Nokea
A clients health history reveals daily consumption of two to three bottles of wine. The nurse should plan assessments and interventions in light of the patients increased risk for what hematologic disorder?
- A. Leukemia
- B. Anemia
- C. Thrombocytopenia
- D. Lymphoma
Correct Answer: B
Rationale: Heavy alcohol use is associated with numerous health problems, including anemia. Leukemia and lymphoma are not associated with alcohol use; RBC levels are typically affected more than platelet levels.
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A nurse is educating a patient about the role of B lymphocytes. The nurses description will include which of the following physiologic processes?
- A. Stem cell differentiation
- B. Cytokine production
- C. Phagocytosis
- D. Antibody production
Correct Answer: D
Rationale: B lymphocytes are capable of differentiating into plasma cells. Plasma cells, in turn, produce antibodies. Cytokines are produced by NK cells. Stem cell differentiation greatly precedes B lymphocyte production.
A patient is being treated for the effects of a longstanding vitamin B12 deficiency. What aspect of the patients health history would most likely predispose her to this deficiency?
- A. The patient has irregular menstrual periods.
- B. The patient is a vegan.
- C. The patient donated blood 60 days ago.
- D. The patient frequently smokes marijuana.
Correct Answer: B
Rationale: Because vitamin B12 is found only in foods of animal origin, strict vegetarians may ingest little vitamin B12. Irregular menstrual periods, marijuana use, and blood donation would not precipitate a vitamin B12 deficiency.
The nurse is providing care for an older adult who has a hematologic disorder. What age-related change in hematologic function should the nurse integrate into care planning?
- A. Bone marrow in older adults produces a smaller proportion of healthy, functional blood cells.
- B. Older adults are less able to increase blood cell production when demand suddenly increases.
- C. Stem cells in older adults eventually lose their ability to differentiate.
- D. The ratio of plasma to erythrocytes and lymphocytes increases with age.
Correct Answer: B
Rationale: Due to a variety of factors, when an older person needs more blood cells, the bone marrow may not be able to increase production of these cells adequately. Stem cell activity continues throughout the lifespan, although at a somewhat decreased rate. The proportion of functional cells does not greatly decrease and the relative volume of plasma does not change significantly.
An older adult client is exhibiting many of the characteristic signs and symptoms of iron deficiency. In addition to a complete blood count, what diagnostic assessment should the nurse anticipate?
- A. Stool for occult blood
- B. Bone marrow biopsy
- C. Lumbar puncture
- D. Urinalysis
Correct Answer: A
Rationale: Iron deficiency in the adult generally indicates blood loss (e.g., from bleeding in the GI tract or heavy menstrual flow). Bleeding in the GI tract can be preliminarily identified by testing stool for the presence of blood. A bone marrow biopsy would not be undertaken for the sole purpose of investigating an iron deficiency. Lumbar puncture and urinalysis would not be clinically relevant.
Two units of PRBCs have been ordered for a patient who has experienced a GI bleed. The patient is highly reluctant to receive a transfusion, stating, Im terrified of getting AIDS from a blood transfusion. How can the nurse best address the patients concerns?
- A. All the donated blood in the United States is treated with antiretroviral medications before it is used.
- B. That did happen in some high-profile cases in the twentieth century, but it is no longer a possibility.
- C. HIV was eradicated from the US blood supply in the early 2000s.
- D. The chances of contracting AIDS from a blood transfusion in the United States are exceedingly low.
Correct Answer: D
Rationale: The patient can be reassured about the very low possibility of contracting HIV from the transfusion. However, it is not an absolute impossibility. Antiretroviral medications are not introduced into donated blood. The blood supply is constantly dynamic, due to the brief life of donated blood.