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97 Cards in this Set
- Front
- Back
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What is the primary site for hematopoiesis?
a) liver b) spleen c) bone marrow d) plasma |
c) bone marrow
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Myeloid stem cells differentiate into what three broad cell types?
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RBC, WBC and platelets
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How long does the process of forming new blood cells in response to low RBCs take?
a) 4 horus b) 1 day c) 2 days d) 5 days |
d) 5 days
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What is the normal concentration of iron in the blood?
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75-175 ug/dL
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Strict vegitarians are at risk for what vitamin deficiency?
a) Vitamin C b) Vitamin K c) Vitamin D d) Vitamin B |
d) Vitamin B, specificaly B12
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People who have had a partial or total gastrectomy may have limited amounts of ___, and therefore the absorption of vitamin B12 may be diminished.
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intrinsic factor
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A low number of ___ is sometimes called a "shift to the left" and indicates that more ____(immature/mature) WBC cells are present in the blood than normal.
a) stem cells, immature b) stem cells, mature c) band cells, immature d) band cell, mature |
c) band cells, immature
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A shift to the left of WBC may indicate:
a) bleeding b) iron deficiency c) sickel cell anemia d) infection |
d) infection
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Mature ___ are the principal cells of the immune system, producing antibodies and identifying other cells and organisms as "foreign".
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lymphocytes
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____ are responsible for delayed allergic reaction, rejection of foreign tissue (transplanted organs) and destruction of tumor clees, collectivily called cellular immunity.
a) Macrophages b) T lymphocytes c) Neutrophils d) Basophils |
b) T lymphocytes
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People with poor hepatic function may have low concentrations of ____, with a resultant decrease in osmotic pressure, and the development of ____.
a) intrinsic factor, dehydration b) intrinsic factor, fluid overload c) albumin, fluid dehydration d) albumin, edema |
d) albumin, edema
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The process of preventing blood loss from intact vessels and stopping bleeding from a severed vessels is termed:
a) hemostasis b) homeostases c) clotting potential d) hemophilia |
a) hemostasis
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Anemia frequently results from what deficiency?
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iron
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Anemia can be caused by a nutritional deficiency of what 2 non-iron components?
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folate and vitamin B12
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What should the nurse encourage the anemic patient to do?
a) exercise vigorously b) get frequent blood tests c) consume as much iron supplements as possible d) limit iron supplements unless they are getting dialysis |
b) get frequent blood tests
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What are the main components of a CBC?
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RBC, WBC and platelets counts as well as H & H
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A patients lab results show an increase in bilirubin. What might this indicate?
a) the pt is constipated b) the pt has increased WBC destruction c) the pt has increased RBC destruction d) the pt has increased platelet destruction |
c) the pt has increased RBC destruction
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True or False: A patient can have a gradual reduction in hemoglobin, as much as 50% without pronounced symptoms of incapacity.
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True
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Patients with what endocrine disorder may be completely asymptomatic with anemia.
a) hypothyroidism b) hyperthyroidism c) hypoparathyroidism c) hyperparathyroidism |
a) hypothyroidism
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Describe the tongue of a person with iron deficient anemia.
a) beefy red and sore b) smooth and red c) long and thin d) white and bumpy |
b) smooth and red
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Describe the tongue of the person with megaloblastic anemia.
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beefy, red and sore
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What unusual cravings might a person with iron deficiency have?
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ice, starch or dirt
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What should nursing interventions should the care of the anemic patient focus on?
a) rotating periods of activity with periods of rest b) finishing tiresome activities ASAP c) performing tiresome activities in the am d) allowing the nurse to perform as much care as possible to prevent fatigue |
a) rotating periods of activity with periods of rest
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What lifestyle change should be recommended for the anemic patient?
a) avoid organ meat b) avoid alcohol c) avoid NSAIDS d) avoid corticosteroids |
b) avoid alcohol- it interferes with the utilization of essential nutrients
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The should the nurse advise the patient receiving chronic blood transfusions?
a) increase intake of organ meat and iron containing food b) do not eat before receiving a blood transfusion c) you can only receive 2 blood transfusion per month before risking a transfusion reaction d) avoid iron supplements |
d) avoid iron supplements- these people are at risk for iron overload from their transfusions so further iron supplementation only increases the risk
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Why would the nurse recommend that the patient with anemia weight himself daily at home and keep a record of his weights?
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To assess for signs and symptoms of heat failure (a significant complication of anemia)
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A patient might experience paresthesias in their lower extremities, difficulty maintaining balance, and mild confusion is what type of anemia?
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Megaloblastic
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In addition to a smooth, sore tongue, what other signs and symptoms might the iron deficient patient experience?
a) tingling toes, pulsating nails b) brittle nails and angular cheilosis c) tingling toes and angular cheilosis d) brittle nails and flushing of the face and hands |
b) brittle nails and angular cheilosis(ulceration of the corner of the mouth)
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Currently the most reliable and clinically useful lab findings in evaluation iron deficiency anemia are:
a) hemoglobin and hematocrit b) hematocrit and intrinsic factor c) hemoglobin and ferritin d) ferritin and albumin |
c) hemoglobin and ferritin
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You know further teaching is necessary when the patient says:
a) anemia can be corrected in a few months b) I should increase my intake of vitamin C c) my iron store replenishment will take place over 6-10 weeks d) IV iron may be needed |
c) my iron store replenishment will take place over 6-10 weeks: It can take as 6-12 months, so iron supplementation needs to continue long after blood levels return to normal
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What are some food sources high in iron?
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organ meats, meat, beans, leafy green veggies, raisins, and molasses
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What disease can result in anemia?
a) heart failure b) renal disease c) respiratory failure d) gout |
b) renal disease- as renal function decreases, erythropoietin, which is produced by the kidneys also decreases
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Which of the following patients would be at most risk for anemia
a) Erica, a 24 year old who had a baby 2 months ago b) Jessica, a 59 year old postmenopausal woman c) Sheila, a 21 year old on dialysis d) Marianne, a 20 year old who takes vitamins that don't contain iron. |
c) Sheila, a 21 year old on dialysis- patients under gong long-term hemodialysis lose blood into the dialyzer and therefore may become iron deficient
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What two things diminish iron supplement absorption?
a) milk and beans b) antacids and potassium c) milk and antacids d) potassium and beans |
c) milk and antacids
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What type of food is folate found in?
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green vegetables and liver
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Patients with pernicious anemia have a higher incidence of ___, so they should have endoscopies at regular intervals for screening
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gastric cancer
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Megaloblastic anemia is caused by deficiencies of what 2 things?
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vitamin B12 or folic acid
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What test would determine if megaloblastic anemia is caused by GI malabsorption of vitamin B12?
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Schilling test
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You know the patient with pernicious anemia needs further teaching when he says:
a) I will need to take vitamin supplements during periods of low plasma B12 b) I will have regular blood lab tests c) I will monitor my children for pernicious anemia d) I will keep follow up appointments |
a) I will need to take vitamin supplements during periods of low plasma B12:To prevent recurrence of pernicious anemia, vitamin B12 therapy must be continued FOR LIFE
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True or False: Blood transfusions are a common treatment option for patients when megaloblastic anemia is severe.
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False: RBC transfusion may not be used because the patient's body has compensated over time by expanding the total blood volume, and you risk precipitating pulmonary edema in elderly patients and those with cardiac dysfunction.
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Can megaloblastic anemias cause jaundice?
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Yes!
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In regards to meals, what can the nurse suggest to the patient that has mouth and tongue soreness?
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eat small amounts of bland, soft foods frequently
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What type of anemia is characterized by dysfunctional RBC, WBC or platelets?
a) Megaloblastic b) Pernicious c) Myelodysplastic Syndrome d) Sickle Cell Anemia |
c) Myelodysplastic Syndrome
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What could cause secondary Myelodysplastic Syndrome(MDS)?
a) low RBC b) low iron c) toxic chemicals d) smoking |
c) toxic chemicals-such as chemotherapy or any medication that causes damage to the cells
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5-azacytadine, lenolidomide, and decifibine were recently approved for use in patients with what type of anemia?
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Myelodysplastic Syndrome (MDS)
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Patients with MDS who are hospitalized may require what special treatment in the hospital?
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Neutropenic precautions
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People receiving chronic blood transfusions may need chelation therapy which removes excess ___.
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iron
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What side effects of chelation therapy should the nurse monitor for?
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hearing changes and visual loss
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How are RBCs affected in hemolytic anemia?
a) they are small b) they are large c) they are mishappen d) they have a shortened life |
d) they have a shortened life
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What is described by: rapidly decreasing hemoglobin level, tachycardia, fever, and bilateral infiltrates seen on the chest x-ray?
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Acute chest syndrome
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A neutrophil count of less than 2000 is termed ___.
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neutropenia
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What blood test can be performed to determine you neutrophil count?
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CBC
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The antidote to heparin is:
a) protamine sulfate b) ipecac c) vitamin K d) Narcan |
a) protamine sulfate
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Which of the following is a symptom of Cooley's anemia?
a) inflammation of the tongue b) inflammation of the mouth c) dyspnea d) bronzing of the skin |
d) bronzing of the skin
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Which of the following best described the function of stem cells in the bone marrow?
a) they produce antibodies against foreign antigens b) they produce all blood cells c) they defend against bacterial infection d) they are active against hypersensitivity reactions |
b) they produce all blood cells
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For a patient with thrombocytopenia, what is the primary nursing intervention while instituting corticosteroid therapy?
a) palpate the lymph nodes and tonsils every shift b) examine the extremities for redness c) gradually taper the dose and frequency of medication d) eliminate aspirin and NSAIDS |
C) gradually taper the dose and frequency of medication
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In a patient with Hodgkin's disease who is at a risk for ineffective gas exchange, why does the nurse place the patient in a high Fowler's position?
a) to increase lung expansion b) to detect a compromised ventilation c) to anticipate the need for the airway management d) to reduce the deficits in the blood oxygen level |
a) to increase the lung expansion
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When assessing a female patient with a disorder of the hematopoietic or the lymphatic system, which of the following assessments is most essential?
a) menstrual history b) lifestyle assessments, such as exercise routines c) age and gender d) health history, such as bleeding, fatigue, or fainting |
d) health history, such as bleeding, fatigue or fainting
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Which of the following is true for the variation in the normal number of RBC?
a) people who live at higher altitudes have a decreased number of RBC b) women have more erythrocytes than men c) people who engage in strenuous activity have an increased number of RBC d) infants have fewer erythrocytes than adults |
c) people who engage in strenuous activity have an increased number or RBCs.
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The term that is used to refer to a primitive cell, capable of self-replication and differentiation, is:
a) spherocyte b) reticulocyte c) band cell d) stem cell |
d) stem cell
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For a patient with pernicious anemia, the nurse emphasizes the importance of lifelong administration of which of the following?
a) vitamin C b) folic acid c) vitamin A d) vitamin B12 |
d) vitamin B12
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A client admitted with anemia is to receive a blood transfusion. Which solution should the nurse use to establish I.V. access?
a) lactated ringer's solution b) 5% dextrose in water c) half-normal saline with potassium chloride d) normal saline |
d) normal saline
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A nurse is assessing a client who may have Hodgkin's disease. The nurse knows that an early sign of this neoplastic disease is:
a) weight loss b) painless lymph node enlargement c) progressive fatigue d) night sweats |
b) painless lymph node enlargement
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A nurse is preparing to administer iron dextran to a client with iron deficiency anemia. To administer the medication, the nurse should:
a) use a 1/2" 25G needle b) use a Z-track technique c) use the same needle to administer the injection that she used to draw up the solution d) prepare the deltoid site for injection |
b) use a Z-track technique
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Which nursing intervention is most important for a client with hemarthrosis secondary to hemophilia?
a) applying moist heat to the joint b) performing passive ROM exercises to the affected joint c) immobilizing the affected joint d) administering analgesics such as aspirin |
c) immobilizing the joint to help reduce bleeding and protect the joint
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The physician expects that the patient has a deficiency in the leukocyte responsible for cell-mediated immunity. The nurse knows to check the white blood cell count for:
a) basophils b) monocytes c) plasma cells d) T lymphocytes |
d) T lymphocytes
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Myeloid and lymphoid stem cells produce specific types of blood cells. The nurse knows, when evaluating blood tests, that myeloid stem cells differentiate into all of the following cells except:
a) erythrocytes b) leukocytes c) lymphocytes d) platelets |
c) lymphocytes
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The nurse notes that a patient, who is a vegetarian, has an abnormal number of megaloblasts. The nurse suspects a deficiency in:
a) iron b) zinc c) vitamin C d) vitamin B12 |
d) vitamin B12
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An elderly patient presents to the physician's office with a complaint of exhaustion. The nurse, aware of the most common hematologic condition affecting the elderly, knows to check the patient's:
a) white blood cell count b) red blood cell count c) thrombocyte count d) levels of plasma proteins |
b) red blood cell count
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A nurse who cares for a patient who has experienced bone marrow aspiration or biopsy should be aware of the most serious hazard, which is:
a) hemorrhage b) infection c) shock d) splintering of bone fragments |
a) hemorrhage
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A person can usually tolerate a gradual reduction in hemoglobin until the level reaches:
a) 5-5.5 b) 4-4.5 c) 3-3.5 d) 2-2.5 |
d) 2-2.5
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The nurse begins to design a nutritional packet of information for a patient diagnosed with iron deficiency anemia. The nurse would recommend an increased intake of:
a) fresh citrus fruits b) milk and cheese c) organ meats d) whole-grain breads |
c) organ meats
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A patient with chronic renal failure is being examined by the nurse practitioner for anemia. The nurse knows to review the laboratory data for a decreased hemoglobin level, decreased RBC count, and:
a) decreased level of erythropoietin b) decreased total iron-binging capacity c) increased mean corpuscular volume d) increased reticulocyte count |
a) decreased level of erythropoietin
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The most frequent symptom of complication of anemia is:
a) bleeding gums b) ecchymosis c) fatigue d) jaundice |
c) fatigue
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During a routine assessment of a patient diagnosed with anemia, the nurse notes the patient's beefy red tongue. The nurse knows that this is a sign of what kind of anemia?
a) autoimmune b) folate deficiency c) iron deficiency d) megaloblastic |
d)megaloblastic
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A nurse should know that a diagnosis of hemolytic anemia is associated with all of the following except:
a) abnormality in the circulation of plasma a) decrease in reticulocyte count c) defect in the erythrocyte d) elevated indirect bilirubin |
b) decrease in reticulocyte
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Absence of intrinsic factor is associated with a vitamin B12 deficiency, because the vitamin cannot bind to be transported for absorption in the:
a) duodenum b) ileum c) jejunum d) stomach |
b) ileum
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A diagnostic sign of pernicious anemia is:
a) a smooth, sore, red tongue b) exertional dyspnea c) pale mucous membranes d) weakness |
a) a smooth, sore, red tongue
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The schilling test is used to diagnose:
a) Aplastic anemia b) iron deficiency anemia c) megaloblastic anemia d) pernicious anemia |
d) pernicious anemia
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The common feature of the leukemias is:
a) a compensatory polycythemia stimulated by thrombocytopenia b) an unregulated accumulation of white cells in the bone marrow, which replace normal marrow elements c) increased blood viscosity, resulting from an overproduction of white cells d) reduced plasma volume in response to a reduced production of cellular elements |
b) an unregulated accumulation of white cells in the bone marrow, which replace normal marrow elements
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The major cause of death in patients with acute myeloid leukemia is believed to be:
a) anemia b) dehydration c) embolus d) infection |
d) infection
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Multiple myeloma:
a) can be diagnosed by roentgenograms that show bone lesion destruction b) is a malignant disease of plasma cells that affect bone and soft tissue c) is suspected is any person who evidences albuminuria d) is associated with all of the above |
b) is a malignant disease of plasma cells that affects bone and soft tissue
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The classic presenting symptom of myeloma is:
a) debilitating fatigue b) bone pain in the back of the ribs c) graudal muscle paralysis d) is associated with all of the above |
b) bone pain in the back of the ribs
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What is the normal value for blood platelets?
a) 50,000-100,000 b) 100,000-150,000 c) 150,000-350,000 d) greater than 350,000 |
c) 150,000-350,000
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The recommended minimum hemoglobin level for a woman to donate blood is:
a) 8 b) 10.5 c) 12.5 d) 14 |
c) 12.5
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What is a normal hemoglobin for a woman? A man?
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12.5-16 for a woman
13-18 for a man |
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The common feature of leukemias is unregulated proliferation of ____ in the bone marrow.
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leukocytes
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True or False: Neutropenic infected patients often do not exhibit the classis signs of inflammation/infection; the only initial sign may be fever.
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True!
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The major cause of death in patients with Acute Myeloid Leukemia is ___.
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bleeding and infection
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How is remission attempted with patiens with Acute Myeloid Leukemia?
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aggresive chemotherapy
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The massive leukemic cell destruction from chemotherapy termed tumor lysis syndrome can make patients more vulnerable to:
a) kidney stones b) increased intraocular pressure c) peripheral neuropathy d) increased bilirubin excretion |
a) kidney stones
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True or False: In patients with leukemia, use lemon-glycerin swabs instead of mouth wash, as the alcohol in the mouth wash is very drying.
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False: Both lemon-glycerin swabs and commercial mouthwashes should never be used because the glycerin and alcohol in them are extremely drying to the tissues
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The enlargement of one or more painless, firm, but not hard lymph nodes may indicate ___?
a) AML b) CML c) Hodgkin's Disease d) Non-Hodgkin's Disease |
c) Hodgkin's Disease
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Why are all organs vulnerable to invasion by Hodgkin's disease?
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Because symptoms will result from compression of organs by the tumor.
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Is radiation therapy and chemotherapy a treatment option for Hodgkin's disease?
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Yes
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What is the difference between stage I and stage IV non-Hodgkin's lymphoma?
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Stage I involves only one area of involvement, and Stage IV involves more sites.
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What is the difference between chemotherapy and radiation in terms of side effects?
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Chemotherapy has systemic side effects while radiation side effects are limited to the area being radiated.
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