Chapter 33: Hematologic Disorders Questions and
Expert Answers
1. What should be a major focus in a teaching plan for a teenager with sickle cell
anemia?
a. Limit tobacco use to no more than two cigarettes a day.
b. Eat foods high in iron and vitamin B.
c. Maintain environmental temperature at 65° F to 68° F.
d. Maintain adequate hydration. - ANS ANS: D
The maintenance of adequate fluid intake (4-6 L/day) prevents
hemoconcentration. The use of alcohol and tobacco are contraindicated for the
patient with sickle cell anemia as the cause vasoconstriction. Warm environments
are more therapeutic as warm environments do not cause vasoconstriction.
DIF: Cognitive Level: Application REF: p. 638 OBJ: 6
TOP: Sickle Cell Anemia KEY: Nursing Process Step: Planning
MSC:
2. Which is considered an approximate normal hematocrit value?
a. Three times the hemoglobin value
b. The same as the hemoglobin value
c. Four times lower than the red blood cell count
d. Same as the red blood cell count - ANS ANS: A
,Hematocrit is approximately three times the hemoglobin value.
DIF: Cognitive Level: Knowledge REF: p. 627 OBJ: 3
TOP: Normal Laboratory Values KEY: Nursing Process Step: Assessment
MSC:
3. A nurse is caring for a patient who is having radiation treatment for cancer. How
many days after the start of radiation should the nurse know that the threat of
thrombocytopenia exists?
a. 2
b. 5
c. 9
d. 12 - ANS ANS: D
Thrombocytopenia becomes a nursing concern 10 to 14 days after therapy has
begun. This concern is true for radiation and chemotherapy.
DIF: Cognitive Level: Knowledge REF: p. 638 OBJ: 6
TOP: Thrombocytopenia KEY: Nursing Process Step: Assessment
MSC:
4. A nurse is caring for a patient receiving a transfusion and assesses that the
patient is wheezing and is complaining of back pain. What nursing action should
take place after stopping the transfusion?
a. Discontinue the intravenous (IV) transfusion.
, b. Notify the charge nurse.
c. Administer heparin.
d. Raise the patient's head. - ANS ANS: B
The charge nurse should be notified immediately after the transfusion is stopped.
The charge nurse will notify the physician and the laboratory or blood bank. The
head of the bed should be raised to aid in respiration, and oxygen should be
administered in high doses. The blood tubing and bag should not be discarded
because the blood bank will want it to check the accuracy of the typing.
DIF: Cognitive Level: Application REF: p. 632 OBJ: 4
TOP: Blood Transfusion Reactions KEY: Nursing Process Step: Implementation
MSC:
5. A patient receiving Epogen asks how soon an increase in the red blood cell count
will occur. When should the nurse say that the initial increase in red blood cells
should be seen?
a. 2 days
b. 1 week
c. 10 days
d. 2 weeks - ANS ANS: D
Epoetin alfa (Epogen) stimulates the bone marrow to produce more red blood cells
in approximately 2 weeks.
DIF: Cognitive Level: Comprehension REF: p. 634 OBJ: 6
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