The nurse notes pallor of the skin and nail beds in a newly admitted patient. The nurse should ensure that which laboratory test has been ordered.

Hematology Review

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Specialty
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University
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Easy

Robin Kern
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7 questions
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1.
MULTIPLE SELECT QUESTION
45 sec • 1 pt
White blood cell count
Neutrophil count
Red blood cell count
Hemoglobin
Platelet count
Answer explanation
Signs and symptoms of anemia include:
▹Tachycardia
▹Palpitations
▹Shortness of breath
▹Fatigue
▹Dizziness or lightheadedness
▹Headache
▹Weakness
▹Pallor or jaundice
▹Cold hands and feet
▹Confusion or disorientation
The nurse should ensure a red blood cell count and hemoglobin level are drawn.
2.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
The information in the table below is about a patient who has just arrived in
the emergency department. Which value is most urgent for the nurse to communicate to the health care provider?
White blood cells
Heart rate
Abdominal pain
Platelet count
Answer explanation
The platelet count is below the 20,000 level where spontaneous, life-threatening bleeding can occur. This is the most concerning value for the nurse. The abdominal pain could indicate a bleed and should be reported but not before the platelet count. The heart rate and white blood cell count are within the normal ranges. Information can be found on page 732 in the textbook or slide 74 in the Power point.
3.
MULTIPLE SELECT QUESTION
45 sec • 1 pt
A 55-year-old male presents to the primary care clinic complaining of fatigue, weakness, and tingling sensations in his fingers and toes. Upon further examination, the nurse notes that the patient has a pale complexion and a slightly swollen, red tongue. The patient has a history of pernicious anemia. Which of the following interventions is most appropriate for this patient? Select all that apply.
Answer explanation
Clients with cobalamin (B12) deficiency suffer from neurological symptoms in addition to the symptoms of anemia. These clients are a fall risk. They should have the bed in lowest position, call light in reach and non-skid footwear near the bedside for ambulation. Placing the client close to the nurse's station helps with safety. B12 cannot be taken orally so they will have to take administer the vitamin as an IM injection. Folic acid will not help the client's symptoms. See page 722 in the text for these interventions.
4.
REORDER QUESTION
1 min • 1 pt
A 55-year-old patient is scheduled to receive a blood transfusion due to severe anemia. The nurse is preparing to administer packed red blood cells (PRBCs). Which of the following actions is the nurse's before initiating the transfusion? Reorder the following actions 1 being the first action to 5 being the last action. Think about the priority here as well.
Assess the vital signs includeing temperature
Prepare Y-set tubing with Normal saline
Verify the patient's blood type with a second nurse
Obtain consent form
Hang the blood.
Answer explanation
Blood administration requires a consent form in most facilities. You should obtain baseline vital signs including temperature prior to starting the transfusion. Prepare the Y-set with normal saline as this is the only fluid you can hang with blood. Verify the blood type with a second nurse as a safety check prior to hanging blood. All information must match to hang the blood. The final step is to hang the blood. Review the information on slides 80 to 85 and on pages 757-759 in the text.
5.
MULTIPLE SELECT QUESTION
45 sec • 1 pt
A 20-year-old female comes to the ED after a trip to Colorado. She is in severe pain in her chest and abdomen. She is short of breath and her O2 sat is 86%. Vital signs show P-110, R- 28. She has crackles in her lungs What are your priority nursing interventions for this patient?
Administer O2 therapy
Start an IV for fluid administration
Assess respiratory status for changes
Administer pain medication
Incentive spirometry every hour
Answer explanation
The client is experiencing manifestations of sickle cell crisis. The priority nursing actions are to provide O2, start IV for fluid administration, assess respiratory status, encourage incentive spirometry. and pain control. This information is found on page 726 in the text or on power point slide 57.
6.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
A 45-year-old male with a history of iron deficiency anemia has been receiving iron supplementation for the past three months as prescribed by the healthcare provider. The nurse is assessing the patient's response to treatment. Which of the following findings would indicate an improvement in the patient's condition?
Increased red cell count
Decreased serum iron levels
Worsening fatigue and pallor
Development of new GI symptoms
Answer explanation
The nurse should look at the RBC count to determine if the interventions are improving the iron deficiency. It should increase from the previous level with the iron supplement. A decrease in serum iron levels, worsening fatigue and pallor, or increased GI symptoms indicate worse condition for the client and should be addressed. See page 720 in the textbook for the information on this answer.
7.
MULTIPLE CHOICE QUESTION
30 sec • 1 pt
A 40-year-old female is brought to the emergency department after a motor vehicle accident. She is pale, diaphoretic, and tachycardic, with a blood pressure of 80/50 mm Hg. The healthcare provider suspects acute blood loss. What is the nurse's priority intervention in this situation?
Administer pain medication
Initiate IV access
Draw a complete blood count
Prepare blood for transfusion
Answer explanation
The client with acute blood loss from trauma needs an IV access first to provide a way to administer blood or fluids. The second action would be to prepare any ordered blood or fluid infusions.
You will obtain an CBC but this is not a priority with this patient. Administering pain medication to the patient could cause the BP to drop lower than the SBP 80.
The information for this question can be found on page 724 in the textbook or power point slide 48.
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