Nokea
Which patient statement from a 15-year-old girl with thrombocytopenia would require more assessment to report to the charge nurse?
- A. I think these red spots on my skin are going away.'
- B. I am so bored lying in bed I could scream.'
- C. I can't tell if the corticosteroids are helping.'
- D. I started my menstrual period this morning.'
Correct Answer: D
Rationale: Menstrual losses may be severe with a low platelet count. The nurse should assess the amount of bleeding to report to the charge nurse.
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The nurse caring for a patient with pernicious anemia should make provisions for which intervention?
- A. frequent iced drinks.
- B. lightweight blanket.
- C. a fan to circulate the air.
- D. reverse isolation.
Correct Answer: B
Rationale: Persons with pernicious anemia are especially sensitive to cold. The provision of a light blanket is beneficial.
A child with hemophilia is hospitalized with hemarthrosis. Which should the nurse caring for that child expect to implement when following the plan of care?
- A. Use analgesia sparingly.
- B. Apply warm compresses to reduce hemorrhages in the joint.
- C. Encourage vigorous joint movement exercises to keep the joints flexible.
- D. Reinforce instructions to receive factor VIII infusions prophylactically
Correct Answer: D
Rationale: Prophylactic infusions of factor VIII reduce episodes of hemarthrosis.
In caring for a patient with multiple myeloma, which should the nurse prioritize from the plan of care?
- A. Limit fluid intake to less than 1000 mL/day
- B. Closely supervise and assist when ambulating
- C. Strain all urine for kidney crystals
- D. Limit the use of an analgesic
Correct Answer: B
Rationale: Because of the constant threat of pathologic fractures, ambulation should be carefully supervised and assisted. Fluids are not restricted. Uric acid is increased and may crystalize in the kidney, but straining is not necessary. Analgesia is necessary for relief of bone pain.
Because older adults suffer from conditions such as colonic diverticula, hiatal hernia, and ulcerations that can cause occult bleeding, the nurse should assess for symptoms of which blood disorder?
- A. leukemia.
- B. iron-deficiency anemia.
- C. sickle cell anemia.
- D. polycythemia.
Correct Answer: B
Rationale: Blood loss is a major cause of iron-deficiency in adults. The major sources of chronic blood loss are from the GI and genitourinary systems.
The nurse is reading the results of a white blood cell count differential. Which abnormal reading indicates a severe allergic reaction?
- A. Increased basophil count
- B. Increased lymphocyte count
- C. Increased monocyte count
- D. Increased neutrophil count
Correct Answer: A
Rationale: An increased basophil count may indicate a severe allergic reaction.