Question Case StudyA.J. is a 63-year-old white woman who is brought to the emergency department by her husband. He came home from work and found his wife at home, weak and lying in bed after she returned from work. She says she has been slowly getting more and more “cold and tired” but “that is what happens when you continue to work at this age.” Her husband states that she has become more and more tired over the last couple of weeks and has been having difficulty working all day and even gets short of breathwhen doing simple errands. She also recently has a “bad cold and sinus infection” that only improved after two courses of antibiotics. A.J. also states, “I’ve noticed I’ve had a lot of bruising lately.”• What are the possible causes of A.J.’s weakness, pallor, and shortness of breath?A.J.’s physical examination findings: BP 100/70 (lying), 88/60 (standing); apical pulse 110 (lying), 124 (standing), but regular in rhythm. Respiratory rate 26, temperature 96.8 F, O2 saturation 90% on room air. No JVD. Weight 106 lbs. Height 5 ft 1 in. Skin pale and two ecchymosis on her arms and one on her left lower leg. A few scattered petechiae on both ankles. No jaundice noted. Conjunctivae are pale. Tongue smooth and shiny. Lungs clear but diminished breath sounds in the bases bilaterally. No visible bleeding. No enlarged lymph nodes, spleen, or liver noted. General weakness with dyspnea on exertion. No numbness or tingling or peripheral edema.• What physical assessment findings are of most concern to you? Why?• What diagnostic tests do you think might be ordered for A.J.? 1) Significant information obtained from the patient’s health history that relates to the hematologic system includes:a. Jaundiceb. Bladder surgeryc. Early menopaused. Multiple pregnancies2) If a lymph node is palpated, what is a normal finding?a. Hard, fixed nodesb. Firm, mobile nodesc. Enlarged, tender nodesd. Hard, nontender nodes3) Nursing care for a patient immediately after a bone marrow biopsy and aspiration includes: (Select all that applya. Administering analgesics as necessaryb. Preparing to administer a blood transfusionc. Instructing on need to lie still with a sterile pressure dressing intactd. Monitoring vital signse. Assessing the site for bleedingf. Instructing the patient on the need for post-procedure antibiotics4) In a severely anemic patient, the nurse would expect to find:a. Dyspnea and tachycardiab. Cyanosis and pulmonary edemac. Cardiomegaly and pulmonary fibrosisd. Ventricular dysrhythmias and wheezing5) A complication of the hyperviscosity of polycythemia is:a. Cardiomyopathyb. Pulmonary edemac. Thrombosisd. Disseminated intravascular coagulation (DIC)6) Priority nursing actions when caring for a hospitalized patient with new-onset temperature of 102.2 F and severe neutropenia include: (Select all that apply)a. Administering prescribed antibiotics STATb. Drawing blood culturesc. Monitoring the patient’s vital signs for symptoms of septic shockd. Reporting vital signs to the physician immediatelye. Administering a transfusion of WBCs7) DIC is a disorder in which:a. The coagulation pathway is genetically altered, leading to thrombus formation in all major blood vesselsb. An underlying disease depletes hemolytic factors in the blood, leading to diffuse thrombotic episodes and infarctsc. A disease process stimulates coagulation processes with resultant thrombosis, as well as depletion of clotting factors, leading to diffuse clotting and hemorrhaged. An inherited predisposition causes a deficiency of clotting factors that leads to overstimulation of coagulation processes in the vasculature8) A patient’s platelet count is 18,000. What is the most appropriate nursing intervention?a. Provide oral hygiene four times per dayb. Institute bleeding precautionsc. Order a high protein dietd. Request an order for oxygen9) A 28-year-old man is admitted with fatigue: discomfort; enlarged, painless cervical lymph nodes; and pruritis. A lymph node biopsy leads to the diagnosis of Hodgkin’s lymphoma. What are the abnormal cells noted by the pathologist in Hodgkin’s lymphoma called?a. Rodem-Lee cellsb. Bullus-Frendelenburg cellsc. Reed-Sternberg cellsd. Stevens-Jorgens cells10) Which statement by the patient with pernicious anemia would indicate that she understood the teaching?a. “I’ll be glad when I can stop taking the injections and take only oral medicine.”b. “I’ll have to take B12 shots for the rest of my life.”c. “After a while I’ll no longer need to take shots, just the pills.”d. “I was glad to hear that pills are available to treat me.”11) A patient is admitted with polycythemia vera. The patient’s Hgb value is 20g/dL. Which treatment will be ordered?a. Whole blood transfusionb. Platelet transfusionc. Therapeutic phlebotomyd. Vitamin B12 injections12) What nursing interventions are indicated for a patient during a sickle cell crisis? (Select all that apply)a. Frequent ambulationb. Apply antiembolism hosec. Restrict sodium intaked. Increase oral fluid intakee. Administer opioid analgesics as needed Health Science Science Nursing NUR 519 Share QuestionEmailCopy link Comments (0)

Question Case StudyA.J. is a 63-year-old white woman who is brought to the emergency department by her husband. He came home from work and found his wife at home, weak and lying in bed after she returned from work. She says she has been slowly getting more and more “cold and tired” but “that is what happens when you continue to work at this age.” Her husband states that she has become more and more tired over the last couple of weeks and has been having difficulty working all day and even gets short of breathwhen doing simple errands. She also recently has a “bad cold and sinus infection” that only improved after two courses of antibiotics. A.J. also states, “I’ve noticed I’ve had a lot of bruising lately.”• What are the possible causes of A.J.’s weakness, pallor, and shortness of breath?A.J.’s physical examination findings: BP 100/70 (lying), 88/60 (standing); apical pulse 110 (lying), 124 (standing), but regular in rhythm. Respiratory rate 26, temperature 96.8 F, O2 saturation 90% on room air. No JVD. Weight 106 lbs. Height 5 ft 1 in. Skin pale and two ecchymosis on her arms and one on her left lower leg. A few scattered petechiae on both ankles. No jaundice noted. Conjunctivae are pale. Tongue smooth and shiny. Lungs clear but diminished breath sounds in the bases bilaterally. No visible bleeding. No enlarged lymph nodes, spleen, or liver noted. General weakness with dyspnea on exertion. No numbness or tingling or peripheral edema.• What physical assessment findings are of most concern to you? Why?• What diagnostic tests do you think might be ordered for A.J.? 1) Significant information obtained from the patient’s health history that relates to the hematologic system includes:a. Jaundiceb. Bladder surgeryc. Early menopaused. Multiple pregnancies2) If a lymph node is palpated, what is a normal finding?a. Hard, fixed nodesb. Firm, mobile nodesc. Enlarged, tender nodesd. Hard, nontender nodes3) Nursing care for a patient immediately after a bone marrow biopsy and aspiration includes: (Select all that applya. Administering analgesics as necessaryb. Preparing to administer a blood transfusionc. Instructing on need to lie still with a sterile pressure dressing intactd. Monitoring vital signse. Assessing the site for bleedingf. Instructing the patient on the need for post-procedure antibiotics4) In a severely anemic patient, the nurse would expect to find:a. Dyspnea and tachycardiab. Cyanosis and pulmonary edemac. Cardiomegaly and pulmonary fibrosisd. Ventricular dysrhythmias and wheezing5) A complication of the hyperviscosity of polycythemia is:a. Cardiomyopathyb. Pulmonary edemac. Thrombosisd. Disseminated intravascular coagulation (DIC)6) Priority nursing actions when caring for a hospitalized patient with new-onset temperature of 102.2 F and severe neutropenia include: (Select all that apply)a. Administering prescribed antibiotics STATb. Drawing blood culturesc. Monitoring the patient’s vital signs for symptoms of septic shockd. Reporting vital signs to the physician immediatelye. Administering a transfusion of WBCs7) DIC is a disorder in which:a. The coagulation pathway is genetically altered, leading to thrombus formation in all major blood vesselsb. An underlying disease depletes hemolytic factors in the blood, leading to diffuse thrombotic episodes and infarctsc. A disease process stimulates coagulation processes with resultant thrombosis, as well as depletion of clotting factors, leading to diffuse clotting and hemorrhaged. An inherited predisposition causes a deficiency of clotting factors that leads to overstimulation of coagulation processes in the vasculature8) A patient’s platelet count is 18,000. What is the most appropriate nursing intervention?a. Provide oral hygiene four times per dayb. Institute bleeding precautionsc. Order a high protein dietd. Request an order for oxygen9) A 28-year-old man is admitted with fatigue: discomfort; enlarged, painless cervical lymph nodes; and pruritis. A lymph node biopsy leads to the diagnosis of Hodgkin’s lymphoma. What are the abnormal cells noted by the pathologist in Hodgkin’s lymphoma called?a. Rodem-Lee cellsb. Bullus-Frendelenburg cellsc. Reed-Sternberg cellsd. Stevens-Jorgens cells10) Which statement by the patient with pernicious anemia would indicate that she understood the teaching?a. “I’ll be glad when I can stop taking the injections and take only oral medicine.”b. “I’ll have to take B12 shots for the rest of my life.”c. “After a while I’ll no longer need to take shots, just the pills.”d. “I was glad to hear that pills are available to treat me.”11) A patient is admitted with polycythemia vera. The patient’s Hgb value is 20g/dL. Which treatment will be ordered?a. Whole blood transfusionb. Platelet transfusionc. Therapeutic phlebotomyd. Vitamin B12 injections12) What nursing interventions are indicated for a patient during a sickle cell crisis? (Select all that apply)a. Frequent ambulationb. Apply antiembolism hosec. Restrict sodium intaked. Increase oral fluid intakee. Administer opioid analgesics as needed Health Science Science Nursing NUR 519 Share QuestionEmailCopy link Comments (0)