Question 1 of 9
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Which clinical finding indicates that the results of the patient’s prothrombin time (PT) need to be reviewed?
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- Difficulty concentrating on simple tasksDifficulty concentrating is associated with low red blood cell count.
- Correct
- Bleeding of the gums while brushing the teethBleeding gums indicate a possible clotting disorder, and a PT test determines the time it takes for the blood to clot.
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- Temperature of 101.8°F (38.8°C)An elevated temperature would prompt the nurse to look at the white blood cell counts.
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- Physical fatigue while walking to the bathroomFatigue is associated with low red blood cell count.
Question 2 of 9
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Which laboratory result would the nurse seek out for a patient who has noticeable small, red, pinpoint lesions on the chest, neck, and face and who readily develops ecchymoses after bumping arm?
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- Red blood cell countPolycythemia is an excessive number of red blood cells; the patient typically has a very ruddy complexion.
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- Platelet countPetechiae appear as small, red, pinpoint lesions. This abnormal finding results from bursting of small capillaries, which can be caused by pressure. Petechiae can manifest in thrombocytopenic purpura, which is associated with a low platelet count. Ecchymoses or bruising also signals a potential clotting disorder.
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- Ferritin, serum levelSerum ferritin level would be evaluated if iron deficient anemia is suspected. Fatigue is one of the first symptoms of anemia. Pale mucous membranes, dizziness, or headache can also occur with anemia.
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- ABO blood typingABO blood typing is performed for patients who may need a blood transfusion to determine blood type.
Question 3 of 9
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Which instruction would the nurse give to unlicensed assistive personnel (UAP) about assisting a patient with hemarthrosis?
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- Assist the patient when standing up because of dizziness.Anemia is one hematologic disorder that could cause dizziness.
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- Allow extra time for the patient to move because of joint discomfort.Hemarthrosis (bleeding into the joints) is a common condition for the patient with hemophilia. This condition manifests with swelling and slight redness around the joints. The nurse would anticipate that the patient may move more slowly and with obvious discomfort, and UAP would be instructed in the care to manage these symptoms.
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- Practice hand hygiene and report any increase in body temperature.For white blood cell abnormalities, the UAP would be reminded to use basic infection control measures.
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- Help the patient to select foods that support blood cell formation.The dietitian or nurse would help the patient review and select foods for specific hematologic disorders.
Question 4 of 9
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What skin finding would the nurse expect in a patient experiencing hemolysis?
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- RuddinessA very ruddy skin color is typical when a patient has an excessive number of red blood cells (RBCs; polycythemia).
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- JaundiceJaundice, or a yellowing discoloration of the skin and sclera of the eyes, can occur as a result of hemolysis, or the destruction of RBCs.
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- CyanosisCyanosis is a bluish discoloration and occurs due to poor circulation or inadequate oxygenation.
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- PallorPallor may be a sign of anemia; however, it is not the most reliable sign.
Question 5 of 9
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The nurse caring for an African American patient will assess which location for cyanosis?
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- Around the mouth and lipsCyanosis can appear around the mouth and lips; however, it is not as easily visible as the gums or roof of the mouth in dark-skinned people.
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- Sclera of the eyeThe sclera of the eye are a good place to check for a yellowing discoloration.
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- Gums or roof of the mouthThe gums or the roof of the mouth are the best places to check for a bluish color in dark-skinned people.
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- Tips of fingers and toesThe tips of fingers and toes can display cyanosis; however, with dark-skinned people it is easier to assess on the gums or roof of the mouth.
Question 6 of 9
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Which substance may make the older adult more prone to bruising? Select all that apply. One, some, or all responses may be correct.
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- AcetaminophenAcetaminophen does not place the older adult at risk for bruising.
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- AspirinAspirin is a blood thinner and would place the older adult at risk for bruising.
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- Vitamin EVitamin E acts as an antiplatelet and would place the older adult at risk for bruising.
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- Vitamin AVitamin A will not place the older adult as risk for bruising.
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- Ginkgo bilobaGinkgo biloba slows blood clotting and can place the older adult at risk for bruising.
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- Omega 3 fatty acidsOmega 3s can increase bleeding and place the older adult at risk for bruising.
Question 7 of 9
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Which assessment finding might the nurse anticipate in a patient who suffers from a blood-related disorder? Select all that apply. One, some, or all responses may be correct.
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- Black, tarry stoolsBlack, tarry stools may indicate gastrointestinal bleed and could be an assessment finding.
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- Difficulty chewingDifficulty chewing or eating may occur as a result of alterations in the mucous membranes.
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- NauseaNausea can be caused by bleeding ulcers and could be an assessment finding.
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- Bleeding of the gumsBleeding of the gums may result from tooth brushing when the platelet counts are low and could be a potential assessment finding.
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- Coffee ground emesisCoffee ground emesis can indicate a gastrointestinal bleed and could be an assessment finding.
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- Stomach painStomach pain can be caused by bleeding ulcers.
Question 8 of 9
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What finding might the nurse suspect if a patient complains of a feeling of fullness on the left side of the upper abdomen?
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- HemarthrosisBleeding into the joints or hemarthrosis might present with swelling and slight redness of the joints, with potential discomfort.
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- Enlarged spleenAn enlarged spleen is often described as a feeling of fullness on the left side of the upper abdomen. Palpation should be gentle as to not rupture the spleen.
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- PolycythemiaPolycythemia is an excessive number of red blood cells (RBCs) and can cause a very ruddy complexion, with a red, florid appearance.
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- Lymph node enlargementSwollen nodes are often palpated under the arm, in the neck, and in the inguinal region, not the left side of the upper abdomen.
Question 9 of 9
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Which problem statement would be appropriate for a patient diagnosed with a hematologic disorder?
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- Potential for injury caused by osteoporosisPotential for injury is more likely related to a low platelet count caused by the risk for bleeding and development of hematomas.
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- Altered activity tolerance related to decreased plateletsAltered activity intolerance is more likely a result of decreased red blood cells (RBCs).
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- Potential for infection caused by decreased leukocytesPotential for infection because of decreased leukocytes is likely in a patient with a hematologic disorder.
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- Altered tissue integrity caused by trauma of the extremitiesAltered tissue integrity is most likely as a result of inflammation as a result of the hematologic disorder.
