Hematologic Review Questions

The nurse observes the laboratory studies for a client in the hospital with fatigue, feeling cold all of the time, and hemoglobin of 8.6 g/dL and a hematocrit of 28%. What finding would be an indicator of iron-deficiency anemia? a) An increased number of erythrocytes b) Erythrocytes that are macrocytic and hyperchromic c) Erythrocytes that are microcytic and hypochromic d) Clustering of platelets with sickled red blood cells

c) Erythrocytes that are microcytic and hypochromic A blood smear reveals erythrocytes that are microcytic (smaller than normal) and hypochromic (lighter in color than normal). It does not reveal macrocytic (larger than normal) or hyperchromic erythrocytes. Clustering of platelets with sickled red blood cells would indicate sickle cell anemia. An increase in the number of erythrocytes would indicate polycythemia vera

The nurse should provide further teaching when a preoperative client considering blood donation makes which of the following statements? a) "I should expect blood withdrawal to take about 15 minutes." b) "Donated blood is tested for blood type and infections." c) "I could donate my own blood in case I need a transfusion." d) "My family will donate blood, because it's safer."

d) "My family will donate blood, because it's safer." Directed donations from friends and family members are not any safer than those provided by random donors. Withdrawal of 450 mL of blood usually takes about 15 minutes. Specimens from donated blood are tested to detect infections and to identify the specific blood type. Autologous blood donation is useful for many elective surgeries where the potential need for transfusion is high

Which iron-rich foods should a nurse encourage an anemic client requiring iron therapy to eat? a) Shrimp and tomatoes b) Lobster and squash c) Lamb and peaches d) Cheese and bananas

c) Lamb and peaches Iron-rich foods include lamb and peaches. Shrimp, tomatoes, lobster, squash, cheese, and bananas aren't high in iron content

A nurse is assessing a client with multiple myeloma. The nurse should keep in mind that clients with multiple myeloma are at risk for: a) hypoxemia. b) pathologic bone fractures. c) chronic liver failure. d) acute heart failure.

b) pathologic bone fractures. Clients with multiple myeloma are at risk for pathologic bone fractures secondary to diffuse osteoporosis and osteolytic lesions. Also, clients are at risk for renal failure secondary to myeloma proteins by causing renal tubular obstruction. Liver failure and heart failure aren't usually sequelae of multiple myeloma. Hypoxemia isn't usually related to multiple myeloma.

The nurse is collecting data for a patient who has been diagnosed with iron-deficiency anemia. What subjective findings does the nurse recognize as symptoms related to this type of anemia? a) "I have a difficult time falling asleep at night." b) "I have an increase in my appetite." c) "I have difficulty breathing when walking 30 feet." .d) "I feel hot all of the time."

c) "I have difficulty breathing when walking 30 feet." Most clients with iron-deficiency anemia have reduced energy, feel cold all the time, and experience fatigue and dyspnea with minor physical exertion. The heart rate usually is rapid even at rest. The CBC and hemoglobin, hematocrit, and serum iron levels are decreased. The client would feel cold and not hot. The client is fatigue and able to sleep often with a decrease in appetite, not an increase.

Which type of lymphocyte is responsible for cellular immunity? a) Basophil b) B lymphocyte c) T lymphocyte d) Plasma cell

c) T lymphocyte T lymphocytes are responsible for delayed allergic reactions, rejection of foreign tissue (e.g., transplanted organs), and destruction of tumor cells. This process is known as cellular immunity. B lymphocytes are responsible for humoral immunity. A plasma cell secretes immunoglobulin. A basophil contains histamine and is an integral part of hypersensivity reactions.

The nurse obtains a unit of blood for the client, Donald D. Smith. The name on the label on the unit of blood reads Donald A. Smith. All the other identifiers are correct. The nurse a) Asks the client if he was ever known as Donald A. Smith b) Administers the unit of blood c) Checks with Blood Bank first and then administers the blood with their permission d) Refuses to administer the blood

d) Refuses to administer the blood To ensure a safe transfusion, all components of the identification must be correct. The nurse should refuse to administer the blood and notify the Blood Bank about the discrepancy. The Blook Bank should then take the necessary steps to correct the name on the label on the unit of blood

For a patient diagnosed with pernicious anemia, the nurse emphasises the importance of lifelong administration of which of the following? a) Vitamin A b) Vitamin C c) Vitamin B12 d) Folic acid

c) Vitamin B12 For a patient with pernicious anaemia, the nurse emphasises the importance of lifelong administration of vitamin B12. He or she teaches the patient or a family member of the proper method to administer vitamin B12 injections. Administration of vitamin A, folic acid, or vitamin C is not recommended for this condition.

The nurse is caring for a client who had undergone hemodilution during surgery. Immediately after surgery, the nurse expects to see which lab result? a) Elevated creatinine b) Elevated erythrocyte concentration c) Critically low arterial oxygen saturation d) Decreased hematocrit

d) Decreased hematocrit The added intravenous solutions used in hemodilution dilute the concentration of erythrocytes and lower the hematocrit. Adverse outcomes include tissue ischemia, particularly in the kidneys. These adverse outcomes can be manifested as low arterial oxygen saturation and elevated creatinine levels.

When assessing a female patient with a disorder of the hematopoietic or the lymphatic system, which of the following assessments is most essential? a) Lifestyle assessments, such as exercise routines b) Menstrual history c) Age and gender d) Health history, such as bleeding, fatigue, or fainting

d) Health history, such as bleeding, fatigue, or fainting When assessing a patient with a disorder of the hematopoietic or the lymphatic system, it is essential to assess the patient's health history. An assessment of drug history is essential because some antibiotics and cancer drugs contribute to hematopoietic dysfunction. Aspirin and anticoagulants may contribute to bleeding and interfere with clot formation. Because industrial materials, environmental toxins, and household products may affect blood-forming organs, the nurse needs to explore exposure to these agents. Age, gender, menstrual history, or lifestyle assessments, such as exercise routines and habits, do not directly affect the hematopoietic or lymphatic system