Chapter 33: Management of Patients With Nonmalignant Hematologic Disorders - Nurselytic

Questions 40

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Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017)

Chapter 33 : Management of Patients With Nonmalignant Hematologic Disorders Questions

Question 1 of 5

A patient's absolute neutrophil count (ANC) is 440/mm3. But the nurse's assessment reveals no apparent signs or symptoms of infection. What action should the nurse prioritize when providing care for this patient?

Correct Answer: A

Rationale: Providing care for a patient with neutropenia requires that the nurse adhere closely to standard precautions and infection control procedures. Hand hygiene is central to such efforts. Prophylactic antibiotics are rarely used and it is not possible to provide a sterile environment for care. Nutrition is highly beneficial, but hand hygiene is the central aspect of care.

Question 2 of 5

A nurse is providing discharge education to a patient who has recently been diagnosed with a bleeding disorder. What topic should the nurse prioritize when teaching this patient?

Correct Answer: B

Rationale: Patients with bleeding disorders need to understand the importance of avoiding activities that increase the risk of bleeding, such as contact sports. Immunizations involve injections and may be contraindicated for some patients. Patients with bleeding disorders do not need to normally avoid crowds. Foods high in vitamin K may be beneficial, not detrimental.

Question 3 of 5

A nurse is a long-term care facility is admitting a new resident who has a bleeding disorder. When planning this resident's care, the nurse should include which of the following?

Correct Answer: C

Rationale:
To prevent bleeding episodes, the nurse should ensure that an older adult with a bleeding disorder does not suffer a fall. Activity limitation is not necessarily required, however. A private room is not necessary and there is no reason to increase fiber intake.

Question 4 of 5

The results of a patient's most recent blood work and physical assessment are suggestive of immune thrombocytopenic purpura (ITP). This patient should undergo testing for which of the following potential causes?

Correct Answer: A,C

Rationale: Viral illnesses have the potential to cause ITP. Renal failure, malignancies, and gall bladder inflammation are not typical causes of ITP.

Question 5 of 5

A patient with a recent diagnosis of ITP has asked the nurse why the care team has not chosen to administer platelets, stating, â??I have low platelets, so why not give me a transfusion of exactly what I'm missing?â?? How should the nurse best respond?

Correct Answer: A

Rationale: Despite extremely low platelet counts, platelet transfusions are usually avoided. Transfusions tend to be ineffective not because the platelets are nonfunctional but because the patient's antiplatelet antibodies bind with the transfused platelets, causing them to be destroyed. Matching the patient's blood type is not usually necessary for a platelet transfusion. Platelet transfusions do not exacerbate low platelet production.

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