Emergency Care, 13e (Limmer et al.)
Chapter 24 Hematologic and Renal Emergencies
1) The correct terminology used for patients whose kidneys are damaged to the point where they
require dialysis to survive is:
A) acute renal failure.
B) end-stage renal disease.
C) hepatic failure.
D) terminal kidney disease.
Objective: 24.1
2) The sensation felt when palpating an arterial-venous fistula or shunt is known as a:
A) bruit.
B) frill.
C) thrill.
D) fluttering.
Objective: 24.1
1
3) How would you define anemia?
A) An inherited disease in which a genetic defect in the hemoglobin results in abnormal structure
of the red blood cells
B) The loss of the kidneys’ ability to filter the blood and remove toxins and excess fluid from the
body
C) The process by which toxins and excess fluid are removed from the body by a medical system
independent of the kidneys
D) A lack of a normal number of red blood cells in the circulation
Objective: 24.1
4) What is continuous ambulatory peritoneal dialysis?
A) A gravity exchange process for peritoneal dialysis in which a bag of dialysis fluid is raised
above the level of an abdominal catheter to fill the abdominal cavity and lowered below the level
of the abdominal catheter to drain the fluid out
B) A gravity exchange process for peritoneal dialysis in which a bag of dialysis fluid is lowered
below the level of an abdominal catheter to fill the abdominal cavity and raised above the level
of the abdominal catheter to drain the fluid out
C) A mechanical process for peritoneal dialysis in which a machine fills and empties the
abdominal cavity of dialysis solution
D) A type of dialysis that is performed while walking
Objective: 24.1
2
5) Which of the following abbreviations is NOT correct?
A) SCA for sickle cell anemia
B) RBC for red blood cells
C) WBC for white blood cells
D) CAPD for continuous acute peripheral disease
Objective: 24.1
6) The blood has many functions critical to a patient’s health. Which one of the listed items
below is NOT a function of the blood?
A) Control of bleeding by clotting
B) Delivery of oxygen to the cells
C) Removal and delivery of other waste products to organs that provide filtration and removal,
such as the kidneys and liver
D) Removal of carbon monoxide from the cells
Objective: 24.2
7) What is the purpose of the red blood cells?
A) They are responsible for the delivery of oxygen to the cells.
B) They are responsible for the removal of oxygen from the cells.
C) They are critical in response to infection and are mediators of the body’s immune response.
D) They are crucial in the formation of clots.
Objective: 24.2
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8) Which of the following medications does NOT interfere with the blood-clotting process?
A) Acetaminophen
B) Warfarin
C) Aspirin
D) Clopidogrel
Objective: 24.3
9) You suspect a patient who has been having a difficult time controlling the bleeding following a
small laceration to the foot may have a history of:
A) sickle cell anemia.
B) taking blood thinners.
C) high blood pressure.
D) poorly controlled diabetes.
Objective: 24.3
4
10) Platelets are actually fragments of larger cells that are crucial to the formation of clots.
Clumping (called aggregation) of platelets is the body’s most rapid response to stop bleeding
from an injured site. However, in some situations the clumping of platelets is not desirable, such
as when a plaque in a coronary artery ruptures. In this situation, the rapid clumping of platelets
can cause a clot that then completely blocks the coronary artery and results in a heart attack
(myocardial infarction). One of the most effective and widely available drugs to prevent the
aggregation of platelets is:
A) aspirin.
B) plasma.
C) hemoglobin.
D) anemia.
Objective: 24.3
11) Certain drugs are commonly referred as “blood thinners” or drugs that inhibit clotting. Which
of the following would NOT be considered such a drug?
A) Coumadin (warfarin)
B) Lovenox (enoxaparin)
C) Aspirin
D) Prilosec
Objective: 24.3
5
12) Which of the following organs may seriously be damaged in sickle cell anemia, and often
subsequently leads to severe infections?
A) Lungs
B) Kidneys
C) Liver
D) Spleen
Objective: 24.4
13) ________ patients are at high risk for acquiring the inherited disorder called sickle cell
anemia.
A) Native American
B) African American
C) Eastern European
D) Hispanic
Objective: 24.4
6
14) Because of abnormally shaped hemoglobin, sickle cell anemia (SCA) patients may
occasionally experience ________, causing a blockage of small blood vessels.
A) sludging
B) aggregation
C) clotting
D) clumping
Objective: 24.4
15) You encounter a patient who has been having diffuse abdominal pain for one week. The
patient has a pulse rate of 86, a blood pressure of 140/90, and a respiratory rate of 20. However,
the patient appears pale, and complains of generalized weakness and shortness of breath during
everyday activities. You suspect the patient is experiencing:
A) anxiety disorder.
B) chronic anemia.
C) sickle cell anemia.
D) acute anemia.
Objective: 24.4
7
16) A patient with a medical history of sickle cell anemia is complaining of chest pain and
shortness of breath. The patient is breathing 26 times a minute in short, shallow respirations.
However, the patient’s oxygen saturation via pulse oximetry is 100% on room air. The best
approach regarding supplemental oxygen is to:
A) do nothing; no supplemental oxygen is necessary.
B) place the patient on a nonrebreather mask.
C) place the patient on a nasal cannula.
D) place the patient on a simple face mask.
Objective: 24.5
17) Patients with a history of chronic sickle cell anemia (SCA) may present with which of the
following signs and symptoms?
A) Bluish discoloration of the skin and shortness of breath
B) Yellowing of the skin and dyspnea on exertion
C) Flushed appearance and shortness of breath
D) Pale appearance and dyspnea on exertion
Objective: 24.5
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18) You are dispatched to a private residence for a 52-year-old African American male sitting in
his living room complaining of chest pain. During your assessment, he discloses that he has the
sickle cell trait. Because of this you should:
A) administer high-concentration oxygen.
B) monitor for signs of inadequate respiration.
C) be prepared to treat for shock if he also has a high fever.
D) treat the patient as any other 52-year-old with chest pain.
Objective: 24.5
19) What is one of the most common diseases to affect the renal and urinary system?
A) Urinary tract infections
B) Acute renal failure
C) End-stage renal disease
D) Kidney stones
Objective: 24.6
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20) The kidney’s major function(s) include(s):
A) maintaining blood volume.
B) balancing electrolytes.
C) excreting urea.
D) All of the above
Objective: 24.6
21) Which of the following pathologies make patients at high risk for acute renal failure?
A) Polycystic kidney disease
B) Shock
C) Uncontrolled diabetes
D) Hypertension
Objective: 24.7
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