Quiz - Hematology
A patient's complete blood count (CBC) shows a hemoglobin of 19 and a hematocrit of 54%. Which question should the nurse ask to determine possible causes of this finding? a) "Do you have any history of lung disease?" b) "Have you noticed any dark or bloody stools?" c) "Have you had a recent weight loss?" d) "What is your dietary intake of meats and protein?"
a) "Do you have any history of lung disease?"
A patient with pancytopenia of unknown origin is scheduled for the following diagnostic tests. The nurse will provide a consent form to sign for which test? a) Bone marrow biopsy b) Abdominal ultrasound c) ABO blood typing d) Complete blood count (CBC)
a) Bone marrow biopsy
When comparing the hematocrit levels of a post-operative patient, the nurse notes that the hematocrit decreased from 36% to 34% on the third day even though the red blood cell count (RBC) and hemoglobin level remianed stable at 4.5 million/uL and 11.9g/dl respectively. The nurse should NEXT: a) Continue to monitor vital signs b) Start oxygen at 2L/min per nasal cannula c) Check the dressing and drains for frank red blood indicating bleeding d) Call the physician
a) Continue to monitor vital signs
The nurse is caring for a patient who is being discharged after an emergency splenectomy following an automobile accident. Which instructions should the nurse include in the discharge teaching? a) Wash hands and avoid persons who are ill. b) Check for swollen lymph nodes. c) Take iron supplements to prevent anemia. d) Watch for excess bruising.
a) Wash hands and avoid persons who are ill.
When a patient with thrombocytopenia has a severe headache, the nurse interprets that this may indicate which of the following? a) Migraine headache b) Cerebral bleeding c) Stress of the disease. d) Sinus congestion
b) Cerebral bleeding
A patient who had a total hip replacement had an intraoperative hemorrhage 14 hours ago. Which laboratory result would the nurse expect to find? a) Decreased white blood cell (WBC) count b) Elevated reticulocyte count c) Hematocrit of 46% d) Hemoglobin of 13.8 g/dL
b) Elevated reticulocyte count
The health care provider's progress note for a patient states that the complete blood count (CBC) shows a "shift to the left." Which assessment finding will the nurse expect? a) Low oxygen saturation b) Elevated temperature c) Cool extremities d) Pallor and weakness
b) Elevated temperature
A patient with pancytopenia has a bone marrow aspiration from the left posterior iliac crest. Which action would be important for the nurse to take after the procedure? a) Use a half-inch sterile gauze to pack the wound. b) Have the patient lie on the left side for 1 hour. c) Apply a non-sterile 2-inch gauze dressing to the site. d) Elevate the head of the bed to 45 degrees
b) Have the patient lie on the left side for 1 hour.
A nurse reviews the laboratory data for an older patient. The nurse would be most concerned about which finding? a) Hemoglobin of 11.8 b) White blood cell (WBC) count of 2,800 (2.8) c) Platelet count of 400,000 d) Hematocrit of 35%
b) White blood cell (WBC) count of 2,800 (2.8)
The nurse reviews the complete blood count (CBC) and white blood cell (WBC) differential of a patient admitted with abdominal pain. Which information will be most important for the nurse to communicate to the health care provider? a) Monocytes 4% b) White blood cells (WBCs) 15,500 (15.5) c) Hemoglobin 13.6 d) Platelet count 168,000
b) White blood cells (WBCs) 15,500 (15.5)
The nurse examines the lymph nodes of a patient during a physical assessment. Which assessment finding would be of most concern to the nurse? a) An inability to palpate any superficial lymph nodes b) Firm inguinal nodes in a patient with an infected foot c) A 2-cm nontender supraclavicular node d) A 1-cm mobile and nontender axillary node
c) A 2-cm nontender supraclavicular node
The health care provider orders a liver/spleen scan for a patient who has been in a motor vehicle accident. Which action should the nurse take before this procedure? a) Insert a large-bore IV catheter. b) Place the patient on NPO status. c) Assist the patient to a flat position. d) Check for any iodine allergy.
c) Assist the patient to a flat position.
The complete blood count (CBC) indicates that a patient is thrombocytopenic. Which action should the nurse include in the plan of care? a) Increase intake of iron-rich foods. b) Encourage increased oral fluids. c) Avoid intramuscular injections. d) Check temperature every 4 hours.
c) Avoid intramuscular injections.
The nurse is reviewing laboratory results and notes an aPTT level of 28 seconds. The nurse should notify the health care provider in anticipation of adjusting which medication? a) Erythropoietin b) Warfarin c) Heparin d) Aspirin
c) Heparin
Which of the following lab values should the nurse report to the health care provider when the patient has anemia? a) Sedimentation rate, 16 b) Red blood cells (RBC's) within normal range. c) Intrinsic factor, absent d) Schilling test, elevated.
c) Intrinsic factor, absent
The nurse assesses a patient with pernicious anemia. Which assessment finding would the nurse expect? a) Shiny, smooth tongue b) Gum bleeding and tenderness c) Numbness of the extremities d) Yellow-tinged sclerae
c) Numbness of the extremities
The nurse should teach the patient with neutropenia and the family to avoid which of the following: a) Using a high-efficiency particulate wire (HEPA) filter mask b) Performing oral care after every meal c) Using suppositories or enemas d) Performing perianal care after every bowel movement
c) Using suppositories or enemas
The nurse assesses a patient who has numerous petechiae on both arms. Which question should the nurse ask the patient? a) "Are you taking any oral contraceptives?" b) "Have you been prescribed antiseizure drugs?" c) "How long have you taken antihypertensive drugs?" d) "Do you take salicylates?"
d) "Do you take salicylates?"
A patient had a partial gastrectomy (with removal of the duodenum) 3 years ago. While obtaining a health history and physical assessment, the nurse finds that the patient has weakness, shortness of breath, and a sore tongue. Which additional information from the client indicates a need for intervention and client teaching? a) "I have been drinking plenty of fluids.' b) "I have been gargling with warm salt water for my sore tongue." c) "I have three to four loose stools per day." d) "I take a vitamin B12 tablet every day."
d) "I take a vitamin B12 tablet every day."
When assessing a newly admitted patient, the nurse notes pallor of the skin and nail beds. The nurse should ensure that which laboratory test has been ordered? a) White blood cell count b) Neutrophil count c) Platelet count d) Hemoglobin (Hgb) level
d) Hemoglobin (Hgb) level