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A patient with abdominal injuries from a motor vehicle crash is scheduled for surgery to remove the spleen. What bodily function will be affected by the removal of this organ?
- A. Filtration of waste products
- B. Removal of old red blood cells from circulation
- C. Clearance of mucous in the tracheobronchial tree
- D. Facilitation of glucose to be used by the cell for energy
Correct Answer: B
Rationale: The correct answer is B: Removal of old red blood cells from circulation. The spleen is responsible for filtering and removing old or damaged red blood cells from the bloodstream. When the spleen is removed, this function is compromised, leading to a decreased ability to clear out old red blood cells. This can result in an increased risk of anemia and other complications related to the breakdown of red blood cells.
Choices A, C, and D are incorrect:
A: Filtration of waste products - The spleen primarily filters blood cells, not waste products.
C: Clearance of mucous in the tracheobronchial tree - This function is mainly carried out by the respiratory system, not the spleen.
D: Facilitation of glucose to be used by the cell for energy - This is a function of the pancreas and insulin, not the spleen.
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The nurse is caring for a patient who has a white blood cell (WBC) count of 8000/mm³. What concern should the nurse have about this finding?
- A. The patient has an infection.
- B. The patient is at risk for infection.
- C. The patient has a hematological disorder.
- D. There is no concern; this is a normal finding.
Correct Answer: D
Rationale: The correct answer is D because a WBC count of 8000/mm³ falls within the normal range of 4000-11000/mm³. The normal WBC count indicates the body's ability to fight infections and maintain immunity. The other choices are incorrect because:
A: The patient does not necessarily have an infection based solely on the WBC count.
B: The patient is not necessarily at risk for infection with a normal WBC count.
C: There is no indication of a hematological disorder based on the WBC count within the normal range.
A nurse is caring for a client who is about to begin taking epoetin. An increase in which of the following laboratory values should indicate to the nurse that the therapy is effective?
- A. PT
- B. WBC
- C. Hgb
- D. Platelets
Correct Answer: C
Rationale: The correct answer is C: Hgb (hemoglobin). Epoetin is a medication used to stimulate the production of red blood cells, which contain hemoglobin. Therefore, an increase in hemoglobin level indicates that the therapy is effective in treating anemia.
Incorrect choices:
A: PT (prothrombin time) is a measure of blood clotting time and is not directly related to epoetin therapy.
B: WBC (white blood cell count) is not affected by epoetin therapy, as it primarily targets red blood cell production.
D: Platelets are involved in blood clotting and are not directly influenced by epoetin therapy for anemia.
In summary, the increase in hemoglobin level is the most relevant indicator of the effectiveness of epoetin therapy for treating anemia.
A nurse is caring for a patient with Hodgkin lymphoma at the oncology clinic. The nurse should be aware of what main goal of care?
- A. Cure of the disease
- B. Enhancing quality of life
- C. Controlling symptoms
- D. Palliation
Correct Answer: A
Rationale: The correct answer is A: Cure of the disease. The main goal of care for a patient with Hodgkin lymphoma is to achieve a cure whenever possible. This is because Hodgkin lymphoma is a potentially curable cancer with appropriate treatment. Achieving a cure means eradicating the cancer cells completely and preventing its recurrence in the future. This is the most desirable outcome for the patient's long-term health and well-being.
Incorrect choices:
B: Enhancing quality of life - While improving the patient's quality of life is important, the primary goal in treating Hodgkin lymphoma is to cure the disease.
C: Controlling symptoms - Symptom management is important in providing comfort to the patient, but the main goal is to cure the disease.
D: Palliation - Palliative care focuses on relieving symptoms and improving quality of life in patients with advanced or incurable diseases. For Hodgkin lymphoma, the main goal is to aim for a cure rather than palliation.
Bone marrow responds to iron therapy by increasing erythropoietic activity. Which of the following in bone marrow would most likely indicate erythropoiesis?
- A. Myelocytes
- B. Reticulocytes
- C. Ring sideroblasts
- D. Target cells
Correct Answer: B
Rationale: Rationale:
1. Bone marrow increases erythropoiesis in response to iron therapy.
2. Reticulocytes are immature red blood cells derived from erythroblasts, indicating active erythropoiesis.
3. Myelocytes are precursors of granulocytes, not involved in erythropoiesis.
4. Ring sideroblasts are abnormal erythroblasts with iron granules, not indicative of active erythropoiesis.
5. Target cells are red blood cells with central "target-like" appearance due to excess membrane, not directly related to erythropoiesis.
A nurse is caring for a patient who has been diagnosed with leukemia. The nurse's most recent assessment reveals the presence of ecchymoses on the patient's sacral area and petechiae in her forearms. In addition to informing the patient's primary care provider, the nurse should perform what action?
- A. Initiate measures to prevent venous thromboembolism (VTE).
- B. Check the patient's most recent platelet level.
- C. Place the patient on protective isolation.
- D. Ambulate the patient to promote circulatory function.
Correct Answer: B
Rationale: Step-by-step rationale for why answer B is correct:
1. Petechiae and ecchymoses indicate potential thrombocytopenia in a leukemia patient.
2. Checking the patient's platelet level will confirm thrombocytopenia and guide treatment.
3. Low platelet levels can lead to bleeding complications, hence the importance of monitoring.
4. Prompt intervention based on platelet level results can prevent worsening complications.
Summary of why other choices are incorrect:
A: Initiating measures to prevent VTE is not directly related to the patient's current presentation of ecchymoses and petechiae.
C: Placing the patient on protective isolation is not indicated for thrombocytopenia.
D: Ambulating the patient may be beneficial for circulation but does not address the underlying issue of potential thrombocytopenia.