NCLEX Review Questions (Wagner) - Chapter (28)

Chapter 28: Alterations in RBC Function and Hemostasis NCLEX® Review This activity contains 10 questions. A patient diagnosed with aplastic anemia has a neutrophil count of 1000/mcL. Based upon this finding, the nurse would include monitoring for which potential complication as part of this patient's plan of care? Severe fatigue Intermittent epistaxis Petechiae and purpura Recurrent infections A patient who has sickle-cell anemia is being monitored for the development of acute chest syndrome. The nurse would include observation for which symptoms in the plan of care for this patient? Select all that apply. Cough Bradypnea Ischemic ECG changes Decreased SaO2 Fever A nurse is completing admission assessment of a patient who has been admitted for treatment of polycythemia vera. Which assessment finding would the nurse attribute to this diagnosis? Easily palpable spleen Dullness percussed in the left lower abdomen. Patient reports getting "light-headed" when standing from a sitting position. Hematocrit of 11.6 g/dL A nurse is preparing to administer heparin when the patient says, "I had a bad reaction to heparin once. I think they called it HIT." From this information the nurse is aware that the heparin to which the patient reacted was most likely of which form? It is impossible to tell from this information. Unfractionated Fractionated Low-molecular weight A patient with disseminated intravascular coagulation (DIC) is experiencing oozing from several partially healed intravenous insertion sites. The nurse plans care for this patient based on the awareness that this finding results from which coagulation problem? Elevated thrombin levels Consumptive thrombocytopenia Decreased plasmin function Altered tissue plasminogen activator A nurse is monitoring the vital signs of a patient hospitalized with acute hemorrhage. Which vital sign change would the nurse interpret as most significant? Change in blood pressure from 124/68 to 118/60 Change in temperature from 37.2°C to 37.6°C. Change in heart rate from 86 bpm to 96 bpm. Change in respirations from 18 breaths/min. to 16 breaths/min. A patient with idiopathic aplastic anemia complains of activity intolerance, inability to concentrate, and orthopnea. The patient heart rate is 106 beats/minute and respirations are 24-26 breaths/minute. Which underlying problem best explains these manifestations? Increased bone marrow activity Chronic infection Increased blood glucose Tissue hypoxia A patient who has had multiple admissions to the Emergency Department for sickle-cell anemia crises presents today in acute pain. Following the protocol established for the care of sickle-cell crisis, the nurse should immediately provide which intervention? Have the patient drink several glasses of water. Apply oxygen therapy 2-4 liters per minute. Administer one low-dose aspirin. Administer hydroxyurea. A patient on heparin therapy has developed an arterial occlusion in the right leg. The medical team suspects heparin-induced thrombocytopenia (HIT) and discontinues the heparin therapy. The nurse should teach the patient that the threat for thrombolytic problems will likely end at which time? Immediately after the heparin has been discontinued Not for several months Within a week of the time the heparin has been discontinued Not for at least 1-2 years. A nurse collects a urine sample from a patient admitted with possible hemolytic anemia. Which urinary assessment requires collaboration with the patient's health care provider? The urine smells like ammonia. The urine is slightly cloudy. The urine has a port-wine color. The urine is crystal clear and colorless.