ATI LPN
Test Bank for Medical Surgical Nursing: Concepts for Interprofessional Collaborative Care 10th Edition
Chapter 40 : Care of Patients with Hematologic Problems Questions
Question 1 of 5
A nurse is preparing to administer a blood transfusion to an older adult. Understanding age-related changes, what alterations to the usual protocol are necessary for the nurse to implement? (Select all that apply.)
Correct Answer: A,B
Rationale: Older adults require frequent vital sign monitoring (every 15 minutes) due to subtle signs of transfusion reactions and holding other IV fluids to prevent fluid overload. Premedication and prolonged transfusion times are not standard alterations.
Question 2 of 5
A client has heparin-induced thrombocytopenia (HIT). The student nurse asks how this is treated. About what drugs does the nurse instructor teach? (Select all that apply.)
Correct Answer: A,B,D
Rationale: Argatroban, bivalirudin, and lepirudin are direct thrombin inhibitors used to treat HIT. Clopidogrel is an antiplatelet agent, and methylprednisolone is a steroid, neither used for HIT.
Question 3 of 5
A client has received a bone marrow transplant and is waiting for engraftment. What actions by the nurse are most appropriate? (Select all that apply.)
Correct Answer: C,D,E
Rationale: Clients awaiting engraftment are immunocompromised, requiring protective precautions like wearing a mask, strict hand hygiene for visitors, and avoiding fresh flowers or plants due to infection risks. Limiting protein is not beneficial, and completely barring visitors is overly restrictive.
Question 4 of 5
A nurse caring for a client with sickle cell disease (SCD) reviews the clients laboratory work. Which finding should the nurse reports to the provider?
Correct Answer: A
Rationale: An elevated creatinine indicates kidney damage, which occurs in SCD. A hematocrit level of 30.9% is an expected finding, as is a slightly elevated white blood cell count. A sodium level of 147 mEq/L, although slightly high, is not concerning.
Question 5 of 5
A client hospitalized with sickle cell crisis frequently asks for opioid pain medications, often shortly after receiving a dose. The nurses on the unit believe the client is drug seeking. When the client requests pain medications, what action by the nurse is best?
Correct Answer: A
Rationale: Clients with sickle cell crisis often have severe pain that is managed with up to 48 hours of IV opioid analgesics. Even if the client is addicted and drug seeking, he or she is still in extreme pain. If the client can receive another dose of medication, the nurse should provide it. The other options are judgmental and do not address the client's pain. Giving placebos is unethical.