Nokea
The client is symptomatic with a Hgb of 7.8 g/dL, but refuses blood and blood products transfusions for religious reasons. The nurse should prepare the client that the HCP may prescribe which alternatives?
- A. Epoetin alfa
- B. Folic acid
- C. Albumin
- D. Platelets
- E. Fresh frozen plasma
- F. Granulocytes
Correct Answer: A, B,
Rationale: Epoetin alfa (erythropoietin growth factor; Procrit) promotes erythropoiesis (production of RBCs), thus decreasing the need for transfusions. B. Folic acid promotes erythropoiesis and production of WBCs and platelets. C. Albumin is a blood product. D. Platelets are blood products. E. Plasma is a blood product. F. Granulocytes are blood products.
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A client who receives a diagnosis of pernicious anemia asks why she must receive vitamin shots. What is the best answer for the nurse to give?
- A. Shots work faster than pills.'
- B. Your body cannot absorb vitamin B12 from foods.'
- C. Vitamins are necessary to make the blood cells.'
- D. You can get more vitamins in a shot than a pill.'
Correct Answer: B
Rationale: In pernicious anemia, the lack of intrinsic factor prevents absorption of vitamin B12 from foods, necessitating injections.
Which sign would the nurse expect to assess in the client diagnosed with idiopathic thrombocytopenic purpura (ITP)?
- A. Petechiae on the anterior chest, arms, and neck.
- B. Capillary refill of less than three (3) seconds.
- C. An enlarged spleen.
- D. Pulse oximeter reading of 95%.
Correct Answer: A
Rationale: ITP causes low platelets, leading to petechiae (A). Capillary refill (B) is normal, splenomegaly (C) is not primary, and SpO2 95% (D) is normal.
The client diagnosed with leukemia is scheduled for bone marrow transplantation. Which interventions should be implemented to prepare the client for this procedure? Select all that apply.
- A. Administer high-dose chemotherapy.
- B. Teach the client about autologous transfusions.
- C. Have the family members' HLA typed.
- D. Monitor the complete blood cell count daily.
- E. Provide central line care per protocol.
Correct Answer: A,C,D,E
Rationale: High-dose chemotherapy (A) ablates marrow, HLA typing (C) identifies donors, CBC monitoring (D) tracks counts, and central line care (E) prevents infection. Autologous transfusions (B) are irrelevant (donor marrow used).
The nurse is assisting the HCP with a bone marrow biopsy. Which intervention postprocedure has priority?
- A. Apply pressure to site for five (5) to 10 minutes.
- B. Medicate for pain with morphine slow IVP.
- C. Maintain head of bed in high Fowler’s position.
- D. Apply oxygen via nasal cannula at five (5) L/min.
Correct Answer: A
Rationale: Applying pressure for 5–10 minutes (A) prevents bleeding post-biopsy, a priority. Pain meds (B), HOB (C), and oxygen (D) are secondary or unrelated.
The client is experiencing pain due to cancer treatment- The client tells the nurse, “Methadone has always worked well for me in the past.” Which effects of methadone should the nurse consider when administering methadone?
- A. Has a long half-life and high level of potency
- B. May cause an increase in BP and confusion
- C. Causes severe allergic reactions and liver failure
- D. Has active metabolites, but it is well tolerated
Correct Answer: A
Rationale: bg