Test Bank for Understanding Nutrition 16th Edition
Whitney | Complete Chapters 1 - 20 | Questions and
Answers with explanation | PDF format | Latest 2024
A nurse is caring for a patient who has sickle cell anemia and the nurses
assessment reveals the possibility of substance abuse. What is the nurses most
appropriate action?
A)Encourage the patient to rely on complementary and alternative therapies.
B)Encourage the patient to seek care from a single provider for pain relief.
C)Teach the patient to accept chronic pain as an inevitable aspect of the disease.
D)Limit the reporting of emergency department visits to the primary health care
provider. - ANSWER B - The patient should be encouraged to use a single primary
health care provider to address health care concerns. Emergency department visits
should be reported to the primary health care provider to achieve optimal
management of the disease. It would inappropriate to teach the patient to simply
accept his or her pain. Complementary therapies are usually insufficient to fully
address pain in sickle cell disease.
A patient newly diagnosed with thrombocytopenia is admitted to the medical unit.
After the admission assessment, the patient asks the nurse to explain the disease.
What should the nurse explain to this patient?
A)There could be an attack on the platelets by antibodies.
B)There could be decreased production of platelets.
C)There could be impaired communication between platelets.
D)There could be an autoimmune process causing platelet malfunction. - ANSWER
B - Thrombocytopenia can result from a decreased platelet production, increased
platelet destruction, or increased consumption of platelets. Impaired platelet
communication, antibodies, and autoimmune processes are not typical pathologies.
A critical care nurse is caring for a patient with autoimmune hemolytic anemia. The
patient is not responding to conservative treatments, and his condition is now
becoming life threatening. The nurse is aware that a treatment option in this case
may include what?
A)Hepatectomy
B)Vitamin K administration
C)Platelet transfusion
D)Splenectomy - ANSWER D - A splenectomy may be the course of treatment if
autoimmune hemolytic anemia does not respond to conservative treatment. Vitamin
K administration is treatment for vitamin K deficiency and does not resolve anemia.
Platelet transfusion may be the course of treatment for some bleeding disorders.
Hepatectomy would not help the patient.
A nurse is providing education to a patient with iron deficiency anemia who has been
prescribed iron supplements. What should the nurse include in health education?
A)Take the iron with dairy products to enhance absorption.
B)Increase the intake of vitamin E to enhance absorption.
,C)Iron will cause the stools to darken in color.
D)Limit foods high in fiber due to the risk for diarrhea. - ANSWER C - The nurse
will inform the patient that iron will cause the stools to become dark in color. Iron
should be taken on an empty stomach, as its absorption is affected by food,
especially dairy products. Patients should be instructed to increase their intake of
vitamin C to enhance iron absorption. Foods high in fiber should be consumed to
minimize problems with constipation, a common side effect associated with iron
therapy.
The nurse is assessing a new patient with complaints of overwhelming fatigue and a
sore tongue that is visibly smooth and beefy red. This patient is demonstrating signs
and symptoms associated with what form of what hematologic disorder?
A)Sickle cell anemia
B)Hemophilia
C)Megaloblastic anemia
D)Thrombocytopenia - ANSWER C - A red, smooth, sore tongue is a symptom
associated with megaloblastic anemia. Sickle cell disease, hemophilia, and
thrombocytopenia do not have symptoms involving the tongue.
A patient with renal failure has decreased erythropoietin production. Upon analysis of
the patients complete blood count, the nurse will expect which of the following
results?
A)An increased hemoglobin and decreased hematocrit
B)A decreased hemoglobin and hematocrit
C)A decreased mean corpuscular volume (MCV) and red cell distribution width
(RDW)
D)An increased MCV and RDW - ANSWER B - The decreased production of
erythropoietin will result in a decreased hemoglobin and hematocrit. The patient will
have normal MCV and RDW because the erythrocytes are normal in appearance.
A patient comes to the clinic complaining of fatigue and the health interview is
suggestive of pica. Laboratory findings reveal a low serum iron level and a low
ferritin level. With what would the nurse suspect that the patient will be diagnosed?
A)Iron deficiency anemia
B)Pernicious anemia
C)Sickle cell anemia
D)Hemolytic anemia - ANSWER A - A low serum iron level, a low ferritin level, and
symptoms of pica are associated with iron deficiency anemia. TIBC may also be
elevated. None of the other anemias are associated with pica.
A patient comes into the clinic complaining of fatigue. Blood work shows an
increased bilirubin concentration and an increased reticulocyte count. What would
the nurse suspect the patient has?
A)A hypoproliferative anemia
B)A leukemia
C)Thrombocytopenia
D)A hemolytic anemia - ANSWER D - In hemolytic anemias, premature destruction
of erythrocytes results in the liberation of hemoglobin from the erythrocytes into the
plasma; the released hemoglobin is converted in large part to bilirubin, and therefore
the bilirubin concentration rises. The increased erythrocyte destruction leads to
,tissue hypoxia, which in turn stimulates erythropoietin production. This increased
production is reflected in an increased reticulocyte count as the bone marrow
responds to the loss of erythrocytes. Hypoproliferative anemias, leukemia, and
thrombocytopenia lack this pathology and presentation.
A nurse is caring for a patient with severe anemia. The patient is tachycardic and
complains of dizziness and exertional dyspnea. The nurse knows that in an effort to
deliver more blood to hypoxic tissue, the workload on the heart is increased. What
signs and symptoms might develop if this patient goes into heart failure?
A)Peripheral edema
B)Nausea and vomiting
C)Migraine
D)Fever - ANSWER A - Cardiac status should be carefully assessed in patients
with anemia. When the hemoglobin level is low, the heart attempts to compensate by
pumping faster and harder in an effort to deliver more blood to hypoxic tissue. This
increased cardiac workload can result in such symptoms as tachycardia,
palpitations, dyspnea, dizziness, orthopnea, and exertional dyspnea. Heart failure
may eventually develop, as evidenced by an enlarged heart (cardiomegaly) and liver
(hepatomegaly), and by peripheral edema. Nausea, migraine, and fever are not
associated with heart failure.
A patient is admitted to the hospital with pernicious anemia. The nurse should
prepare to administer which of the following medications?
A)Folic acid
B)Vitamin B12
C)Lactulose
D)Magnesium sulfate - ANSWER B - Pernicious anemia is characterized by
vitamin B12 deficiency. Magnesium sulfate, lactulose, and folic acid do not address
the pathology of this type of anemia.
A patients blood work reveals a platelet level of 17,000/mm3. When inspecting the
patients integumentary system, what finding would be most consistent with this
platelet level?
A)Dermatitis
B)Petechiae
C)Urticaria
D)Alopecia - ANSWER B - When the platelet count drops to less than
20,000/mm3, petechiae can appear. Low platelet levels do not normally result in
dermatitis, urticaria (hives), or alopecia (hair loss).
A nurse is admitting a patient with immune thrombocytopenic purpura to the unit. In
completing the admission assessment, the nurse must be alert for what medications
that potentially alter platelet function? Select all that apply.
A)Antihypertensives
B)Penicillins
C)Sulfa-containing medications
D)Aspirin-based drugs
E)NSAIDs - ANSWER C,D,E - The nurse must be alert for sulfa-containing
medications and others that alter platelet function (e.g., aspirin-based or other
NSAIDs). Antihypertensive drugs and the penicillins do not alter platelet function.
, A patient, 25 years of age, comes to the emergency department complaining of
excessive bleeding from a cut sustained when cleaning a knife. Blood work shows a
prolonged PT but a vitamin K deficiency is ruled out. When assessing the patient,
areas of ecchymosis are noted on other areas of the body. Which of the following is
the most plausible cause of the patients signs and symptoms?
A)Lymphoma
B)Leukemia
C)Hemophilia
D)Hepatic dysfunction - ANSWER D - Prolongation of the PT, unless it is caused
by vitamin K deficiency, may indicate severe hepatic dysfunction. The majority of
hemophiliacs are diagnosed as children. The scenario does not describe signs or
symptoms of lymphoma or leukemia.
A patient with a history of cirrhosis is admitted to the ICU with a diagnosis of
bleeding esophageal varices; an attempt to stop the bleeding has been only partially
successful. What would the critical care nurse expect the care team to order for this
patient?
A)Packed red blood cells (PRBCs)
B)Vitamin K
C)Oral anticoagulants
D)Heparin infusion - ANSWER A - Patients with liver dysfunction may have life-
threatening hemorrhage from peptic ulcers or esophageal varices. In these cases,
replacement with fresh frozen plasma, PRBCs, and platelets is usually required.
Vitamin K may be ordered once the bleeding is stopped, but that is not what is
needed to stop the bleeding of the varices. Anticoagulants would exacerbate the
patients bleeding.
The nurse on the pediatric unit is caring for a 10-year-old boy with a diagnosis of
hemophilia. The nurse knows that a priority nursing diagnosis for a patient with
hemophilia is what?
A)Hypothermia
B)Diarrhea
C)Ineffective coping
D)Imbalanced nutrition: Less than body requirements - ANSWER C - Most patients
with hemophilia are diagnosed as children. They often require assistance in coping
with the condition because it is chronic, places restrictions on their lives, and is an
inherited disorder that can be passed to future generations. Children with hemophilia
are not at risk of hypothermia, diarrhea, or imbalanced nutrition.
A group of nurses are learning about the high incidence and prevalence of anemia
among different populations. Which of the following individuals is most likely to have
anemia?
A)A 50-year-old African-American woman who is going through menopause
B)An 81-year-old woman who has chronic heart failure
C)A 48-year-old man who travels extensively and has a high-stress job
D)A 13-year-old girl who has just experienced menarche - ANSWER B - The
incidence and prevalence of anemia are exceptionally high among older adults, and
the risk of anemia is compounded by the presence of heart disease. None of the
Whitney | Complete Chapters 1 - 20 | Questions and
Answers with explanation | PDF format | Latest 2024
A nurse is caring for a patient who has sickle cell anemia and the nurses
assessment reveals the possibility of substance abuse. What is the nurses most
appropriate action?
A)Encourage the patient to rely on complementary and alternative therapies.
B)Encourage the patient to seek care from a single provider for pain relief.
C)Teach the patient to accept chronic pain as an inevitable aspect of the disease.
D)Limit the reporting of emergency department visits to the primary health care
provider. - ANSWER B - The patient should be encouraged to use a single primary
health care provider to address health care concerns. Emergency department visits
should be reported to the primary health care provider to achieve optimal
management of the disease. It would inappropriate to teach the patient to simply
accept his or her pain. Complementary therapies are usually insufficient to fully
address pain in sickle cell disease.
A patient newly diagnosed with thrombocytopenia is admitted to the medical unit.
After the admission assessment, the patient asks the nurse to explain the disease.
What should the nurse explain to this patient?
A)There could be an attack on the platelets by antibodies.
B)There could be decreased production of platelets.
C)There could be impaired communication between platelets.
D)There could be an autoimmune process causing platelet malfunction. - ANSWER
B - Thrombocytopenia can result from a decreased platelet production, increased
platelet destruction, or increased consumption of platelets. Impaired platelet
communication, antibodies, and autoimmune processes are not typical pathologies.
A critical care nurse is caring for a patient with autoimmune hemolytic anemia. The
patient is not responding to conservative treatments, and his condition is now
becoming life threatening. The nurse is aware that a treatment option in this case
may include what?
A)Hepatectomy
B)Vitamin K administration
C)Platelet transfusion
D)Splenectomy - ANSWER D - A splenectomy may be the course of treatment if
autoimmune hemolytic anemia does not respond to conservative treatment. Vitamin
K administration is treatment for vitamin K deficiency and does not resolve anemia.
Platelet transfusion may be the course of treatment for some bleeding disorders.
Hepatectomy would not help the patient.
A nurse is providing education to a patient with iron deficiency anemia who has been
prescribed iron supplements. What should the nurse include in health education?
A)Take the iron with dairy products to enhance absorption.
B)Increase the intake of vitamin E to enhance absorption.
,C)Iron will cause the stools to darken in color.
D)Limit foods high in fiber due to the risk for diarrhea. - ANSWER C - The nurse
will inform the patient that iron will cause the stools to become dark in color. Iron
should be taken on an empty stomach, as its absorption is affected by food,
especially dairy products. Patients should be instructed to increase their intake of
vitamin C to enhance iron absorption. Foods high in fiber should be consumed to
minimize problems with constipation, a common side effect associated with iron
therapy.
The nurse is assessing a new patient with complaints of overwhelming fatigue and a
sore tongue that is visibly smooth and beefy red. This patient is demonstrating signs
and symptoms associated with what form of what hematologic disorder?
A)Sickle cell anemia
B)Hemophilia
C)Megaloblastic anemia
D)Thrombocytopenia - ANSWER C - A red, smooth, sore tongue is a symptom
associated with megaloblastic anemia. Sickle cell disease, hemophilia, and
thrombocytopenia do not have symptoms involving the tongue.
A patient with renal failure has decreased erythropoietin production. Upon analysis of
the patients complete blood count, the nurse will expect which of the following
results?
A)An increased hemoglobin and decreased hematocrit
B)A decreased hemoglobin and hematocrit
C)A decreased mean corpuscular volume (MCV) and red cell distribution width
(RDW)
D)An increased MCV and RDW - ANSWER B - The decreased production of
erythropoietin will result in a decreased hemoglobin and hematocrit. The patient will
have normal MCV and RDW because the erythrocytes are normal in appearance.
A patient comes to the clinic complaining of fatigue and the health interview is
suggestive of pica. Laboratory findings reveal a low serum iron level and a low
ferritin level. With what would the nurse suspect that the patient will be diagnosed?
A)Iron deficiency anemia
B)Pernicious anemia
C)Sickle cell anemia
D)Hemolytic anemia - ANSWER A - A low serum iron level, a low ferritin level, and
symptoms of pica are associated with iron deficiency anemia. TIBC may also be
elevated. None of the other anemias are associated with pica.
A patient comes into the clinic complaining of fatigue. Blood work shows an
increased bilirubin concentration and an increased reticulocyte count. What would
the nurse suspect the patient has?
A)A hypoproliferative anemia
B)A leukemia
C)Thrombocytopenia
D)A hemolytic anemia - ANSWER D - In hemolytic anemias, premature destruction
of erythrocytes results in the liberation of hemoglobin from the erythrocytes into the
plasma; the released hemoglobin is converted in large part to bilirubin, and therefore
the bilirubin concentration rises. The increased erythrocyte destruction leads to
,tissue hypoxia, which in turn stimulates erythropoietin production. This increased
production is reflected in an increased reticulocyte count as the bone marrow
responds to the loss of erythrocytes. Hypoproliferative anemias, leukemia, and
thrombocytopenia lack this pathology and presentation.
A nurse is caring for a patient with severe anemia. The patient is tachycardic and
complains of dizziness and exertional dyspnea. The nurse knows that in an effort to
deliver more blood to hypoxic tissue, the workload on the heart is increased. What
signs and symptoms might develop if this patient goes into heart failure?
A)Peripheral edema
B)Nausea and vomiting
C)Migraine
D)Fever - ANSWER A - Cardiac status should be carefully assessed in patients
with anemia. When the hemoglobin level is low, the heart attempts to compensate by
pumping faster and harder in an effort to deliver more blood to hypoxic tissue. This
increased cardiac workload can result in such symptoms as tachycardia,
palpitations, dyspnea, dizziness, orthopnea, and exertional dyspnea. Heart failure
may eventually develop, as evidenced by an enlarged heart (cardiomegaly) and liver
(hepatomegaly), and by peripheral edema. Nausea, migraine, and fever are not
associated with heart failure.
A patient is admitted to the hospital with pernicious anemia. The nurse should
prepare to administer which of the following medications?
A)Folic acid
B)Vitamin B12
C)Lactulose
D)Magnesium sulfate - ANSWER B - Pernicious anemia is characterized by
vitamin B12 deficiency. Magnesium sulfate, lactulose, and folic acid do not address
the pathology of this type of anemia.
A patients blood work reveals a platelet level of 17,000/mm3. When inspecting the
patients integumentary system, what finding would be most consistent with this
platelet level?
A)Dermatitis
B)Petechiae
C)Urticaria
D)Alopecia - ANSWER B - When the platelet count drops to less than
20,000/mm3, petechiae can appear. Low platelet levels do not normally result in
dermatitis, urticaria (hives), or alopecia (hair loss).
A nurse is admitting a patient with immune thrombocytopenic purpura to the unit. In
completing the admission assessment, the nurse must be alert for what medications
that potentially alter platelet function? Select all that apply.
A)Antihypertensives
B)Penicillins
C)Sulfa-containing medications
D)Aspirin-based drugs
E)NSAIDs - ANSWER C,D,E - The nurse must be alert for sulfa-containing
medications and others that alter platelet function (e.g., aspirin-based or other
NSAIDs). Antihypertensive drugs and the penicillins do not alter platelet function.
, A patient, 25 years of age, comes to the emergency department complaining of
excessive bleeding from a cut sustained when cleaning a knife. Blood work shows a
prolonged PT but a vitamin K deficiency is ruled out. When assessing the patient,
areas of ecchymosis are noted on other areas of the body. Which of the following is
the most plausible cause of the patients signs and symptoms?
A)Lymphoma
B)Leukemia
C)Hemophilia
D)Hepatic dysfunction - ANSWER D - Prolongation of the PT, unless it is caused
by vitamin K deficiency, may indicate severe hepatic dysfunction. The majority of
hemophiliacs are diagnosed as children. The scenario does not describe signs or
symptoms of lymphoma or leukemia.
A patient with a history of cirrhosis is admitted to the ICU with a diagnosis of
bleeding esophageal varices; an attempt to stop the bleeding has been only partially
successful. What would the critical care nurse expect the care team to order for this
patient?
A)Packed red blood cells (PRBCs)
B)Vitamin K
C)Oral anticoagulants
D)Heparin infusion - ANSWER A - Patients with liver dysfunction may have life-
threatening hemorrhage from peptic ulcers or esophageal varices. In these cases,
replacement with fresh frozen plasma, PRBCs, and platelets is usually required.
Vitamin K may be ordered once the bleeding is stopped, but that is not what is
needed to stop the bleeding of the varices. Anticoagulants would exacerbate the
patients bleeding.
The nurse on the pediatric unit is caring for a 10-year-old boy with a diagnosis of
hemophilia. The nurse knows that a priority nursing diagnosis for a patient with
hemophilia is what?
A)Hypothermia
B)Diarrhea
C)Ineffective coping
D)Imbalanced nutrition: Less than body requirements - ANSWER C - Most patients
with hemophilia are diagnosed as children. They often require assistance in coping
with the condition because it is chronic, places restrictions on their lives, and is an
inherited disorder that can be passed to future generations. Children with hemophilia
are not at risk of hypothermia, diarrhea, or imbalanced nutrition.
A group of nurses are learning about the high incidence and prevalence of anemia
among different populations. Which of the following individuals is most likely to have
anemia?
A)A 50-year-old African-American woman who is going through menopause
B)An 81-year-old woman who has chronic heart failure
C)A 48-year-old man who travels extensively and has a high-stress job
D)A 13-year-old girl who has just experienced menarche - ANSWER B - The
incidence and prevalence of anemia are exceptionally high among older adults, and
the risk of anemia is compounded by the presence of heart disease. None of the
