Nokea
The nursing instructor is teaching her clinical group about laboratory blood tests. What is the major function of erythrocytes?
- A. Act as mediators for the immune system
- B. Destroy invading organisms
- C. Transportation of Oâ?? to the tissues and removal of COâ?? from the tissues
- D. Oxygenation of the brain
Correct Answer: C
Rationale: Erythrocytes (or RBCs) are flexible, anuclear (lacking a nucleus), biconcave disks covered by a thin membrane through which oxygen (Oâ??) and carbon dioxide (COâ??) pass freely. The flexibility of erythrocytes allows them to change shape as they travel through capillaries. Their major function is to transport Oâ?? to and remove COâ?? from the tissues. The RBCs are not involved in immunological functions, so choices A and B are not correct. Oxygenation of the brain is important but that is not a major function of RBCs.
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The nurse is preparing the client for a bone marrow aspiration at the posterior iliac crest. What would be the best position for the nurse to place the client in for the test?
- A. Head of the bed in a 90?° semi-Fowler's position
- B. Prone position
- C. On the side or back
- D. Lithotomy position
Correct Answer: C
Rationale: The client should be positioned on the back or side to facilitate access to the aspiration site. The 90?° semi-Fowler's and prone position would not allow adequate access to the bone marrow aspiration site. The lithotomy position is used for genitourinary and gynecological testing and procedures.
The nurse will be assisting the physician with a bone marrow aspiration. Where should the nurse cleanse, clip hair, and drape the skin prior to the procedure?
- A. Over the posterior superior iliac crest.
- B. Over the anterior tibia
- C. Over the radius
- D. Over the metatarsal area
Correct Answer: A
Rationale: The posterior superior iliac crest is the preferred site because no vital organs or blood vessels are nearby. The anterior tibia, radius, or metatarsal area are not used for bone marrow aspirations.
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.
The nurse is assisting the physician with obtaining a sample to determine the status of blood cell formation. What type of procedure will the nurse have prepared the client for?
- A. A bone marrow aspiration
- B. A Schilling test
- C. A thoracentesis
- D. A urine sample
Correct Answer: A
Rationale: A bone marrow aspiration is performed to determine the status of blood cell formation. In this procedure, the physician applies local anesthesia and removes bone marrow from the posterior iliac crest or the sternum. The marrow is examined for the types and percentage of immature and maturing blood cells.
The nurse is observing the skin of a client who is taking medications that depress the hematopoietic system and notices multiple areas of ecchymosis on the arms; bleeding for a prolonged period after an IV was started; and reports of black, tarry stool. What does the nurse understand may be a side effect of this medication that the client displays?
- A. Leukocytosis
- B. Leukopenia
- C. Thrombocytopenia
- D. Neutropenia
Correct Answer: C
Rationale: Signs of thrombocytopenia include unusual or easy bleeding; oozing from injection sites; bleeding gums; and dark, tarry stools. Leukocytosis would cause fever as well as other signs and symptoms of infection. Leukopenia symptoms are fever, sore throat, and chills. Neutropenia reduces the client's ability to fight infection and makes susceptible to microorganisms.