Hemo Function Questions 13

Question1A nurse is assessing a client with multiple myeloma. Due to this condition, what will this client be at risk for?  pathologic bone fractures. Explanation:Clients with multiple myeloma are at risk for pathologic bone fractures secondary to diffuse osteoporosis and osteolytic lesions. Also, clients are at risk for renal failure secondary to myeloma proteins by causing renal tubular obstruction. Liver failure and heart failure aren't usually sequelae of multiple myeloma. Hypoxemia isn't usually related to multiple myeloma. Question2 a client with multiple myeloma. Which laboratory value is the nurse most likely to see?  Hypercalcemia Explanation:Calcium is released when bone is destroyed, causing hypercalcemia. Multiple myeloma doesn't affect potassium, sodium, or magnesium levels. Question3The nursing instructor is discussing disorders of the hematopoietic system with the prenursing pathophysiology class. What disease would the instructor list with a primary characteristic of erythrocytosis?  Polycythemia vera Explanation:Polycythemia vera is associated with a rapid proliferation of blood cells produced by the bone marrow. In sickle cell disease, HbS causes RBCs to assume a sickled shape under hypoxic conditions. Aplastic anemia has a deficiency of erythrocytes. The other options do not have the characteristics of erythrocytosis. Question4Which statement best describes the function of stem cells in the bone marrow?  They produce all blood cells. Explanation:All blood cells are produced from undifferentiated precursors called pluripotent stem cells in the bone marrow. Other cells produced from the pluripotent stem cells help defend against bacterial infection, produce antibodies against foreign antigens, and are active against hypersensitivity reactions. Question5Which term refers to a form of white blood cell involved in immune response?  Lymphocyte Explanation:Both B and T lymphocytes respond to exposure to antigens. Granulocytes include basophils, neutrophils, and eosinophils. A spherocyte is a red blood cell without central pallor, seen with hemolysis. A thrombocyte is a platelet. Question6A client has completed induction therapy and has diarrhea and severe mucositis. What is the appropriate nursing goal?  Maintain nutrition. Explanation:Maintaining nutrition is the most important goal after induction therapy because the client experiences severe diarrhea and can easily become nutritionally deficient and develop fluid and electrolyte imbalance. The client is most likely not in pain at this point, and this is an intervention, not a goal. Question7What assessment finding best indicates that the client has recovered from induction therapy?  Neutrophil and platelet count within normal limits Explanation:Recovery from induction therapy is indicated when the neutrophil and platelet counts have returned to normal, and any infection has resolved. Stable vital signs, lack of edema, and absence of pain are not indicative of recovery from induction therapy. Question8A client presents with peripheral neuropathy and hypoesthesia of the feet. What is the best nursing intervention?  Assess for signs of injury. Explanation:A client with hypoesthesia of the feet will have decreased sensation and numbness. The nurse should assess for signs of injury. If the client is injured, he or she will not be able to feel it; this could lead to the development of infection. Ambulation will not help the client, and elevating the legs may make the problem worse, as blood flow to the feet would be decreased. Keeping the feet cold will also decrease blood flow. Question9A client with AML has pale mucous membranes and bruises on the legs. What is the primary nursing intervention?  Assess the client’s hemoglobin and platelets. Explanation:Clients with AML may develop pallor from anemia and a tendency to bleed because of a low platelet count. Assessing the client’s hemoglobin and platelets will help to determine whether this is the cause of the symptoms. This would be the priority above assessing pulses, blood pressure, history, or skin. Question10A client with acute myeloid leukemia has a fever. What pathophysiological process does the nurse recognize is the cause of the client's fever?  Neutropenia Explanation:Fever and infection result from a decrease in neutrophils (neutropenia). Decreased red blood cells (anemia) cause weakness, fatigue, dyspnea on exertion, and pallor in AML. Pancytopenia, an overall decrease in all blood components, is not cause of fever in clients with AML. Decreased platelet count (thrombocytopenia) causes petechiae and bruising in AML.