ATI RN
Hematology Oncology Question Bank Questions
Question 1 of 5
Nursing care of patients with pernicious anemia during the acute phase should include
Correct Answer: B
Rationale: In the acute phase of pernicious anemia, nursing care should focus on addressing the symptoms and complications of the condition. Bed rest with range-of-motion exercises is the correct option because it helps prevent complications like deep vein thrombosis and promotes circulation without exerting excessive energy that the patient may lack due to anemia. Option A is incorrect as placing limits on food, fluids, and activity can worsen the patient's condition by restricting essential nutrients and preventing necessary movement. Option C, preparation for blood transfusion, is incorrect because pernicious anemia is primarily due to vitamin B12 deficiency, not necessarily a lack of blood that would require a transfusion. Option D, providing a heating pad, is incorrect as warmth does not address the underlying cause or symptoms of pernicious anemia. Educationally, understanding the rationale behind the correct answer emphasizes the importance of tailored nursing care for patients with pernicious anemia. It highlights the need for interventions that address the specific needs and symptoms of the condition to promote optimal patient outcomes. This question also reinforces the significance of knowledge in providing evidence-based care to individuals with hematologic disorders.
Question 2 of 5
Hemarthrosis is a common problem for individuals with hemophilia. The family can be taught to minimize this problem by
Correct Answer: D
Rationale: The correct answer is option D) resting the joint when painful or swollen. Hemarthrosis, which is bleeding into joint spaces, is a common issue in individuals with hemophilia due to impaired blood clotting. Resting the joint when painful or swollen helps prevent further damage and allows the body to naturally reabsorb the blood, reducing pain and inflammation. Option A) restricting the individual's activity is incorrect because complete restriction may lead to joint stiffness and muscle weakness without addressing the immediate need for joint rest. Option B) applying heat at the first indication of pain or swelling is incorrect as heat can exacerbate bleeding by dilating blood vessels, increasing blood flow to the joint, and worsening the condition. Option C) giving frequent intramuscular injections of analgesics is incorrect as it does not address the underlying cause of hemarthrosis and can potentially lead to further bleeding complications. In an educational context, teaching families about the importance of recognizing early signs of hemarthrosis and the appropriate management, such as resting the joint, can help prevent complications and improve the quality of life for individuals with hemophilia. Encouraging open communication with healthcare providers for timely interventions is also crucial in managing hemarthrosis effectively.
Question 3 of 5
In the process of admitting Mr. Johnson, the nurse observes multiple bruising, especially on the hands and forearms. These bruises are referred to as
Correct Answer: D
Rationale: In the scenario presented, the correct answer is D) ecchymoses. Ecchymoses are large, non-elevated bruises caused by the leakage of blood into the skin due to damaged blood vessels. This is a common manifestation in conditions such as thrombocytopenia or coagulopathies, where there is a decreased ability to clot blood, leading to easy bruising. Option A) erythropoiesis refers to the process of red blood cell production and is not directly related to bruising. Option B) leukoplakia is a condition affecting the mucous membranes, characterized by white patches, and is not associated with bruising. Option C) megakaryocytic hyperplasia is an increase in the production of platelet precursor cells, which would actually lead to increased platelet count and reduced bruising tendency. In an educational context, understanding the clinical significance of different types of bruising can help healthcare providers in diagnosing underlying conditions such as hematological disorders or coagulopathies. Recognizing ecchymoses can prompt further investigations to determine the cause and initiate appropriate management, highlighting the importance of keen observation and clinical assessment skills in patient care.
Question 4 of 5
A protocol of chlorambucil (Leukeran) and prednisone is prescribed for Mr. Johnson. The most serious delayed toxic symptom of antileukemic chemotherapy is
Correct Answer: A
Rationale: The correct answer is A) bone marrow depression. In the context of antileukemic chemotherapy like chlorambucil and prednisone, the most serious delayed toxic symptom is bone marrow depression. This is because these drugs target rapidly dividing cells, which include not only cancer cells but also normal cells in the bone marrow responsible for producing blood cells. Option B) loss of hair and libido is a common side effect of chemotherapy, but it is not the most serious delayed toxic symptom in this case. Option C) periorbital edema is not typically associated with chlorambucil and prednisone chemotherapy. Option D) orange urine may be a side effect of certain medications but is not the most serious delayed toxic symptom of antileukemic chemotherapy. In an educational context, understanding the potential toxicities and side effects of chemotherapy is crucial for healthcare professionals managing patients with hematologic malignancies. Recognizing the most serious toxicities can help in monitoring patients for potential complications and providing timely interventions to minimize risks and improve outcomes.
Question 5 of 5
Mr. D., who has suffered pelvic and crushing chest injuries, complains of a nose bleed and large bruises on his arms and legs. Laboratory data indicate prolonged prothrombin time, low platelet count, and incoagulable blood. A diagnosis of disseminated intravascular coagulation (DIC) is made and Mr. D. should be prepared for
Correct Answer: B
Rationale: In the case of Mr. D. presenting with DIC due to pelvic and chest injuries, the correct preparation is intravenous heparin administration. DIC is characterized by widespread activation of coagulation pathways, leading to both thrombosis and hemorrhage. Heparin, an anticoagulant, helps prevent further clot formation in DIC by inhibiting clotting factors. Option A, administration of furosemide, is incorrect as it is a diuretic that does not address the underlying coagulation abnormalities in DIC. Option C, thoracentesis, is a procedure to remove fluid from the pleural space and is not directly related to managing DIC. Option D, gastroscopy, is a procedure to visualize the upper gastrointestinal tract and is not the appropriate intervention for DIC. Educationally, understanding the pathophysiology of DIC and the role of heparin in managing this condition is crucial for healthcare professionals, especially those in hematology/oncology. This knowledge helps in timely and appropriate management of patients like Mr. D. to improve outcomes and prevent further complications associated with DIC.