Hemo Function Questions 9

Question1A client with pernicious anemia is receiving parenteral vitamin B therapy. Which client 12 statement indicates effective teaching about this therapy?  "I will receive parenteral vitamin B12 therapy for the rest of my life." Explanation:Because a client with pernicious anemia lacks intrinsic factor, oral vitamin B12 can't be absorbed. Therefore, parenteral vitamin B12 therapy is recommended and required for life. Question2A client is prescribed 325 mg/day of oral ferrous sulfate. What does the nurse include in client teaching?  Take 1 hour before breakfast Explanation:Instructions the nurse will provide for the client taking oral ferrous sulfate is to administer the medication on an empty stomach. Instructions also include that there is decreased absorption of iron with food, particularly dairy products. The client is to increase vitamin C intake (fruits, juices, tomatoes, broccoli), which will enhance iron absorption. The client is to also increase foods high in fiber to decrease risk of constipation. Question3A client is hospitalized 3 days prior to a total hip arthroplasty and reports a high level of pain with ambulation. The client has been taking warfarin at home, which is now discontinued. To prevent the formation of blood clots, which action should the nurse take?  Administer the prescribed enoxaparin (Lovenox). Explanation:Clients who are prescribed warfarin at home and need to have a major invasive procedure stop taking warfarin prior to the procedure. Low molecular weight heparin, such as enoxaparin, may be used until the procedure is performed. The client will continue with a diet that has a daily consistent amount of vitamin K. The client needs to ambulate frequently throughout the day. Prothrombin (PT) time is monitored, not PTT, when warfarin had been administered. Question4A nurse is doing a physical examination of a child with sickle cell anemia. When the child asks why the nurse auscultates the lungs and heart, what would be best the response by the nurse?  To detect the abnormal sounds suggestive of acute chest syndrome and heart failure Explanation:The nurse auscultates the lungs and heart to detect abnormal sounds that indicate pneumonia, acute chest syndrome, and heart failure. The nurse assesses vital signs to detect evidence of infection, such as fever and tachycardia. During the physical examination, the nurse observes the client's appearance, looking for evidence of dehydration, which may have triggered a sickle cell crisis. The nurse assesses mental status, verbal ability, and motor strength to detect stroke-related signs and symptoms. Question5A client with a diagnosis of pernicious anemia comes to the clinic and reports numbness and tingling in the arms and legs. What do these symptoms indicate?  Neurologic involvement Explanation:In clients with pernicious anemia, numbness and tingling in the arms and legs, and ataxia are the most common signs of neurologic involvement. Some affected clients lose vibratory and position senses. Jaundice, irritability, confusion, and depression are present when the disease is severe. Insufficient intake of dietary nutrients is not indicated by these symptoms. Question6Which of the following is the most common hematologic condition affecting elderly patients  Anemia Explanation:Anemia is the most common hematologic condition affecting elderly patients: with each successive decade of life, the incidence of anemia increases. Thrombocytopenia is a low platelet count. Leukopenia is a low leukocyte count. Bandemia is an increased number of band cells. Question8A patient with end-stage kidney disease (ESKD) has developed anemia. What laboratory finding does the nurse understand to be significant in this stage of anemia?  Creatinine level of 6 mg/100 mL Explanation:The degree of anemia in patients with end-stage renal disease varies greatly; however, in general, patients do not become significantly anemic until the serum creatinine level exceeds 3 mg/100 mL. Question9A nurse cares for a client with severe hemoglobinuria after an upper respiratory infection and fever. Diagnostic testing reveals degraded hemoglobin within the client's erythrocytes. Which hematological condition does the nurse suspect the client has?  Glucose-6-phosphate dehydrogenase deficiency Explanation:Glucose-6-phosphate dehydrogenase deficiency (G-6-PD) is the deficiency of a gene that produces an enzyme within the erythrocyte essential for membrane stability. Clients are asymptomatic and have normal hemoglobin levels and reticulocyte counts most of the time. However, after a normally-harmless virus or ingestion of a particular medication, clients develop pallor, jaundice, and hemoglobinuria (hemoglobin in the urine). The other answer choices are hematological diseases or conditions; however, these do not present in the same manner.