Hematology practice questions

A clinic nurse instructs the mother of a child with sickle cell disease about the precipitating factors related to pain crisis. Which of the following, if identified by the mother as e precipitating factor, indicates the need for further instructions? 1. infection 2. trauma 3. fluid overload 4. stress

3. fluid overload

Laboratory studies are performed for a child suspected of having iron deficiency anemia. THe nurse reviews the laboratory results, knowing that which of the following results would indicate this type of anemia? 1. An elevated hemoglobin level 2. a decreased reticulocyte count 3. an elevated rbc count 4. rbc that are microcytic and hypochromic

4.

A complete blood count is commonly performed before a client goes into surgery. What does this test seek to identify? Potential hepatic dysfunction indicated by decreased blood urea nitrogen (BUN) and creatinine levels Low levels of urine constituents normally excreted in the urine Abnormally low hematocrit (HCT) and hemoglobin (Hb) levels Electrolyte imbalance that could affect the blood's ability to coagulate properly

Abnormally low hematocrit (HCT) and hemoglobin (Hb) levels

A client reports feeling tired, cold, and short of breath at times. Assessment reveals tachycardia and reduced energy. What would the nurse expect the physician to order? CBC antibiotic chest radiograph ECG

CBC Explanation: 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. A CBC would be ordered.

*The nurse observes a co-worker who always seems to be eating a cup of ice. The nurse encourages the co-worker to have an examination and diagnostic workup with the physician. What type of anemia is the nurse concerned the co-worker may have? Iron deficiency anemia Megaloblastic anemia Sickle cell anemia Aplastic anemia

Correct response: Iron deficiency anemia Explanation: People with iron deficiency anemia may crave ice, starch, or dirt; this craving is known as pica.

During the review of morning laboratory values for a client reporting severe fatigue and a red, swollen tongue, the nurse suspects chronic, severe iron deficiency anemia based on which finding? Elevated hematocrit concentration Enlarged mean corpuscular volume (MCV) Low ferritin level concentration Elevated red blood cell (RBC) count

Correct response: Low ferritin level concentration Explanation: The most consistent indicator of iron deficiency anemia is a low ferritin level, which reflects low iron stores. As the anemia progresses, the MCV, which measures the size of the erythrocytes, also decreases. Hematocrit and RBC levels are also low in relation to the hemoglobin concentration.

A nurse is a clinic is caring for a client who has suspected anemia. The nurse should anticipate a prescription from the provider for which of the following tests? A. INR B. Platelet count C. WBC count D. Hgb

Hgb

Which cell of hematopoiesis is responsible for the production of red blood cells (RBCs) and platelets? Myeloid stem cell Lymphoid stem cell Monocyte Neutrophil

Myeloid stem cell

Parents arrive to the clinic with their young child and inform the nurse the child has just been diagnosed with sickle cell disease. The parents ask the nurse how this could have happened and which one of them is the carrier. What is the best response by the nurse? "Most likely, the father is the carrier of the gene." "The trait is passed down through the mother." "The child must inherit two defective genes, one from each parent." "It is an acquired, not a hereditary disorder."

The child must inherit two defective genes, one from each parent."

A nurse in a providers office is reviewing the laboratory findings of the client who's being evaluated for primary hypothyroidism. Which of the following laboratory findings is expected for a client who has hypothyroidism? A. Serum T4 10 mcg/dL B. Serum T3 200 ng/dL C. Hematocrit 34% D. Serum cholesterol 100 mg/dL

hematocrit 34% (indicates anemia)

A client with sickle cell anemia has a low hematocrit. high hematocrit. normal hematocrit. normal blood smear.

low hematocrit. A client with sickle cell anemia has a low hematocrit and sickled cells on the smear. A client with sickle cell trait usually has a normal hemoglobin level, a normal hematocrit, and a normal blood smear.

A child is suspected of having sickle cell disease is seen in a clinic, and laboratory studies are performed. A nurse checks the laboratory results, knowing that which of the following would be increased in this disease? 1. platelet count 2. hematocrit level 3. reticulocyte count 4. Hemoglobin level

reticulocyte count (decreased hemoglobin, decreased hematocrit)

After receiving chemotherapy for lung cancer, a client's platelet count falls to 98,000/mm3. What term should the nurse use to describe this low platelet count? Anemia Leukopenia Thrombocytopenia Neutropenia

thrombocytopenia

A nurse is planning care for a client who has a Hgb of 7.5 and a Hct of 21.5. Which of the following should the nurse include in the plan of care? (Select all that apply.) A. Provide assistance with ambulation. B. Monitor oxygen saturation. C. Weigh the client weekly. D. Obtain stool specimen for occult blood. E. Schedule daily rest periods.

A. Provide assistance with ambulation. B. Monitor oxygen saturation. D. Obtain stool specimen for occult blood. E. Schedule daily rest periods.

A nurse is monitoring a client who began receiving a unit of blood 10 min ago. Which of the following should pose an immediate concern for the nurse? (Select all that apply.) A. Temperature change from 37° C (98.6° F) pretransfusion to 37.2° C (99.0° F) posttransfusion B. Dyspnea C. Heart rate increase from 74/min pretransfusion to 81/min posttransfusion D. Client report of itching E. Client appears flushed

A. Temperature change from 37° C (98.6° F) pretransfusion to 37.2° C (99.0° F) posttransfusion B. Dyspnea D. Client report of itching E. Client appears flushed

A client is found to have a low hemoglobin and hematocrit when laboratory work was performed. What does the nurse understand the anemia may have resulted from? Select all that apply. Infection Blood loss Abnormal erythrocyte production Destruction of normally formed red blood cells Inadequate formed white blood cells

Blood loss Abnormal erythrocyte production Destruction of normally formed red blood cells Explanation: Most anemias result from (1) blood loss, (2) inadequate or abnormal erythrocyte production, or (3) destruction of normally formed red blood cells. The most common types include hypovolemic anemia, iron-deficiency anemia, pernicious anemia, folic acid deficiency anemia, sicklecell anemia, and hemolytic anemias. Although each form of anemia has unique manifestations, all share a common core of symptoms. Anemia does not result from infection or inadequate formed white blood cells.