Question 1

A patient has microcytic hypochromic anemia.Which of the following pathogenic mechanisms may cause anemia in this patient? (Select all that apply.)

Accepted Answer

A)  Decreased erythrocyte life span 
B)  Failure of mechanisms of compensatory erythropoiesis 
C)  Disturbances of the iron cycle 
D)  Increased basal metabolic rate 
E)  Swelling in the tissues

Question 2

A 20-year-old female undergoes lab testing for anemia.Results show high iron,bilirubin,and transferrin and low hemoglobin and hematocrit.Which of the following is the most likely diagnosis to be documented on the chart?

Accepted Answer

A)  Pernicious anemia 
B)  Folate deficiency anemia 
C)  Iron deficiency anemia 
D)  Sideroblastic anemia

Question 3

An oncologist is discussing multiple myeloma.Which information should the oncologist include? Multiple myeloma can be defined as a neoplasm of:

Accepted Answer

A)  T cells 
B)  B cells 
C)  Immature plasma cells 
D)  Mature red blood cells

Question 4

A 68-year-old female is admitted to the emergency department with a diagnosis of polycythemia vera (PV).A nurse realizes the patient's symptoms are mainly the result of:

Accepted Answer

A)  A decreased erythrocyte count 
B)  Rapid blood flow to the major organs 
C)  Increased blood viscosity 
D)  Vessel injury

Question 5

A 35-year-old female is diagnosed with lymphadenopathy.Which assessment finding will help confirm this diagnosis?

Accepted Answer

A)  Small, hard lymph nodes 
B)  Disordered lymph nodes 
C)  Nonpalpable, nontender lymph nodes 
D)  Enlarged lymph nodes

Question 6

A 15-year-old male with infectious mononucleosis is being given instructions on how to prevent the spread of this infection to others.Which statement represents a correct instruction?

Accepted Answer

A)  Wear a surgical mask when others are in the room. 
B)  Do not share drinking glasses or eating utensils. 
C)  Avoid all contact with other people. 
D)  No precautions are necessary.

Question 7

A nurse recalls posthemorrhagic anemia can result in death when a patient's blood loss is in excess of:

Accepted Answer

A)  20% to 29% 
B)  30% to 39% 
C)  40% to 49% 
D)  50% to 59%

Question 8

A patient's anemia is described as having erythrocytes that demonstrate anisocytosis.The nurse would recognize the erythrocytes would be:

Accepted Answer

A)  Pale in color 
B)  Present in various sizes 
C)  Able to assume various shapes 
D)  Live only a few days

Question 9

A 22-year-old female just delivered a healthy baby girl.She suffered from eclampsia during her pregnancy,and on the second postpartum day she complained of bleeding gums and bruising on her arms and legs.Hematology lab tests indicate that she had disseminated intravascular coagulation (DIC).Further review of lab tests by the nurse revealed an increase in:

Accepted Answer

A)  Platelets 
B)  Hematocrit 
C)  Fibrin degradation products (FDPs) 
D)  Protein C

Question 10

A staff member asks what leukocytosis means.How should the nurse respond? Leukocytosis can be defined as:

Accepted Answer

A)  A normal leukocyte count 
B)  A high leukocyte count 
C)  A low leukocyte count 
D)  Another term for leukopenia

Question 11

The nurse will check which of the following tests to directly measure iron stores?

Accepted Answer

A)  Serum ferritin 
B)  Transferrin saturation 
C)  Bone marrow biopsy 
D)  Total iron-binding capacity

Question 12

A 67-year-old female is admitted to the emergency department with a diagnosis of polycythemia vera.Upon taking the history,the patient will most likely report:

Accepted Answer

A)  Hyperactivity 
B)  Decreased blood pressure 
C)  Chest pain 
D)  A pale skin color

Question 13

A 21-year-old female was recently diagnosed with iron deficiency anemia.In addition to fatigue and weakness,which of the following clinical signs and symptoms would she most likely exhibit?

Accepted Answer

A)  Hyperactivity 
B)  Spoon-shaped nails 
C)  Gait problems 
D)  Petechiae

Question 14

After initial compensation,what hemodynamic change should the nurse monitor for in a patient who has a reduction in the number of circulating erythrocytes?

Accepted Answer

A)  Increased viscosity of blood 
B)  Decreased cardiac output 
C)  Altered coagulation 
D)  Hyperdynamic circulatory state

Question 15

A 2-year-old malnourished child has vitamin B12 and folate deficiencies.A blood smear suggests the deficiency is macrocytic and normochromic.The nurse would expect the hemoglobin to be:

Accepted Answer

A)  Normal 
B)  Sporadic 
C)  Low 
D)  High

Question 16

Which of the following individuals should the nurse assess first for a vitamin B12 deficiency anemia?

Accepted Answer

A)  3-year-old female who is a fussy eater 
B)  26-year-old female in the second trimester of her first pregnancy 
C)  47-year-old male who had a gastrectomy procedure (removal of the stomach) 
D)  64-year-old male with a history of duodenal ulcers and gastrointestinal bleeding

Question 17

A 10-year-old male is diagnosed with leukemia.The nurse assesses for which other condition that could be associated with his disease?

Accepted Answer

A)  Down syndrome 
B)  Hemophilia 
C)  Hyperthyroidism 
D)  Pheochromocytoma

Question 18

A 57-year-old male presents to his primary care provider for red face,hands,feet,ears,and headache and drowsiness.A blood smear reveals an increased number of erythrocytes,indicating:

Accepted Answer

A)  Polycythemia vera (PV) 
B)  Leukemia 
C)  Sideroblastic anemia 
D)  Hemosiderosis

Question 19

A 25-year-old female has a heavy menses during which she loses a profuse amount of blood.Which of the following adaptations should the nurse expect?

Accepted Answer

A)  Movement of fluid into the cell 
B)  Decreased cardiac output 
C)  Decreased oxygen release from hemoglobin 
D)  Peripheral vasoconstriction

Question 20

How should the nurse prepare a patient who is to receive a Schilling test for pernicious anemia?

Accepted Answer

A)  Administer radioactive cobalamin and measure its excretion in the urine. 
B)  Measure antigen-antibody immune complexes. 
C)  Measure serum ferritin and total iron-binding capacity. 
D)  Administer folate and evaluate folate content in a blood serum sample.

Exam 20: Alterations of Hematologic Function