NURS 316 Unit 4 Exam 270 Questions and

NURS 316 Unit 4 Exam 270 Questions and Verified Accurate Answers Guaranteed A+

"__" anemia describes a primary condition of bone marrow stem cells that results in a reduction of all three hematopoietic cell lines: red blood cells, white blood cells, and

platelets - Correct Answer: Aplastic

"__" is common in chronic lymphocytic leukemia, especially in persons with advanced

disease - Correct Answer: Hypogammaglobulinemia

"__" is the orderly, stepwise process for stopping bleeding that involves vasospasm, formation of a platelet plug, and the development of a fibrin clot. - Correct Answer: Hemostasis

A 2 y/o weighing 32 lbs is to take ferrous sulfate (Feosol) 6mg/kg/d PO. How many mg will the child receive per dose?

• 47 mg
• 67 mg
• 87 mg

D. 107 - Correct Answer: C. 87 mg

A 6 month-old infant was born with a murmur. The pediatrician is recommending valve replacement/repair surgery based on which of the following lab values indicating intravascular hemolysis?

• Increase in the number of red blood cells (polycythemia)

B Excess of hemoglobin in the blood plasma (hemoglobinemia)

• Elevated bilirubin levels
• Decreased number of reticulocytes. - Correct Answer: B Excess of hemoglobin in the

blood plasma (hemoglobinemia)

A 12 month old infant is displaying pale skin, rapid HR, and increased RR. The parents bring the child to the clinic. Which statement by the parents points the nurse to suspect iron deficiency anemia?

• He has 1-2 BM's a day
• We give him regular cows milk with all his meals and snacks
• He doesn't like to eat any vegetables
• His grandma feeds him cookies every time she comes to visit. - Correct Answer: B.

We give him regular cows milk with all his meals and snacks

A 16 y/o girl has been brought to her primary care provider by her mother due to the daughter's recent malaise and lethargy. Which of the following assessments should the clinician preform in an effort to confirm or rule out infectious mononucleosis?

• Auscultating the client's lungs
• Palpating the client's lymph nodes
• Assessing the client's cranial nerve reflexes 1 / 4

• Assessing the client's for bone pain. - Correct Answer: B. Palpating the client's lymph

nodes

A 22 y/o woman who has severe dysmenorrhea has been prescribed ferrous gluconate (Fergon) to treat iron deficiency anemia. What is important for the nurse to instruct the pt to avoid when taking the drug?

• Eggs
• Chocolate
• Pork

D. Whole wheat - Correct Answer: A. Eggs

A 23 y/o female client has been diagnosed with von Willebrand disease following a long history of "heavy periods" and occasional nosebleeds. Which of the client's following statements demonstrates a sound understanding of her new diagnosis?

• I'm really disappointed that I won't be able to do sports anymore
• I read on a website that I might have to get blood transfusions from time to time.
• I'll make sure to take Tylenol instead of aspirin when I get aches and pains
• I hope my insurance covers the injections that I'll need to help my blood clot. -

Correct Answer: C. I'll make sure to take Tylenol instead of aspirin when I get aches and pains

A 42 y/o woman with breast cancer has had a radical masectomy. She will have radiation therapy and then begin chemotherapy. Drug therapy will consist of a combination of doxorubicin, cyclophosphamide, and paclitaxel. What will the nurse include in her teaching plan concerning the drug therapy?

• Stay on a low-fat diet during the course of drug therapy.
• Take special care when shaving or brushing her teeth.
• Continue to go to church or to the mall just as she did before the diagnosis of cancer
• Stay in bed 2 days post administration. - Correct Answer: B. Take special care when

shaving or brushing her teeth.

A 48 y/o male client, who normally enjoys good health, has been admitted to the hospital for the treatment of polycythemia vera. The nurse who is providing care of the client should prioritize assessments aimed at the early identification of which of the following health problems?

• Orthostatic hypotension
• Hyperventilation
• Vasculitis

D. Thromboembolism - Correct Answer: D. Thromboembolism

A 50 y/o ot with pernicious anemia asks why she can't just take a vitamin B12 pill instead of getting an injection.

• Pernicious anemia is caused by the body's inability to absorb vitamin B12
• Oral ingestion of vitamin B12 irritates the GI tract and bleeding could occur.
• Pernicious anemia alters mucous membrane lining of the bowel and impairs

absorption 2 / 4

• With severe deficiencies like yours, PO B12 does not work fast enough. - Correct

Answer: A. Pernicious anemia is caused by the body's inability to absorb vitamin B12

A 62 y/o female pt is started on vitamin B12 for pernicious anemia. When the nurse develops the pan of care, what expected outcome will the nurse include?

• Decreased bleeding.
• Increased Hgb
• Decreased joint pain

D. Less fatigue. - Correct Answer: B. Increased Hgb

A 68 y/o client with an 80 pack/year history of smoking was diagnosed with emphysema 18 months ago. The client's most recent scheduled blood work showed excessive increase in production of red blood cell (erythrocytes), a problem that suggests the need for which of the following interventions?

• Vitamin B12 supplements
• Increased supplementary oxygen therapy
• Hemodialysis or peritoneal dialysis
• Scheduled erythropoietin injections - Correct Answer: B. Increased supplementary

oxygen therapy

A 69 y/o client who is obese and has a diagnosis of angina pectoris has been prescribed clopidogrel (Plavix) by his primary care provider. The client asks, "Why do I need this medication? It won't help my chest pain." The best response would be that

this medication:

• Prevents the blood cells from forming a clot in your heart vessels
• Activates plasminogen, which converts to plasmin to digest clots in your heart

vessels

• Inhibits the intrinsic clotting pathway to keep RBCs from clumping together in the

heart vessels.D, Inactivates calcium ions, thereby preventing blood clotting - Correct Answer: A.Prevents the blood cells from forming a clot in your heart vessels --- Clopidogrel (Plavix) is a common platelet aggregation inhibitor. It does not achieve a therapeutic effect by activating plasminogen, inhibiting the intrinsic pathway, or inactivating calcium ions.

A 72 y/o woman with complaints of increased fatigue has completed a series of fecal occult blood tests that indicate the presence of blood in her stool. Which of the following health problems is likely to accompany this client's gastrointestinal bleed?A Hemolytic anemia

• Aplastic anemia
• Iron deficiency anemia

D. Megaloblastic anemia - Correct Answer: C. Iron deficiency anemia

A 76y/o is receiving IV heparin 5,000 units every 8 hours. An activated thromboplastin time (aPTT) is drawn 1 hour before the 0800 dose; the aPTT is at 3.5 times the control value. What is the nurse's priority action?

• Give a large dose to increase the aPTT. 3 / 4

• Give the dose as ordered and chart the results.
• Check the pt's vitals prior to administering
• Hold the dose and call the result to the MD. - Correct Answer: D. Hold the dose and

call the result to the MD.

A child has Down syndrome and has been experiencing unexplained nose bleeds for the past several months. His blood tests identify blast cells in the peripheral smear. In addition to nose bleeds, his acute leukemia will typically manifest which of the following signs/symptoms? Select all that apply.

• Infections due to neutropenia
• Fatigue due to RBC deficiency
• Hypogammaglobulinemia due to progressive infiltration of the bone marrow and

lymphoid tissues

• Bleeding due to thrombocytopenia
• Palpation of solid tumours on the kidneys - Correct Answer: A. Infections due to

neutropenia

• Fatigue due to RBC deficiency
• Bleeding due to thrombocytopenia ---- Hypogammaglobulinemia is common with

chronic lymphocytic leukemia, in addition to all the manifestations of a blood cell malignancy. Infections, fatigue, and bleeding are seen in all clients with acute leukemias and will also be present in clients with chronic leukemias. Splenomegaly often causes a feeling of abdominal fullness and discomfort. Solid tumours in the kidneys are not associated with CLL.

A client asks the nurse why he is taking allopurinol. The client states, "I don't have gout.

My grandpa took this for his gout." The best response would be:

• We just don't want you to hurt in your toes if you don't have to.
• I will check with the doctor. Maybe it is a mistake
• When the chemo kills the leukemia cells, this causes your uric acid levels to rise.

Allopurinol will help lower uric acid levels.

• Everyone who is on chemo will develop gout. We give it prophylactically to prevent

you from getting the severe pain associated with gout. - Correct Answer: C. When the chemo kills the leukemia cells, this causes your uric acid levels to rise. Allopurinol will help lower uric acid levels

A client asks, "What do these basophils and mast cells do in the body?" The nurse

responds:

• Are involved when you have an allergic reaction
• Stiffen your cell membranes so bacteria cannot enter
• Help your body to eliminate parasitic infections
• Help your body produce immune responses - Correct Answer: A. Are involved when

you have an allergic reaction - The basophil is related to the connective tissue mast cell that contains similar granules. Both the basophils and mast cells are thought to be involved in allergic and hypersensitivity reactions. These cells do not stiffen the cell membranes. In parasitic infections, the eosinophils use surface markers to attach themselves to the parasite and then release hydrolytic enzymes that kill it. Lymphocytes

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