NUR 104- WVJC Exam 4 Questions with 100% Verified Answersand rationales . 1
SECTION 1: HEMATOLOGY & CARDIOVASCULAR DISORDERS (Questions 1-70)
Hematology: Blood Components & Lab Values
Question 1
A client's laboratory results show a white blood cell count of 14,500 cells/μL. How
should the nurse interpret this finding?
A) Normal value
B) Leukopenia, indicating immunosuppression
C) Leukocytosis, indicating possible infection or inflammation
D) Thrombocytopenia, indicating bleeding risk
Answer: C
Rationale: The normal WBC range is 4,300-10,800 cells/μL. A value of 14,500
cells/μL is elevated (leukocytosis), which typically indicates infection,
inflammation, or stress response .
Question 2
,A male client's hemoglobin level is 11 g/dL. Which nursing action is most
appropriate?
A) Document as a normal finding
B) Notify the healthcare provider immediately
C) Assess for fatigue, pallor, and shortness of breath
D) Prepare for an immediate blood transfusion
Answer: C
Rationale: Normal hemoglobin for males is 13-18 g/dL. A level of 11 g/dL indicates
anemia. The nurse should assess for signs of decreased oxygen-carrying capacity
such as fatigue, pallor, dyspnea, and tachycardia. Transfusion is not indicated
without active bleeding or severe symptoms .
Question 3
Which platelet count places a client at the highest risk for spontaneous bleeding?
A) 250,000/μL
B) 150,000/μL
C) 50,000/μL
D) 20,000/μL
,Answer: D
Rationale: Normal platelet count is 150,000-400,000/μL. Spontaneous bleeding
risk increases significantly when platelets drop below 20,000/μL. At this level,
even minor trauma can cause serious bleeding .
Question 4
A client on warfarin (Coumadin) has an INR of 3.5. The client is not bleeding. The
nurse should:
A) Administer vitamin K immediately
B) Hold the next dose and notify the provider
C) Continue the medication as prescribed
D) Prepare for fresh frozen plasma transfusion
Answer: C
Rationale: The therapeutic INR range for clients on warfarin is typically 2.0-3.0. An
INR of 3.5 is mildly elevated. Without bleeding, the provider may adjust the dose,
but vitamin K is reserved for significantly elevated INR (>5.0) or active bleeding .
Question 5
A client's fasting blood glucose is 180 mg/dL. The nurse recognizes this value is:
, A) Within normal limits
B) Indicative of hypoglycemia
C) Above normal, indicating hyperglycemia
D) Only significant if the client has diabetes
Answer: C
Rationale: Normal fasting glucose is 70-110 mg/dL. A value of 180 mg/dL is
elevated (hyperglycemia). Additional testing is needed to determine if diabetes is
present .
Hematology: Red Blood Cell Disorders
Question 6
Which statement best describes the pathophysiology of anemia?
A) Excessive production of white blood cells leading to infection risk
B) Decreased oxygen-carrying capacity of the blood due to reduced RBCs or
hemoglobin
C) Overproduction of platelets causing blood hyperviscosity
D) Destruction of bone marrow stem cells
Answer: B
SECTION 1: HEMATOLOGY & CARDIOVASCULAR DISORDERS (Questions 1-70)
Hematology: Blood Components & Lab Values
Question 1
A client's laboratory results show a white blood cell count of 14,500 cells/μL. How
should the nurse interpret this finding?
A) Normal value
B) Leukopenia, indicating immunosuppression
C) Leukocytosis, indicating possible infection or inflammation
D) Thrombocytopenia, indicating bleeding risk
Answer: C
Rationale: The normal WBC range is 4,300-10,800 cells/μL. A value of 14,500
cells/μL is elevated (leukocytosis), which typically indicates infection,
inflammation, or stress response .
Question 2
,A male client's hemoglobin level is 11 g/dL. Which nursing action is most
appropriate?
A) Document as a normal finding
B) Notify the healthcare provider immediately
C) Assess for fatigue, pallor, and shortness of breath
D) Prepare for an immediate blood transfusion
Answer: C
Rationale: Normal hemoglobin for males is 13-18 g/dL. A level of 11 g/dL indicates
anemia. The nurse should assess for signs of decreased oxygen-carrying capacity
such as fatigue, pallor, dyspnea, and tachycardia. Transfusion is not indicated
without active bleeding or severe symptoms .
Question 3
Which platelet count places a client at the highest risk for spontaneous bleeding?
A) 250,000/μL
B) 150,000/μL
C) 50,000/μL
D) 20,000/μL
,Answer: D
Rationale: Normal platelet count is 150,000-400,000/μL. Spontaneous bleeding
risk increases significantly when platelets drop below 20,000/μL. At this level,
even minor trauma can cause serious bleeding .
Question 4
A client on warfarin (Coumadin) has an INR of 3.5. The client is not bleeding. The
nurse should:
A) Administer vitamin K immediately
B) Hold the next dose and notify the provider
C) Continue the medication as prescribed
D) Prepare for fresh frozen plasma transfusion
Answer: C
Rationale: The therapeutic INR range for clients on warfarin is typically 2.0-3.0. An
INR of 3.5 is mildly elevated. Without bleeding, the provider may adjust the dose,
but vitamin K is reserved for significantly elevated INR (>5.0) or active bleeding .
Question 5
A client's fasting blood glucose is 180 mg/dL. The nurse recognizes this value is:
, A) Within normal limits
B) Indicative of hypoglycemia
C) Above normal, indicating hyperglycemia
D) Only significant if the client has diabetes
Answer: C
Rationale: Normal fasting glucose is 70-110 mg/dL. A value of 180 mg/dL is
elevated (hyperglycemia). Additional testing is needed to determine if diabetes is
present .
Hematology: Red Blood Cell Disorders
Question 6
Which statement best describes the pathophysiology of anemia?
A) Excessive production of white blood cells leading to infection risk
B) Decreased oxygen-carrying capacity of the blood due to reduced RBCs or
hemoglobin
C) Overproduction of platelets causing blood hyperviscosity
D) Destruction of bone marrow stem cells
Answer: B
