SAUNDERS MDS EXAM-HEMATOLOGY QUIZ WITH VERIFIED SOLUTIONS GRADED A+ 2023, Exams of Nursing

Download SAUNDERS MDS EXAM-HEMATOLOGY QUIZ WITH VERIFIED SOLUTIONS GRADED A+ 2023 and more Exams Nursing in PDF only on Docsity! SAUNDERS MDS EXAM-HEMATOLOGY QUIZ WITH VERIFIED SOLUTIONS GRADED A+ 2023 1. A client enters the hospital emergency department with a nosebleed. On assessment the client tells the nurse that the nosebleed just suddenly began. The nurse notes no obvious facial injury. Which is the initial nursing action? Rationale: The initial nursing action for a client with a nosebleed is to sit the client down, ask the client to lean forward slightly, and apply pressure to the nose for 5 to 10 minutes. Inserting nasal packing or preparing a nasal balloon is not an appropriate initial intervention. These interventions are used when conservative measures fail. Placing the client in a semi Fowler's position would promote swallowing blood, which is not helpful because of the risk of vomiting and resultant aspiration. Cognitive Ability: Applying Client Needs: Physiological Integrity Integrated Process: Nursing Process: Implementation Content Area: Adult Health: Hematological Strategy(ies): Strategic Words Priority Concepts: Clinical Judgment, Clotting 1. Insert nasal packing. 2. Prepare a nasal balloon for insertion. 3. Place the client in a semi Fowler's position, and apply ice packs to the nose. 4. Sit the client down, ask the client to lean forward slightly, and apply pressure to the nose for 5 to 10 minutes. SAUNDERS MDS EXAM-HEMATOLOGY QUIZ WITH VERIFIED SOLUTIONS GRADED A+ 2023 2. The nurse is performing an assessment on a client with a diagnosis of pernicious anemia. Which finding would the nurse expect to note in this client? Rationale: Classic signs of pernicious anemia include weakness, mild diarrhea, and a smooth red tongue that is sore. The client also may have nervous system signs and symptoms such as paresthesias, difficulty with balance, and occasional confusion. The client does not exhibit dyspnea, the mucous membranes do not become dusky, and the client does not exhibit shortness of breath. Cognitive Ability: Analyzing Client Needs: Physiological Integrity Integrated Process: Nursing Process: Assessment Content Area: Adult Health: Hematological Strategy(ies): Subject, Comparable or Alike Options Priority Concepts: Clinical Judgment, Gas Exchange 1. Dyspnea 2. Dusky mucous membranes 3. Shortness of breath on exertion 4. Red tongue that is smooth and sore 3. The nurse has provided instructions to a client with sickle cell disease regarding measures SAUNDERS MDS EXAM-HEMATOLOGY QUIZ WITH VERIFIED SOLUTIONS GRADED A+ 2023 Rationale: The priorities in management of sickle cell crisis are hydration therapy and pain relief. To achieve this, the client is given IV fluids to promote hydration and reverse the agglutination of sickled cells in small blood vessels. Opioid analgesics may be given to relieve the pain that accompanies the crisis. Genetic counseling is recommended but not during the acute phase of illness. Red blood cell transfusion may be done in selected circumstances such as aplastic crisis or when the episode is refractive to other therapy. Oxygen would be administered according to individual need, but the client would not require intubation and mechanical ventilation. Cognitive Ability: Analyzing Client Needs: Physiological Integrity Integrated Process: Nursing Process: Planning Content Area: Adult Health: Hematological Strategy(ies): Strategic Words Priority Concepts: Clinical Judgment, Gas Exchange 1. Initiate an intravenous (IV) line for the administration of fluids. 2. Consult with the psychiatric department regarding genetic counseling. 3. Call the blood bank and request preparation of a unit of packed red blood cells. 4. Call the respiratory department to prepare for intubation and mechanical ventilation. 6. The nurse is performing an assessment on a client with a diagnosis of anemia that developed as a result of blood loss after a traumatic injury. The nurse should expect to find which sign or symptom in the client as a result of the anemia? SAUNDERS MDS EXAM-HEMATOLOGY QUIZ WITH VERIFIED SOLUTIONS GRADED A+ 2023 Rationale: The client with anemia is likely to experience shortness of breath and complain of fatigue because of the decreased ability of the blood to carry oxygen to the tissues to meet metabolic demands. The client is likely to have tachycardia, not bradycardia, as a result of efforts by the body to compensate for the effects of anemia. Muscle cramps are an unrelated finding. Increased respiratory rate is not an associated finding. Cognitive Ability: Analyzing Client Needs: Physiological Integrity Integrated Process: Nursing Process: Assessment Content Area: Adult Health: Hematological Strategy(ies): Subject Priority Concepts: Clinical Judgment, Gas Exchange 1. Bradycardia 2. Muscle cramps 3. Increased respiratory rate 4. Shortness of breath with activity 7. The nurse has provided medication instructions to a client with an iron deficiency anemia who will be taking iron supplements. Which statement made by the client indicates an understanding of this medication? SAUNDERS MDS EXAM-HEMATOLOGY QUIZ WITH VERIFIED SOLUTIONS GRADED A+ 2023 Rationale: Iron preparations can be very irritating to the stomach and are best taken between meals. Because iron supplements may be associated with constipation, the client should increase fluids and fiber in the diet to counteract this side effect of therapy. Iron preparations should be taken with a substance that is high in vitamin C to increase its absorption. The tablet is swallowed whole and not chewed. Cognitive Ability: Evaluating Client Needs: Physiological Integrity Integrated Process: Nursing Process: Evaluation Content Area: Adult Health: Hematological Strategy(ies): Subject Priority Concepts: Client Education, Safety 1. "I need to increase my fluid intake." 2. "I should eliminate fiber foods from my diet." 3. "I need to take the medication with water before a meal." 4. "I should be sure to chew the tablet thoroughly before swallowing it." 8. A client who was diagnosed with toxic shock syndrome (TSS) now exhibits petechiae, oozing from puncture sites, and coolness of the digits of the hands and feet. Clotting times determined for this client are prolonged. The nurse interprets these clinical signs as being most compatible with which condition? Rationale: SAUNDERS MDS EXAM-HEMATOLOGY QUIZ WITH VERIFIED SOLUTIONS GRADED A+ 2023 10. The nurse is preparing to care for a client with chronic kidney disease and anemia. Which describes the relationship between chronic kidney disease and anemia? Rationale: Clients with chronic kidney disease do not manufacture adequate amounts of erythropoietin, which is a glycoprotein needed to synthesize red blood cells. Renin, aldosterone, and angiotensin are substances that assist in maintaining blood pressure. Cognitive Ability: Applying Client Needs: Physiological Integrity Integrated Process: Nursing Process: Planning Content Area: Adult Health: Hematological Strategy(ies): Subject Priority Concepts: Cellular Regulation, Clinical Judgment 1. Lack of angiotensin I may cause anemia. 2. Increased production of aldosterone leads to anemia. 3. Anemia is caused by insufficient production of renin. 4. Decreased production of erythropoietin is causing anemia. 10. When obtaining assessment data from a client with a microcytic normochromic {This must be HYPOCHROMIC NOT SAUNDERS MDS EXAM-HEMATOLOGY QUIZ WITH VERIFIED SOLUTIONS GRADED A+ 2023 normochromic}anemia, which should the nurse question the client about? Rationale: Microcytic HYPOchromic anemias involve the presence of small, pale- colored red blood cells. {Microcytic hypochromic [NOT NORMOCHROMIC as you may see in Saunders or other resources] anemias involve the presence of small, pale-colored red blood cells. Small size = microcytic; pale-colored red blood cells = hypochromic}. Causes are iron deficiency anemia, thalassemia, and lead poisoning. The only choice that fits this description is option 2. Folic acid deficiency is caused by macrocytic normochromic cells; these are large red blood cells. Gastric surgery can result in vitamin B12 deficiency. Sickle cell anemia results in sickled cells and erythrocyte destruction. Cognitive Ability: Applying Client Needs: Physiological Integrity Integrated Process: Nursing Process: Assessment Content Area: Adult Health: Hematological Strategy(ies): Subject Priority Concepts: Cellular Regulation, Clinical Judgment SAUNDERS MDS EXAM-HEMATOLOGY QUIZ WITH VERIFIED SOLUTIONS GRADED A+ 2023 1. Folic acid intake 2. Dietary intake of iron 3. A history of gastric surgery 4. A history of sickle cell anemia 11. The nurse is preparing a client with thrombocytopenia for discharge. Which statement by the client about measures minimizing injury indicates that discharge teaching was effective? Select all that apply. Rationale: Bleeding precautions are used to protect the client with thrombocytopenia from bleeding. The client with thrombocytopenia may experience internal and external bleeding. Bleeding is frequently provoked by trauma, but it also may be spontaneous. The client with thrombocytopenia should be educated about activities that increase the risk for bleeding, such as contact sports and trauma to oral, nasal, and rectal mucosa. This will help to eliminate options 3 and 4. Cognitive Ability: Evaluating Client Needs: Physiological Integrity Integrated Process: Nursing Process: Evaluation Content Area: Adult Health: Hematological Strategy(ies): Strategic Words, Subject Priority Concepts: Client Education, Clotting