blood loss is a major cause of iron deficiency in adults. The major sources of chronic blood loss are from the GI and genitourinary systems.
If wrong: Blood loss is a major cause of iron deficiency in adults. The major sources of chronic blood loss are from the GI and genitourinary systems.

Q: The nurse is administering a blood transfusion to an older adult for hypovolemic shock. During the transfusion, which nursing intervention would be the most important?
- Prevention of infection
- Balanced nutritional diet with sodium reduction
- Cardiopulmonary function assessment
- Monitoring of hemoglobin and hematocrit levels
A: Cardiopulmonary function assessment
If right: Administer blood products with caution because older adults are at increased risk of developing congestive heart failure. Careful assessment of cardiopulmonary function and intake and output is essential.
If wrong: Administer blood products with caution because older adults are at increased risk of developing congestive heart failure. Careful assessment of cardiopulmonary function and intake and output is essential.

Q: If a patient is diagnosed with anemia, how are the tissues and cells affected?
- More oxygen is able to be distributed in the cells and tissue.
- More carbon monoxide is rapidly delivered to the cells and tissue.
- Insufficient amounts of oxygen are delivered to the cells and tissue.
- The tissue and cells are not affected.
A: Insufficient amounts of oxygen are delivered to the cells and tissue.
If right: Anemia is a disorder characterized by levels of RBCs, hemoglobin, and hematocrit that are below normal range. In persons with anemia, insufficient amounts of oxygen are delivered to tissues and cells.
If wrong: Anemia is a disorder characterized by levels of RBCs, hemoglobin, and hematocrit that are below normal range. In persons with anemia, insufficient amounts of oxygen are delivered to tissues and cells.