Chapter 31: Nursing Management: Hematologic Problems

Chapter 31: Nursing Management: Hematologic Problems

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. A patient with anemia is experiencing increased fatigue and occasional palpitations at
rest. The nurse would expect the patient’s laboratory findings to include
a. normal red blood cell (RBC) indices.
b. a hematocrit (Hct) of 38%.
c. a hemoglobin (Hb) of 8.6 g/dL (86 g/L).
d. an RBC count of 4,500,000/L.
ANS: C
The patient’s clinical manifestations indicate moderate anemia, which is consistent with
an Hb of 6 to 10 g/dL. The other values are all within the range of normal.
DIF: Cognitive Level: Comprehension REF: 662 | 663
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
2. Which menu choice indicates that the patient understands the nurse’s teaching about best
dietary choices for iron-deficiency anemia?
a. Omelet and whole wheat toast
b. Cantaloupe and cottage cheese
c. Strawberry and banana fruit plate
d. Cornmeal muffin and orange juice
ANS: A
Eggs and whole grain breads are high in iron. The other choices are appropriate for other
nutritional deficiencies, but are not the best choice for a patient with iron-deficiency
anemia.
DIF: Cognitive Level: Application REF: 666 TOP: Nursing Process:
Evaluation
MSC: NCLEX: Physiological Integrity
3. A patient who is receiving methotrexate develops a megaloblastic anemia. The nurse will
anticipate teaching the patient about increasing oral intake of
a. iron.
b. folic acid.
c. cobalamin (vitamin B12).
d. ascorbic acid (vitamin C).
ANS: B
Test Bank 31-2
Methotrexate use can lead to folic acid deficiency. Supplementation with oral folic acid
supplements is the usual treatment. The other nutrients would not correct folic acid
deficiency, although they would be used to treat other types of anemia.
DIF: Cognitive Level: Application REF: 669 TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity
4. A 52-year-old patient has a new diagnosis of pernicious anemia. After teaching the
patient about pernicious anemia, the nurse determines that the patient understands the
disorder when the patient states,
a. “I need to start eating more red meat or liver.”
b. “I will stop having a glass of wine with dinner.”
c. “I will need to take a proton pump inhibitor like omeprazole (Prilosec).”
d. “I would rather use the nasal spray than have to get injections of vitamin B12.”
ANS: D
Since pernicious anemia prevents the absorption of vitamin B12, this patient requires
injections or intranasal administration of cobalamin. Alcohol use does not cause
cobalamin deficiency. Proton pump inhibitors decrease the absorption of vitamin B12.
Eating more foods rich in vitamin B12 is not helpful because the lack of intrinsic factor
prevents absorption of the vitamin.
DIF: Cognitive Level: Application REF: 669 TOP: Nursing Process:
Evaluation
MSC: NCLEX: Physiological Integrity