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Hematologic Problems Questions with Solutions
1. Which response would the nurse provide to a patient who asks about what caused their
anemia? "Decreased erythropoietin production causes blood loss." "Iron deficiency accelerates RBC destruction." "Chronic colorectal cancer leads to decreased RBC production." "Decreased iron availability decreases RBC production.": "Decreased iron availability de- creases RBC production."
2. Which information would the nurse keep in mind when assessing an older adult?
Anemia is normal in older adults due to normal aging physiology. Anemia may be overlooked because of other health problems. Older adults become anemic because of expected large changes in RBC mass. Increased production of estrogen in older females accelerates hemoglobin decline.: Anemia may be overlooked because of other health problems.
3. Which acidic nutrient would the nurse include when teaching a patient about increasing red
blood cell (RBC) production? Select all that apply. Pantothenic acid Ascorbic acid Amino acid Folic acid Niacinamide acid
2 / 28 Ferric acid: Pantothenic acid Ascorbic acid Amino acid Folic acid
4. Which assessment finding is a specific manifestation of iron deficiency ane- mia?
Blurred vision Intermittent claudication Anorexia Glossitis: Glossitis
5. Which instruction would the nurse include when teaching a patient about iron
supplementation? "Avoid drinking orange juice with your iron supplements." "Take stool softeners as prescribed by the doctor." "It could take up to a week of taking iron supplements to see improvement in your hemoglobin levels." "Call the doctor immediately to report any black stools.": "Take stool softeners as pre- scribed by the doctor."
6. Which information would the nurse consider when preparing to administer an iron
supplement? Iron can be administered intravenously (IV), intramuscularly (IM), or subcuta- neously (SQ). Z-track injection should be avoided when administering iron. The preferred method of administration of iron is parenterally. Staining of the skin may occur with IM solutions.: Staining of the skin may occur with IM solutions.
4 / 28 Nausea and vomiting Weakness
10. Which patient statement indicates effective teaching about aplastic anemia?
"Nearly all cases of aplastic anemia are fatal over time." "It causes a decrease in only the red blood cells." "A majority of cases are due to autoreactive T lymphocytes." "Aplastic anemia is the most common type of anemia.": "A majority of cases are due to autoreactive T lymphocytes."
11. Which manifestation is associated with aplastic anemia? Select all that apply.
Infection Nosebleed Glossitis Pruritus
5 / 28 Petechiae Ecchymosis: Infection Nosebleed Petechiae Ecchymosis
12. Which treatment would the nurse anticipate for a patient with aplastic ane- mia? Select
all that apply. High-dose cyclophosphamide Intravenous (IV) or subcutaneous (SQ) deferoxamine Antithimocyte globulin and cyclosporine Luspatercept-aamt (Reblozyl) Iron-binding agent: High-dose cyclophosphamide Antithimocyte globulin and cyclosporine Iron- binding agent
13. A patient undergoing radiation therapy for breast cancer who reports feeling fatigued
during normal daily activities may be at risk for anemia due to which physiologic effect of cancer treatment? Excessive blood loss Destruction of red blood cells Decreased synthesis of hemoglobin Decreased number of red blood cell precursors: Decreased number of red blood cell precur- sors
7 / 28 therapy Intrinsic factor exchange therapy High-dose cyclophosphamide: Hematopoietic stem cell transplantation (HSCT)
17. Blood transfusions are generally given to patients
with thalassemia when he- moglobin (Hgb) drops to less than g/dL based on the patient's symptoms.: 7
18. A patient who just had a bowel resection of the distal ileum is at risk for which type of
anemia? Select all that apply. Iron deficiency anemia Pernicious anemia Megaloblastic anemia Sickle cell anemia Thalassemia Aplastic anemia: Pernicious anemia Megaloblastic anemia
19. Which disease can cause cobalamin deficiency anemia? Select all that apply.
Crohn's disease Celiac disease Esophageal stricture Ileitis Small-intestine diverticula: Crohn's disease Celiac disease Ileitis Small-intestine diverticula
20. Which food would the nurse incorporate into the dietary teaching for a patient
8 / 28 with folic acid deficiency anemia? Select all that apply. Green, leafy vegetables Orange juice Lean beef and chicken Peanut butter Potatoes Strawberries: Green, leafy vegetables Orange juice Peanut butter
21. Which anemia can result from chronic exposure to benzene?
Thalassemia major Megaloblastic anemia Sickle cell anemia Aplastic anemia: Aplastic anemia
22. Which laboratory result would be expected in a patient with aplastic anemia? Select all
that apply. One, some, or all responses may be correct. Neutropenia Hypochromia Normochromia Macrocytosis Thrombocytopenia Normocytosis: Neutropenia Normochromia Thrombocytopenia Normocytosis
23. Which intravenous (IV) fluid is given emergently to a patient with anemia caused by
acute blood loss? Select all that apply.
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26. Which effect does hemoglobin (Hgb) S have on the red blood cells (RBCs) in sickle cell
disease? Causes RBCs to stiffen and elongate Responds to a low hemoglobin level Decreases production of erythrocytes Causes RBCs to be phagocytized: Causes RBCs to stitten and elongate
27. Match the type of sickle cell disorder to its description.
A person inherits hemoglobin (Hgb) S from both parents. Inherits Hgb S from 1 parent and another type of abnormal Hgb from the other parent. Inheritance of Hgb S from 1 parent and normal Hgb from the other parent: A person inherits hemoglobin (Hgb) S from both parents. Sickle cell anemia Inherits Hgb S from 1 parent and another type of abnormal Hgb from the other parent. Sickle cell- thalassemia Inheritance of Hgb S from 1 parent and normal Hgb from the other parent Sickle cell trait
28. Which pharmacologic approach would the nurse anticipate for a patient with sickle cell
disease? Select all that apply. Cyclophosphamide (Cytoxan) Crizanlizumab (Adakveo) Bavencio avelumab Oral glutamine Hydroxyurea
11 / 28 (Hydrea) Voxelotor (Oxbryta): Crizanlizumab (Adakveo) Oral glutamine Hydroxyurea (Hydrea) Voxelotor (Oxbryta
29. Hemochromatosis is caused by which mechanism?
Red blood cell (RBC) overproduction Hemoglobin deficiency Chromatin deficiency Iron overload: Iron overload
30. Which medication would the nurse anticipate incorporating into the plan of care for a
patient with hemochromatosis? Hydroxyurea Deferasirox Ruxolitinib ( Jakafi) Voxelotor (Oxbryta): Deferasirox
31. The presence of JAK2 V617F or JAK2 Exon 12 mutation is diagnostic of which hematologic
problem? Sickle cell disease Hemophilia Polycythemia vera Hemochromatosis: Polycythemia vera
32. Which condition results in anemia caused by decreased red blood cell (RBC) precursors?
Select all that apply.
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36. Which patient population is at most risk for hematochromatosis?
Europeans African Americans Pacific Islanders Latinos: Europeans
37. Which food would the nurse tell the patient with hemochromatosis to avoid? Select all
that apply. Oranges Dark green leafy vegetables Uncooked seafood Lean beef Beans: Oranges Dark green leafy vegetables Uncooked seafood Lean beef Beans
38. Which serum laboratory values are expected in hemochromatosis?
High iron Low total iron-binding capacity (TIBC) Low ferritin High platelets: High iron
39. Which gene mutation is associated with polycythemia vera? HBB
JAK
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HFE
BRCA: JAK
40. Which intervention would the nurse incorporate into the plan of care for a patient
newly diagnosed with polycythemia vera? Blood transfusion Phlebotomy Chelation Diuretics: Phlebotomy
41. Which symptom would the nurse expect to observe in a patient with throm- bocytopenia?
Select all that apply. Petechiae Vomiting Numbness Tachycardia Hypotension Abdominal pain: Petechiae Tachycardia Hypotension Abdominal pain
42. Which laboratory result would be expected for a patient with thrombotic
thrombocytopenic purpura (TTP)? Normal red blood cell morphology Increased lactate dehydrogenase Abnormal coagulation Increased platelets: Increased lactate dehydrogenase
16 / 28 Female hemophilia occurs often. All daughters of males with hemophilia are carriers. Female carriers transmit the genetic defect to all of their sons.: All daughters of males with hemophilia are carriers.
45. Which laboratory study would the nurse anticipate being ordered to diag- nose von
Willebrand disease? Factor assays Thrombin time Platelet count Prothrombin time: Factor assays
46. Which treatment would the nurse anticipate for a patient who needs an increase in
factor VIII? Antifibrinolytic therapy Emicizumab Factor VIII inhibitor bypassing activity (FEIBA) Desmopressin acetate: Desmopressin acetate
47. Which action is the first priority of care for a patient with a diagnosis of
disseminated intravascular coagulation (DIC)? Administer heparin. Administer whole blood. Treat the causative
17 / 28 problem. Administer fresh frozen plasma.: Treat the causative problem.
48. Which sign or symptom would the nurse expect in a patient with disseminat- ed
intravascular coagulation (DIC) who is hemorrhaging? Delirium Petechiae Gangrene Oliguria: Petechiae
49. Which diagnostic finding would the nurse expect in a patient with leukemia who has
acute disseminated intravascular coagulation (DIC) and is bleeding? Elevated D dimers Elevated fibrinogen Reduced prothrombin time (PT) Reduced fibrin degradation products (FDPs): Elevated D dimers
50. Which cause of neutropenia is most common?
Hemodialysis Antiinflammatory drugs Diuretics Chemotherapy: Chemotherapy
51. The nurse would question which provider order when diagnosing a suspect- ed
neutropenia? "A total white blood cell count is needed." "Please assess
19 / 28 Daily nasal swabs for culture Monitoring temperature every hour Daily skin care and oral hygiene Private room with a high-efficiency particulate air (HEPA) filter: Strict hand washing Daily skin care and oral hygiene Private room with a high-efficiency particulate air (HEPA) filter
54. Which morning blood test would the nurse review to assess for heparin-in- duced
thrombocytopenia (HIT) for a patient receiving heparin subcutaneously twice a day? Prothrombin time Erythrocyte count Hemoglobin level Platelet count: Platelet count
55. Which action is important for the nurse to take for a patient with leukemia who is
admitted for severe hypovolemia after prolonged diarrhea and a platelet count of 43,000/μL? Insert two 18-gauge intravenous (IV) catheters. Check stools for presence of frank or occult blood. Administer prescribed enoxaparin. Monitor the patient's temperature every 2 hours.: Check stools for presence of frank or occult blood.
56. What action would be the emergency nurse's immediate response for a patient with a
diagnosis of hemophilia who had a fall down an escalator earlier in the day and now has bleeding in the left knee joint? Immediate transfusion of platelets Resting the patient's knee to prevent hemarthroses Assistance with
20 / 28 intracapsular injection of corticosteroids Range-of-motion exercises to prevent thrombus formation: Resting the patient's knee to prevent hemarthroses
57. Which disorder explains why a 44-year-old patient presenting to the emer- gency
department with a fever, blood clots, and history of an abnormal enzyme deficiency, who has not taken any medications in the past month, is also likely to experience pain with the condition? Heparin-induced thrombocytopenia (HIT) Disseminated intravascular coagulation (DIC) Thrombotic thrombocytopenic purpura (TTP) Immune thrombocytopenic purpura (ITP): Thrombotic thrombocytopenic purpura (TTP)
58. A platelet transfusion would be appropriate for which of the following pa- tients with
thrombocytopenia? Heparin-induced therapy (HIT) and platelet count <10,000/μL Thrombocytopenic purpura (ITP), painful splenomegaly, and platelet count <60,000/μL HIT and a platelet count <30,000/μL Immune thrombocytopenic purpura (ITP) with a platelet count <10,000/μL: Im- mune thrombocytopenic purpura (ITP) with a platelet count <10,000/μL
59. The nurse would provide information about which treatment to a patient with late-
stage cancer who has been diagnosed with chronic disseminated intravascular coagulation (DIC) but does not have hemorrhagic symptoms? Administration of fresh frozen plasma (FFP) Platelet administration
