Blood and Community Study Guide

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Sample questions from Blood and Community Study Guide

This material has 15 questions with answers and rationales. Here are the first 5.

1. 1.Ten minutes after a packed red blood cell transfusion begins, a client develops chills and severe lower back pain. Which action should the nurse take first?

   • A.Obtain a urine specimen.
   • B.Administer the prescribed as-needed antipyretic.
   • C.Stop the transfusion.
   • D.Reduce the rate by half.

   Rationale: A is correct because stopping the transfusion limits further exposure during a possible acute hemolytic reaction. B continues exposure and is unsafe. C may be part of the investigation but follows immediate stabilization. D may treat fever but does not address the potentially life-threatening reaction.

2. 2.A client receiving chemotherapy has a WBC count of 1,000/mcL, neutrophils of 20%, and bands of 5%. The temperature is 38.4 C (101.1 F). Which interpretation is most appropriate?

   • A.The ANC is 250/mcL, and the fever requires urgent evaluation.
   • B.The client should wait for purulent drainage before reporting infection.
   • C.The ANC is 2,500/mcL, so routine follow-up is sufficient.
   • D.The fever is expected because the white count is low.

   Rationale: A is correct: 1,000 x 0.25 = 250/mcL, indicating severe neutropenia with an emergency fever finding. B miscalculates the ANC. C incorrectly normalizes a potentially serious infection. D is unsafe because neutropenic clients may not produce pus or other strong inflammatory signs.

3. 3.Which statement by a client starting oral iron requires further teaching?

   • A.I should ask how to separate iron from my calcium supplement.
   • B.I may need a plan to prevent constipation.
   • C.I will store the tablets where children cannot reach them.
   • D.Any black stool means the iron is working, even if I feel faint.

   Rationale: C is correct because black, tarry stool accompanied by faintness can indicate gastrointestinal bleeding and needs evaluation. A recognizes a common adverse effect. B prevents potentially fatal pediatric poisoning. D appropriately addresses an absorption interaction.

4. 4.A client has macrocytic anemia, numb feet, and an unsteady gait. Which issue should the nurse prioritize when reviewing the treatment plan?

   • A.Whether an iron infusion is automatically scheduled
   • B.Whether vitamin B12 deficiency has been evaluated before folate-only treatment
   • C.Whether all dietary protein has been restricted
   • D.Whether the client can discontinue treatment once fatigue improves

   Answer and rationale are in the full material.

5. 5.A client hospitalized for sickle cell pain develops a cough, temperature of 38.2 C (100.8 F), and oxygen saturation of 89%. What is the nurse's priority?

   • A.Initiate urgent respiratory assessment, provide oxygen, and notify the treating team.
   • B.Encourage rapid intake of several liters of water.
   • C.Delay action until the next scheduled chest radiograph.
   • D.Document the findings as expected during a pain episode.

   Answer and rationale are in the full material.