ATI LPN
Lewis's Medical Surgical Nursing in Canada, 5th Edition
Chapter 33 Questions
Question 1 of 5
The nurse is caring for a patient with myelodysplastic syndrome who has 20% blasts in marrow and the health care provider has prescribed high-intensity treatment. Which of the following treatments should the nurse prepare the patient to receive?
Correct Answer: C
Rationale: Low-risk patients (<5% blasts in marrow) can often be treated with transfusions, antibiotics, antifungals, EPO, and hematopoietic growth factors. High-risk patients (<5% blasts in marrow) may be treated with single-agent chemotherapy (e.g., hydroxyurea) or intensive chemotherapy as in AML.
Question 2 of 5
Which of the following laboratory tests should the nurse use to determine whether the prescribed filgrastim is effective in the treatment of a patient who is receiving chemotherapy for acute lymphocytic leukemia?
Correct Answer: D
Rationale: Filgrastim increases the neutrophil count and function in neutropenic patients. Although total lymphocyte, platelet, and reticulocyte counts also are important to monitor in this patient, the absolute neutrophil count is used to evaluate the effects of filgrastim.
Question 3 of 5
The nurse is caring for a patient with polycythemia vera. Which of the following actions should the nurse implement during treatment?
Correct Answer: D
Rationale: Monitoring hydration status is essential in polycythemia vera to prevent thrombosis due to increased blood viscosity. Aspirin therapy is used to decrease risk for thrombosis. The patient should be encouraged to ambulate to prevent deep vein thrombosis (DVT). Iron is contraindicated in patients with polycythemia vera.
Question 4 of 5
The nurse is teaching a patient with a new diagnosis of pernicious anemia about the disorder. Which of the following patient statements indicates that the teaching has been effective?
Correct Answer: D
Rationale: Since pernicious anemia prevents the absorption of vitamin B12, this patient requires injections or intranasal administration of cobalamin. Alcohol use does not cause cobalamin deficiency. Proton pump inhibitors decrease the absorption of vitamin B12. Eating more foods rich in vitamin B12 is not helpful because the lack of intrinsic factor prevents absorption of the vitamin.
Question 5 of 5
The nurse is caring for a patient with anemia who is experiencing increased fatigue and occasional palpitations at rest. Which of the following laboratory findings should the nurse expect?
Correct Answer: C
Rationale: The patient's clinical manifestations indicate moderate anemia, which is consistent with an Hb of 60-100 g/L. The other values are all within the range of normal.