Chapter 30: Nursing Assessment: Hematologic System

Chapter 30: Nursing Assessment: Hematologic System

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. When doing discharge teaching for a patient who has had an emergency splenectomy
following an automobile accident, the nurse will teach the patient about the increased risk
for
a. infection.
b. lymphedema.
c. chronic anemia.
d. prolonged bleeding.
ANS: A
Splenectomy increases the risk for infection, especially with gram-positive bacteria. The
risks for lymphedema, bleeding, and anemia are not increased after splenectomy.
DIF: Cognitive Level: Application REF: 647
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
2. While obtaining a health history from a patient with numerous petechiae on the skin, the
nurse asks the patient specifically about the patient’s use of
a. salicylates.
b. contraceptives.
c. antiseizure drugs.
d. antihypertensives.
ANS: A
Salicylates interfere with platelet function and can lead to petechiae and ecchymoses.
Antiseizure drugs may cause anemia, but not bleeding. Oral contraceptives increase
clotting risk. Antihypertensives do not commonly cause problems with decreased
clotting.
DIF: Cognitive Level: Comprehension REF: 649
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
3. The nurse who is reviewing laboratory data for an 86-year-old patient will be most
concerned about
a. a white blood cell (WBC) count of 3500/L.
b. a hematocrit of 37%.
c. a platelet count of 400,000/L.
d. a hemoglobin of 11.8 g/dL.
ANS: A
Test Bank 30-2
The total WBC count is not usually affected by aging, and the low WBC here would
indicate that the patient’s immune function may be compromised. The platelet count is
normal. The slight decrease in hemoglobin and hematocrit are not unusual for an older
patient.
DIF: Cognitive Level: Application REF: 648
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
4. The health care provider performs a bone marrow aspiration from the left posterior iliac
crest on a patient with pancytopenia. Following the procedure, the nurse should
a. elevate the head of the bed to 45 degrees.
b. apply a sterile Band-Aid at the aspiration site.
c. use half-inch sterile gauze to pack the wound.
d. have the patient lie on the left side for an hour.
ANS: D
To decrease the risk for bleeding, the patient should lie on the left side for 30 to 60
minutes. The wound after bone marrow biopsy is small and will not be packed with
gauze. A pressure dressing is used to cover the aspiration site. There is no indication that
the head needs to be elevated for this patient.
DIF: Cognitive Level: Application REF: 658
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity