Steven Cook
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Nursing Quiz on Hematologic Disorders/Acid-Base/Electrolyte Imbalance, created by Steven Cook on 10/04/2018.

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Steven Cook
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Hematologic Disorders/Acid-Base/Electrolyte Imbalance

Question 1 of 32

1

A nurse in a clinic is caring for a client who has suspected anemia. Which of the following laboratory test results should the nurse expect?

Select one of the following:

  • Iron 90 mcg/dL

  • RBC 6.5 million/uL

  • WBC 4,800 mm3

  • Hgb 10 g/dL

Explanation

Question 2 of 32

1

A nurse is caring for a client who is receiving warfarin for anticoagulation therapy. Which of the following laboratory test results indicates to the nurse that the client needs an increase in the dosage?

Select one of the following:

  • aPTT 38 seconds

  • INR 1.1

  • PT 22 seconds

  • D‑dimer negative

Explanation

Question 3 of 32

1

A nurse is providing teaching for a client who is scheduled for a bone marrow biopsy of the iliac crest. Which of the following statements made by the client indicates an understanding of the teaching?

Select one of the following:

  • “This test will be performed while I am lying flat on my back.”

  • “I will need to stay in bed for about an hour after the test.”

  • “This test will determine which antibiotic I should take for treatment.”

  • “I will receive general anesthesia for the test.”

Explanation

Question 4 of 32

1

A nurse is preparing to administer packed RBCs to a client who has a Hgb of 8 g/dL. Which of the following actions should the nurse plan to take during the first 15 min of the transfusion?

Select one of the following:

  • Obtain consent from the client for the transfusion.

  • Assess for an acute hemolytic reaction.

  • Explain the transfusion procedure to the client.

  • Obtain blood culture specimens to send to the lab.

Explanation

Question 5 of 32

1

A nurse is caring for a client who is receiving a blood transfusion. Which of the following actions should the nurse expect if an allergic transfusion reaction is suspected? (Select all that apply.)

Select one or more of the following:

  • Stop the transfusion.

  • Monitor for hypertension.

  • Maintain an IV infusion with 0.9% sodium chloride.

  • Position the client in an upright position with the feet lower than the heart.

  • Administer diphenhydramine.

Explanation

Question 6 of 32

1

A nurse is monitoring a client who began receiving a unit of packed RBCs 10 min ago. Which of the following findings should the nurse identify as an indication of a febrile transfusion reaction? (Select all that apply.)

Select one or more of the following:

  • Temperature change from 37° C (98.6° F) pretransfusion to 37.2° C (99.0° F)

  • Current blood pressure 178/90 mm Hg

  • Heart rate change from 88/min pretransfusion to 120/min

  • Client report of itching

  • Client appears flushed

Explanation

Question 7 of 32

1

A nurse is providing preoperative teaching for a client who requests autologous donation in preparation for a scheduled orthopedic surgical procedure. Which of the following statements should the nurse include in the teaching?

Select one of the following:

  • “you should make an appointment to donate blood 8 weeks prior to the surgery.”

  • “If you need an autologous transfusion, the blood your brother donates can be used.”

  • “you can donate blood each week if your hemoglobin is stable.”

  • “Any unused blood that is donated can be used for other clients.”

Explanation

Question 8 of 32

1

A nurse preceptor is observing a newly licensed nurse on the unit who is preparing to administer a blood transfusion to an older adult client. Which of the following actions by the newly licensed nurse indicates an understanding of the procedure?

Select one of the following:

  • Inserts an 18‑gauge IV catheter in the client

  • Verifies blood compatibility and expiration date of the blood with an assistive personnel (AP)

  • Administers dextrose 5% in 0.9% sodium chloride IV with the transfusion

  • Obtains vital signs every 15 min throughout the procedure

Explanation

Question 9 of 32

1

A nurse is planning care for a client who has Hgb 7.5 g/dL and Hct 21.5%. Which of the following actions should the nurse include in the plan of care? (Select all that apply.)

Select one or more of the following:

  • Provide assistance with ambulation.

  • Monitor oxygen saturation.

  • Weigh the client weekly.

  • Obtain stool specimen for occult blood.

  • Schedule daily rest periods.

Explanation

Question 10 of 32

1

A nurse is teaching a client who has a new prescription for ferrous sulfate. Which of the following information should the nurse include in the teaching?

Select one of the following:

  • Stools will be dark red.

  • Take with a glass of milk if gastrointestinal distress occurs.

  • Foods high in vitamin C will promote absorption.

  • Take for 14 days.

Explanation

Question 11 of 32

1

A nurse is providing discharge teaching to a client who had a gastrectomy for stomach cancer. Which of the following information should the nurse include in the teaching? (Select all that apply.)

Select one or more of the following:

  • “you will need a monthly injection of vitamin B12 for the rest of your life.”

  • “Using the nasal spray form of vitamin B12 on a daily basis can be an option.”

  • “An oral supplement of vitamin B12 taken on a daily basis can be an option.”

  • “you should increase your intake of animal proteins, legumes, and dairy products to increase vitamin B12 in your diet.”

  • “Add soy milk fortified with vitamin B12 to your diet to decrease the risk of pernicious anemia.”

Explanation

Question 12 of 32

1

A nurse is completing an integumentary assessment of a client who has anemia. Which of the following findings should the nurse expect?

Select one of the following:

  • Absent turgor

  • Spoon‑shaped nails

  • Shiny, hairless legs

  • Yellow mucous membranes

Explanation

Question 13 of 32

1

A nurse in a clinic receives a phone call from a client seeking information about a new prescription for erythropoietin. Which of the following information should the nurse review with the client?

Select one of the following:

  • The client needs an erythrocyte sedimentation rate (ESR) test weekly.

  • The client should have his hemoglobin checked twice a week.

  • Oxygen saturation levels should be monitored.

  • Folic acid production will increase.

Explanation

Question 14 of 32

1

A nurse is caring for a client who has disseminated intravascular coagulation (DIC). Which of the following laboratory values indicates the client’s clotting factors are depleted? (Select all that apply.)

Select one or more of the following:

  • Platelets 100,000/mm3

  • Fibrinogen levels 57 mg/dL

  • Fibrin degradation products 4.3 mcg/mL

  • D‑dimer 0.03 mcg/mL

  • Sedimentation rate 38 mm/hr

Explanation

Question 15 of 32

1

A nurse is assessing a client and suspects the client is experiencing DIC. Which of the following physical findings should the nurse anticipate?

Select one of the following:

  • Bradycardia

  • Hypertension

  • Epistaxis

  • Xerostomia

Explanation

Question 16 of 32

1

A nurse is caring for a client who has idiopathic thrombocytopenic purpura (ITP). The nurse should notify the provider and report possible small‑vessel clotting when which of the following is assessed?

Select one of the following:

  • Petechiae on the upper chest

  • Hypotension

  • Cyanotic nail beds

  • Severe headache

Explanation

Question 17 of 32

1

A nurse is caring for a client who has DIC. Which of the following medications should the nurse anticipate administering?

Select one of the following:

  • Heparin

  • Vitamin K

  • Mefoxin

  • Simvastatin

Explanation

Question 18 of 32

1

A nurse is teaching a newly licensed nurse about heparin‑induced thrombocytopenia. Which of the following risk factors for this disorder should the nurse include in the teaching?

Select one of the following:

  • Warfarin therapy for atrial fibrillation

  • Placental abruption

  • Systemic lupus erythematosus

  • Heparin therapy for deep‑vein thrombosis

Explanation

Question 19 of 32

1

A nurse is admitting a client who reports nausea, vomiting, and weakness. The client has dry oral mucous membranes, temperature 38.5° C (101.3° F), pulse 92/min, respirations 24/min, skin cool with tenting present, and blood pressure 102/64 mm Hg. Urine is concentrated with a high specific gravity. Which of the following are manifestations of fluid volume deficit for which the nurse should monitor? (Select all that apply.)

Select one or more of the following:

  • Decreased skin turgor

  • Concentrated urine

  • Bradycardia

  • Low‑grade fever

  • Tachypnea

Explanation

Question 20 of 32

1

A nurse is admitting an older adult client who is experiencing dyspnea, weakness, weight gain of 2 lb, and 1+ bilateral edema of the lower extremities. The client has temperature 37.2° C (99° F), pulse 96/min, respirations 26/min, oxygen saturation 94% on 3 L oxygen via nasal cannula, and blood pressure 152/96 mm Hg. Which of the following manifestations of fluid volume excess should the nurse expect? (Select all that apply.)

Select one or more of the following:

  • Dyspnea

  • Edema

  • Bradycardia

  • Hypertension

  • Weakness

Explanation

Question 21 of 32

1

A nurse is assessing a client who is dehydrated for fluid volume deficit. Which of the following findings should the nurse expect in the client?

Select one of the following:

  • Moist skin

  • Distended neck veins

  • Increased urinary output

  • Tachycardia

Explanation

Question 22 of 32

1

A nurse is caring for an older adult client in a long‑term care facility. The client has become weak and confused. He ate 40% of his breakfast and lunch. The client’s temperature is 38.3° C (100.9° F), pulse 92/min, respirations 20/min, and blood pressure 108/60 mm Hg. He has lost ¾ lb and reports dizziness when assisted to the bathroom. He also has a nonproductive cough with diminished breath sounds in the right lower lobe. Which of the following actions should the nurse take?

Select one of the following:

  • Initiate fluid restrictions to limit intake.

  • Observe for signs of peripheral edema.

  • Encourage the client to ambulate to promote oxygenation.

  • Monitor for orthostatic hypotension

Explanation

Question 23 of 32

1

A nurse is caring for a client who has a serum sodium level 133 mEq/L and serum potassium level 3.4 mEq/L. The nurse should recognize that which of the following treatments can result in these laboratory findings?

Select one of the following:

  • Three tap water enemas

  • 0.9% sodium chloride solution IV at 50 mL/hr

  • 5% dextrose in water solution with 20 mEq of K+ IV at 80 mL/hr

  • Antibiotic therapy

Explanation

Question 24 of 32

1

A nurse is caring for a client who has a serum potassium 5.4 mEq/L. The nurse should assess for which of the following manifestations?

Select one of the following:

  • ECG changes

  • Constipation

  • Polyuria

  • Hypotension

Explanation

Question 25 of 32

1

A nurse is caring for a client who has a nasogastric tube attached to low intermittent suctioning. The nurse should monitor for which of the following electrolyte imbalances?

Select one of the following:

  • Hypercalcemia

  • Hyponatremia

  • Hyperphosphatemia

  • Hypomagnesemia

Explanation

Question 26 of 32

1

A nurse is assessing a client who has hyperkalemia. The nurse should identify which of the following conditions as being associated with this electrolyte imbalance?

Select one of the following:

  • Diabetic ketoacidosis

  • Heart failure

  • Cushing’s syndrome

  • Thyroidectomy

Explanation

Question 27 of 32

1

A nurse is assessing a client for Chvostek’s sign. Which of the following techniques should the nurse use to perform this test?

Select one of the following:

  • Apply a blood pressure cuff to the client’s arm.

  • Place the stethoscope bell over the client’s carotid artery.

  • Tap lightly on the client’s cheek.

  • Ask the client to lower her chin to her chest.

Explanation

Question 28 of 32

1

A nurse is caring for a client admitted with confusion and lethargy. The client was found at home unresponsive with an empty bottle of aspirin lying next to her bed. Vital signs reveal blood pressure 104/72 mm Hg, heart rate 116/min with regular rhythm, and respiratory rate 42/min and deep. Which of the following arterial blood gas findings should the nurse expect?

Select one of the following:

  • pH 7.68 PaO2 96 mm Hg PaCO2 38 mm Hg HCO3− 28 mEq/L

  • pH 7.48 PaO2 100 mm Hg PaCO2 28 mm Hg HCO3− 23 mEq/L

  • pH 6.98 PaO2 100 mm Hg PaCO2 30 mm Hg HCO3− 18 mEq/L

  • pH 7.58 PaO2 96 mm Hg PaCO2 38 mm Hg HCO3− 29 mEq/L

Explanation

Question 29 of 32

1

A nurse is caring for a client who was in a motor‑vehicle accident. The client reports chest pain and difficulty breathing. A chest x‑ray reveals the client has a pneumothorax. Which of the following arterial blood gas findings should the nurse expect?

Select one of the following:

  • pH 7.06 PaO2 86 mm Hg PaCO2 52 mm Hg HCO3− 24 mEq/L

  • pH 7.42 PaO2 100 mm Hg PaCO2 38 mm Hg HCO3− 23 mEq/L

  • pH 6.98 PaO2 100 mm Hg PaCO2 30 mm Hg HCO3− 18 mEq/L

  • pH 7.58 PaO2 96 mm Hg PaCO2 38 mm Hg HCO3− 29 mEq/L

Explanation

Question 30 of 32

1

A nurse is obtaining arterial blood gases for a client who has vomited for 24 hr. The nurse should expect which of the following acid‑base imbalances to result from vomiting for 24 hr?

Select one of the following:

  • Respiratory acidosis

  • Respiratory alkalosis

  • Metabolic acidosis

  • Metabolic alkalosis

Explanation

Question 31 of 32

1

A charge nurse is teaching a group of nurses about conditions related to metabolic acidosis. Which of the following statements by a unit nurse indicates the teaching has been effective?

Select one of the following:

  • “Metabolic acidosis can occur due to diabetic ketoacidosis.”

  • “Metabolic acidosis can occur in a client who has myasthenia gravis.”

  • “Metabolic acidosis can occur in a client who has asthma.”

  • “Metabolic acidosis can occur due to cancer.”

Explanation

Question 32 of 32

1

A nurse is assessing a client who has pancreatitis. The client’s arterial blood gases reveal metabolic acidosis. Which of the following are expected findings? (Select all that apply.)

Select one or more of the following:

  • Tachycardia

  • Hypertension

  • Bounding pulses

  • Hyperreflexia

  • Dysrhythmia

  • Tachypnea

Explanation

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