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A client is in the hospital with a bleeding gastric ulcer and requires a blood transfusion. He has been typed and crossmatched for 2 units of packed red blood cells and found to have type O blood. What type of blood will the nurse administer to this client?
- A. Type A
- B. Type B
- C. Type AB
- D. Type O
Correct Answer: D
Rationale: Those with type O blood can only receive type O blood. Clients with all other blood types can receive type O blood provided the Rh factor is compatible.
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A client is scheduled for a bone marrow aspiration and is extremely apprehensive about having the procedure done. The nurse explains that there may be a feeling of pressure or discomfort when puncturing the bone. What intervention can the nurse provide to assist with this concern?
- A. Inform the client that he will not be able to move and will have to tolerate the discomfort for 20 minutes.
- B. Inform the client that if he is concerned that he will move when the bone is punctured, soft wrist restraints can be used if the client approves.
- C. Assist the client with focused imagery to avoid focusing on the procedure and any discomfort associated with it.
- D. Suggest chewing gum or eating candy in order to focus on something other than the discomfort.
Correct Answer: C
Rationale: Suggest distraction techniques to avoid focusing on the pressure or discomfort associated with puncturing the bone that may take approximately 20 minutes. Restraints should not be applied during the procedure because the client may not be able to determine if they are too tight. The client has a right to pain relief and should not have to 'tolerate' pain for 20 minutes. Chewing gum or eating candy may increase the client's risk for aspiration during the procedure.
Why would it be important for the nurse to obtain information regarding the dietary history of a client with a possible abnormality of the hematopoietic or lymphatic system?
- A. It could determine if the illness is self-induced by nutritional starvation.
- B. If the client has impaired protein intake, it will cause diseases of the hematopoietic system.
- C. Altered nutrition is the cause of abnormalities of the hematopoietic and lymphatic system.
- D. Compromised nutrition interferes with production of blood cells and hemoglobin.
Correct Answer: D
Rationale: The nurse obtains a dietary history because compromised nutrition interferes with the production of blood cells and hemoglobin. The history cannot determine if the illness is self-induced by starvation. Nutritional deficiencies do not cause diseases of the hematopoietic system and lymphatic system.
Macrophages attack and destroy foreign substances to the body. Where does this action occur?
- A. At the site of trauma
- B. In the lymph node
- C. In the vascular system
- D. In the thymus
Correct Answer: B
Rationale: As lymph passes through the node, macrophages attack and engulf foreign substances such as bacteria and viruses, abnormal body cells, and other debris. The other options are incorrect.
The nurse is caring for three clients who have the following blood count values: Client A has 24,500/mm?³ white blood cells (WBCs), client B has 13.4 g/dL hemoglobin, and client C has a 250,000/mm?³ platelet count. Which statement correctly describes the condition of each client?
- A. Client A has a normal WBC count, client B has a higher hemoglobin count than normal, and client C has a normal platelet count.
- B. Client A has a higher WBC count than normal, client B has a normal hemoglobin count, and client C has a normal platelet count.
- C. Client A has a higher WBC count than normal, client B has a normal hemoglobin count, and client C has a higher platelet count than normal.
- D. Client A has a lower WBC count than normal, client B has a normal hemoglobin count, and client C has a normal platelet count.
Correct Answer: B
Rationale: The normal leukocyte count is between 5000 and 10,000/mm?³. Client A has an increased number of leukocytes greater than 10,000/mm?³ and hence has leukocytosis. In adults, the normal amount of hemoglobin is 12.0 to 17.4 g/dL; therefore, client B has a normal hemoglobin count. A normal circulating platelet count is 150,000 to 350,000/mm?³ platelets; therefore, client C has a normal platelet count.
The nurse is reviewing laboratory studies that determine a client is deficient in copper. What does the nurse understand is the importance of copper in the body?
- A. Essential for the maturation of red blood cells
- B. Basic nutritional component of heme in hemoglobin
- C. Involved in the transfer of iron from storage to plasma
- D. Serves as a coenzyme in hemoglobin formation
Correct Answer: C
Rationale: Copper is involved in the transfer of iron from storage to plasma. Folic acid and Bâ??â?? are essential for the maturation of red blood cells. Iron is the basic nutritional component of heme in hemoglobin. Vitamin B6 serves as a coenzyme in hemoglobin formation.