Chapter 42: Care of Patients with Hematologic Problems

Chapter 42: Care of Patients with Hematologic Problems

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The registered nurse is assigning a practical nurse to care for a client who has leukemia. Which instruction does the registered nurse provide to the practical nurse when delegating this client’s care?

a.	Evaluate the amount of protein the client eats.
b.	Assess the client’s roommate for symptoms of infection.
c.	Perform effective hand hygiene frequently.
d.	Wear a mask when entering the room.

 

 

ANS:  C

A major objective in caring for the client with leukemia is protection from infection. Frequent handwashing is of the utmost importance. If at all possible, the client should be in a private room. Masks are worn by anyone who has an upper respiratory tract infection. The client may be on a “minimal bacteria diet.” Protein is not a factor in this diet.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Safe and Effective Care Environment (Safety and Infection Control—Standard Precautions/Transmission-Based Precautions/Surgical Asepsis)

MSC:  Integrated Process: Communication and Documentation

 

2. The nurse is teaching a client who has sickle cell disease and was admitted for splenomegaly and abdominal pain. Which instruction does the nurse include in the client’s discharge teaching?

a.	“Avoid drinking large amounts of fluids.”
b.	“Eat six small meals daily instead of large meals.”
c.	“Engage in aerobic exercise 3 days a week.”
d.	“Receive a yearly influenza vaccination.”

 

 

ANS:  D

Abdominal pain and a palpable spleen could indicate blood trapping in the spleen. Over time, the spleen may become nonfunctional, which makes the client at risk for infection. An annual influenza vaccination helps prevent infection. A client with sickle cell disease should not become dehydrated or engage in strenuous physical activity because this could precipitate a crisis. Eating smaller meals has no impact on sickle cell disease or infection.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Health Promotion and Maintenance (Health Promotion/Disease Prevention)          MSC:           Integrated Process: Teaching/Learning

 

3. The nurse is planning discharge teaching for a client who has acute myelogenous leukemia (AML). Which instruction does the nurse include in this client’s discharge plan?

a.	Avoid contact sports.
b.	Refrain from intercourse.
c.	Apply heat to any bruised areas.
d.	Use aspirin for headaches.

 

 

ANS:  A

Clients with AML have a low platelet count and are at risk for bleeding. Contact sports can cause bleeding and should be avoided by those with a low platelet count. Anal intercourse should be avoided, but it is not necessary to refrain from all types of intercourse. Ice should be placed on bruised areas instead of heat, and aspirin should not be used by those with a low platelet count.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Health Promotion and Maintenance (Self-Care)

MSC:  Integrated Process: Teaching/Learning

 

4. The nurse is caring for a client who has autoimmune thrombocytopenic purpura. Which intervention does the nurse implement for this client?

a.	Avoid intramuscular injections.
b.	Administer prescribed anticoagulants.
c.	Infuse intravenous normal saline.
d.	Monitor for an increase in temperature.

 

 

ANS:  A

With autoimmune thrombocytopenic purpura, the total number of circulating platelets is greatly reduced. As a result of the decreased platelet count, the client is at great risk for bleeding, and intramuscular injections should be avoided. Anticoagulants should not be given. A low platelet count is not treated with saline, and thrombocytopenia will not cause a change in body temperature.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Complications from Surgical Procedures and Health Alterations)

MSC:  Integrated Process: Nursing Process (Implementation)