Chapter 16: Care of Patients with Hematologic Disorders deWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition

MULTIPLE CHOICE 1. The nurse is caring for a 79-year-old male who underwent a gastrectomy 1 month ago. The nurse recognizes that this patient is at the greatest risk for which type of anemia? a. Aplastic anemia b. Pernicious anemia c. Iron deficiency anemia d. Nutritional anemia ANS: B Pernicious anemia may result from the lack of the intrinsic factor found in the stomach lining. Without the intrinsic factor, the body is unable to absorb vitamin B12. Aplastic anemia is related to bone marrow suppression. Iron deficiency anemia is often related to a deficiency of iron in the diet. PTS:1 DIF: Cognitive Level: Clinical Application REF: 345, Cues OBJ:1 (theory) TOP: Pernicious Anemia: Etiology KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 2. Iron deficiency anemia impacts adequate production of which component? a. Plasma b. White blood cells (WBCs) c. Hemoglobin d. Antibodies ANS: C Deficiency of iron causes reduced production of hemoglobin. PTS:1 DIF: Cognitive Level: Comprehension REF: 345 OBJ:1 (theory) TOP: Iron Deficiency Anemia KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. The nurse is caring for a patient with anemia who has a past medical history of diabetes, hypertension, chronic kidneydisease, and acid reflux. The nurse is aware the patient’s anemia is likely related to which condition? a. Diabetes b. Hypertension c. Chronic kidney disease d. Acid reflux ANS: C The kidney makes most of the body’s erythropoietin stimulating factor, which then prompts the liver to release erythropoietin for erythrocyte production. Damaged kidneys produce decreased amounts of erythropoietin, which ultimately leads to decreased red blood cell production and anemia. Diabetes, hypertension, and acid reflux do not cause anemia. PTS:1 DIF: Cognitive Level: Application REF:344 OBJ:1 (theory) TOP: Causes of Anemia KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. Which descriptions accurately characterize the appearance of red blood cells (RBCs) in iron deficiency anemia? a. Normochromic and normocytic b. Hypochromic and microcytic c. Hyperchromic and macrocytic d. Normochromic and microcytic