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Ch. 34: Hematologic Problems Lewis: Medical-Surgical Nursing Exam Study Questions and Answers
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Ch. 34: Hematologic Problems Lewis: Medical-Surgical Nursing Exam Study Questions and Answers A 62-year old man with chronic anemia is experiencing increased fatigue and occasional palpitations at rest. The nurse would expect the patient's laboratory test findings to include a. an RBC count of...

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  • October 23, 2024
  • 44
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • ch 34 hematologic problems lewis medical surgic

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  • Lewis Medical-Surgical Nursing

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©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




Ch. 34: Hematologic Problems Lewis:
Medical-Surgical Nursing Exam Study
Questions and Answers

A 62-year old man with chronic anemia is experiencing increased fatigue and occasional


palpitations at rest. The nurse would expect the patient's laboratory test findings to include


a. an RBC count of 4,500,000/L.


b. a hematocrit (Hct) value of 38%.


c. normal red blood cell (RBC) indices.


d. a hemoglobin (Hgb) of 8.6 g/dL (86 g/L). - Ans:✔✔-ANS: D


The patient's clinical manifestations indicate moderate anemia, which is consistent with a Hgb


of 6 to 10 g/dL. The other values are all within the range of normal.


DIF: Cognitive Level: Understand (comprehension) REF: 607


TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity

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, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




Which menu choice indicates that the patient understands the nurse's teaching about


recommended dietary choices for iron-deficiency anemia?


a. Omelet and whole wheat toast


b. Cantaloupe and cottage cheese


c. Strawberry and banana fruit plate


d. Cornmeal muffin and orange juice - Ans:✔✔-ANS: A


Eggs and whole grain breads are high in iron. The other choices are appropriate for other


nutritional deficiencies but are not the best choice for a patient with iron-deficiency anemia.


DIF: Cognitive Level: Apply (application) REF: 610


TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity


A patient who is receiving methotrexate for severe rheumatoid arthritis develops a


megaloblastic anemia. The nurse will anticipate teaching the patient about increasing oral


intake of


a. iron.




Page 2/44

, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




b. folic acid.


c. cobalamin (vitamin B12).


d. ascorbic acid (vitamin C). - Ans:✔✔-ANS: B


Methotrexate use can lead to folic acid deficiency. Supplementation with oral folic acid


supplements is the usual treatment. The other nutrients would not correct folic acid deficiency,


although they would be used to treat other types of anemia.


DIF: Cognitive Level: Apply (application) REF: 612


TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity


A 52-yr-old patient has a new diagnosis of pernicious anemia. The nurse determines that the


patient understands the teaching about the disorder when the patient states,


a. "I need to start eating more red meat and liver."


b. "I will stop having a glass of wine with dinner."


c. "I could choose nasal spray rather than injections of vitamin B12."


d. "I will need to take a proton pump inhibitor such as omeprazole (Prilosec)." - Ans:✔✔-ANS: C




Page 3/44

, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED

FIRST PUBLISH OCTOBER 2024




Because pernicious anemia prevents the absorption of vitamin B12, this patient requires


injections or intranasal administration of cobalamin. Alcohol use does not cause cobalamin


deficiency. Proton pump inhibitors decrease the absorption of vitamin B12. Eating more foods


rich in vitamin B12 is not helpful because the lack of intrinsic factor prevents absorption of the


vitamin.


DIF: Cognitive Level: Apply (application) REF: 612


TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity


An appropriate nursing intervention for a hospitalized patient with severe hemolytic anemia is


to


a. provide a diet high in vitamin K.


b. alternate periods of rest and activity.


c. teach the patient how to avoid injury.


d. place the patient on protective isolation. - Ans:✔✔-ANS: B


Nursing care for patients with anemia should alternate periods of rest and activity to




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