Chapter 16: Care of Patients with Hematologic Disorders

Chapter 16: Care of Patients with Hematologic Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse is caring for a 79-year-old male who underwent a gastrectomy 1 month ago. The nurse recognizes that this patient is at the greatest risk for which type of anemia?

a.	Aplastic anemia
b.	Pernicious anemia
c.	Iron deficiency anemia
d.	Nutritional anemia

 

 

ANS:  B

Pernicious anemia may result from the lack of the intrinsic factor found in the stomach lining. Without the intrinsic factor, the body is unable to absorb vitamin B₁₂. Aplastic anemia is related to bone marrow suppression. Iron deficiency anemia is often related to a deficiency of iron in the diet.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   345, Clinical Cues

OBJ:   1 (theory)       TOP:   Pernicious Anemia: Etiology

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

2. Iron deficiency anemia impacts adequate production of which component?

a.	Plasma
b.	White blood cells (WBCs)
c.	Hemoglobin
d.	Antibodies

 

 

ANS:  C

Deficiency of iron causes reduced production of hemoglobin.

 

PTS:   1                    DIF:    Cognitive Level: Comprehension     REF:   345

OBJ:   1 (theory)       TOP:   Iron Deficiency Anemia

KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

3. The nurse is caring for a patient with anemia who has a past medical history of diabetes, hypertension, chronic kidney disease, and acid reflux. The nurse is aware the patient’s anemia is likely related to which condition?

a.	Diabetes
b.	Hypertension
c.	Chronic kidney disease
d.	Acid reflux

 

 

ANS:  C

The kidney makes most of the body’s erythropoietin stimulating factor, which then prompts the liver to release erythropoietin for erythrocyte production. Damaged kidneys produce decreased amounts of erythropoietin, which ultimately leads to decreased red blood cell production and anemia. Diabetes, hypertension, and acid reflux do not cause anemia.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   344

OBJ:   1 (theory)       TOP:   Causes of Anemia

KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

4. Which descriptions accurately characterize the appearance of red blood cells (RBCs) in iron deficiency anemia?

a.	Normochromic and normocytic
b.	Hypochromic and microcytic
c.	Hyperchromic and macrocytic
d.	Normochromic and microcytic

 

 

ANS:  B

Iron deficiency anemia causes the RBCs to be smaller (microcytic) and have less color (hypochromic).

 

PTS:   1                    DIF:    Cognitive Level: Comprehension     REF:   345

OBJ:   1 (theory)       TOP:   Characteristics of RBCs

KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

5. The home health nurse is caring for a patient who is taking ferrous sulfate (Feosol). Which statement indicates that the patient requires additional teaching about this medication?

a.	“It tastes better when I take my medicine with milk.”
b.	“My wife says I should take my medicine with orange juice.”
c.	“I am always careful not to break open the capsule.”
d.	“I usually take my iron with my whole-grain toast during breakfast.”

 

 

ANS:  A

Milk products inhibit the absorption of iron. Iron is better absorbed if vitamin C is in the gastrointestinal tract at the same time, so drinking orange juice with the ferrous sulfate is beneficial. Capsules and enteric-coated iron preparations should not be opened or crushed. Whole grains are not known as inhibitors of iron absorption.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   347, Table 16-3

OBJ:   2 (clinical)      TOP:   Anemia Treatment: Feosol

KEY:  Nursing Process Step: Evaluation

MSC:   NCLEX: Physiological Integrity: Pharmacological Therapies