Hematologic Nursing 2026
| Comprehensive
Hematology Study Guide,
Practice Questions,
Answers, Rationales &
NCLEX Review | Complete
Ethics Study Guide
Updated 2026 Questions and Answers
100% Verified Exam Prep and Comprehensive
Rationales
Included
,The nurse is admitting a client suspected of 3. 4. 5. 6.
having sickle cell anemia. The client has a fever
of 38.9°C or 102°F, faint yellow-tinged sclera, The client with sickle cell anemia develops
and is complaining of abdominal pain. Which skin ulcers on the lower extremities from the
of the following clinical manifestations further vaso-occlusive aspects of the disease. The client
support this diagnosis? would have shortness of breath and be fatigued
Select all that apply: and pale. The client may have swollen fingers.
[ ] 1. Rapid but regular breathing The hemolysis of red blood cells results in
[ ] 2. Pale, dilute urine bilirubinuria. The client's urine is dark colored.
[ ] 3. Skin ulcers on the lower extremities
[ ] 4. Swollen fingers
[ ] 5. Pallor
[ ] 6. Fatigue
The nurse making a care plan for a client with 3
severe thrombocytopenia should include which
of the following? Severe thrombocytopenia is a platelet count of
1. Careful examination of spinal fluid obtained <10,000 to 20,000/mm3. The client with this
by lumbar puncture low number of platelets is at great risk of
2. A private room with reverse isolation bleeding from any invasive procedure. Intramuscular injections can cause a
precautions hematoma
3. Avoid intramuscular administration of in the muscle and should be avoided if possible. A lumbar puncture would put the
medications client at an unnecessary risk of bleeding. A private room is not indicated unless
4. Careful monitoring of urinary output while there are other reasons for isolation (infection, neutropenia). Furosemide is a
titrating the dosage of furosemide (Lasix) diuretic and not used as therapy for thrombocytopenia.
The nurse is performing an assessment on a client with C is correct.
possible
pernicious anemia. Which data would support this A red, beefy tongue is characteristic of the client with pernicious anemia. Answer A,
diagnosis? a weight loss of 10 pounds in 2 weeks, is abnormal but is not seen in pernicious
anemia. Numbness and tingling, in answer B, can be associated with anemia but
A. A weight loss of 10 pounds in 2 weeks are not particular to pernicious anemia. This is more likely associated with
B. Complaints of numbness and tingling in the extremities peripheral vascular diseases involving vasculature. In answer D, the hemoglobin is
C. A red, beefy tongue below normal.
D. A hemoglobin level of 12.0gm/dL
A client with lung cancer is admitted with a 2.
new diagnosis of acute disseminated
intravascular coagulation (DIC). Which of the Acute disseminated intravascular coagulation
following actions is a priority? (DIC) is a serious disorder resulting in bleeding
1. Obtain a diet history from the client for the and clotting. It is a priority that the client must
last 3 days be assessed frequently by the nurse for
2. Assess the client for any indications of bleeding. After ensuring that there is no active
internal or external bleeding bleeding, the nurse may obtain a detailed diet
3. Take the family to the family lounge and history or implement family teaching. A delay
discuss home care for a client with DIC to do family teaching away from the client or to
4. Call the dialysis unit to determine when the dwell on diet history would not be appropriate.
client may be transferred Some clients with chronic DIC may eventually
require dialysis.
A client has been receiving cyanocobalamine (B12) Answer D is correct.
injections for
the past 6 weeks. Which laboratory finding indicates that Cyanocolamine is a B12 medication that is used for pernicious anemia, and a
the medication is having the desired effect? reticulocyte count of 1% indicates that it is having the desired effect.
A. Neutrophil count of 60% Answers A, B, and C are white blood cells and have nothing to do with this
B. Basophil count of 0.5% medication.
C. Monocyte count of 2%
D. Reticulocyte count of 1%
A client with sickle cell anemia is admitted to the labor and Answer A is correct.
delivery
unit during the first phase of labor. The nurse should Clients with sickle cell crises are treated with heat, hydration, oxygen, and pain
anticipate relief. Fluids are increased, not decreased, so answer B is incorrect. Answer C is
the client's need for: incorrect because blood transfusions are usually not required. Answer D is incorrect
A. Supplemental oxygen because these clients can be delivered vaginally.
B. Fluid restriction
C. Blood transfusion
D. Delivery by Caesarean section
, A client with rheumatoid arthritis is receiving Methotrexate. Answer D is correct.
After
reviewing the client's chart, the physician orders Methotrexate is a folic acid antagonist. Leucovorin is the drug given for toxicity to
Wellcovorin (leucovorin calcium). The rationale for this drug. Answers A, B, and C are incorrect because the drug is not used to treat
administering leucovorin calcium to a client receiving iron-deficiency anemia, create a synergistic effects, or increase the number of
Methotrexate is to: circulating neutrophils.
❍ A. Treat iron-deficiency anemia caused by
chemotherapeutic
agents
❍ B. Create a synergistic effect that shortens treatment
time
❍ C. Increase the number of circulating neutrophils
❍ D. Reverse drug toxicity and prevent tissue damage
The nurse is providing dietary instructions for a client with Answer A is correct.
iron-deficiency anemia. Which food is a poor source of
iron? Tomatoes are a poor source of iron, although they are an excellent source of
❍ A. Tomatoes vitamin C, which increases iron absorption. Answers B, C, and D are good sources
❍ B. Legumes of iron; therefore, they are incorrect.
❍ C. Dried fruits
❍ D. Nuts
The nurse is completing an assessment history of a client Answer B is correct.
with
pernicious anemia. Which complaint differentiates Numbness and tingling in the extremities is common in the client with pernicious
pernicious anemia anemia, but not those with other types of anemia. Answers A, C, and D are incorrect
from other types of anemia? because they are symptoms of all types of anemia.
❍ A. Difficulty in breathing after exertion
❍ B. Numbness and tingling in the extremities
❍ C. A faster-than-usual heart rate
❍ D. Feelings of lightheadedness
The primary cause of anemia in a client with chronic renal Answer D is correct.
failure
is: Insufficient erythropoietin production is the primary cause of anemia in the client
❍ A. Poor iron absorption with chronic renal failure. Answers A, B, and C do not relate to the anemia seen in
❍ B. Destruction of red blood cells the client with chronic renal failure; therefore, they are incorrect.
❍ C. Lack of intrinsic factor
❍ D. Insufficient erythropoietin
The doctor has prescribed a diet high in vitamin B12 for a Answer A is correct.
client
with pernicious anemia. Which foods are highest in B12? Meat, eggs, and dairy products are foods high in vitamin B12. Answer B is incorrect
❍ A. Meat, eggs, dairy products because peanut butter, raisins, and molasses are sources rich in
❍ B. Peanut butter, raisins, molasses iron. Answer C is incorrect because broccoli, cauliflower, and cabbage are all
sources rich in vitamin K. Answer D is incorrect because shrimp, legumes, and bran
❍ C. Broccoli, cauliflower, cabbage
cereals are high in magnesium.
❍ D. Shrimp, legumes, bran cereals
A client with iron deficiency anemia is taking an oral iron Answer A is correct.
supplement.
The nurse should tell the client to take the medication with: Iron is better absorbed when taken with ascorbic acid. Orange juice is an excellent
❍ A. Orange juice source of ascorbic acid. Answer B is incorrect because the medication should be
❍ B. Water only taken with orange juice or tomato juice. Answer C is incorrect because iron should
not be taken with milk because it interferes with absorption.
❍ C. Milk
Answer D is incorrect because apple juice does not contain high amounts of
❍ D. Apple juice ascorbic acid.
A hospitalized client with severe anemia is to receive a unit Answer B is correct.
of
blood. Which facet of care is most appropriate for the The most appropriate facet of care for the newly licensed practical nurse is the
newly monitoring of the client's vital signs. Answers A and C are incorrect because
licensed practical nurse? initiation of IV fluids and administration of blood is the responsibility of the registered
❍ A. Initiating the IV of normal saline nurse. Answer D is incorrect because in the hospital setting, the registered
❍ B. Monitoring the client's vital signs nurse would be responsible for notifying the physician of a reaction.
❍ C. Initiating the blood transfusion
❍ D. Notifying the physician of a reaction
| Comprehensive
Hematology Study Guide,
Practice Questions,
Answers, Rationales &
NCLEX Review | Complete
Ethics Study Guide
Updated 2026 Questions and Answers
100% Verified Exam Prep and Comprehensive
Rationales
Included
,The nurse is admitting a client suspected of 3. 4. 5. 6.
having sickle cell anemia. The client has a fever
of 38.9°C or 102°F, faint yellow-tinged sclera, The client with sickle cell anemia develops
and is complaining of abdominal pain. Which skin ulcers on the lower extremities from the
of the following clinical manifestations further vaso-occlusive aspects of the disease. The client
support this diagnosis? would have shortness of breath and be fatigued
Select all that apply: and pale. The client may have swollen fingers.
[ ] 1. Rapid but regular breathing The hemolysis of red blood cells results in
[ ] 2. Pale, dilute urine bilirubinuria. The client's urine is dark colored.
[ ] 3. Skin ulcers on the lower extremities
[ ] 4. Swollen fingers
[ ] 5. Pallor
[ ] 6. Fatigue
The nurse making a care plan for a client with 3
severe thrombocytopenia should include which
of the following? Severe thrombocytopenia is a platelet count of
1. Careful examination of spinal fluid obtained <10,000 to 20,000/mm3. The client with this
by lumbar puncture low number of platelets is at great risk of
2. A private room with reverse isolation bleeding from any invasive procedure. Intramuscular injections can cause a
precautions hematoma
3. Avoid intramuscular administration of in the muscle and should be avoided if possible. A lumbar puncture would put the
medications client at an unnecessary risk of bleeding. A private room is not indicated unless
4. Careful monitoring of urinary output while there are other reasons for isolation (infection, neutropenia). Furosemide is a
titrating the dosage of furosemide (Lasix) diuretic and not used as therapy for thrombocytopenia.
The nurse is performing an assessment on a client with C is correct.
possible
pernicious anemia. Which data would support this A red, beefy tongue is characteristic of the client with pernicious anemia. Answer A,
diagnosis? a weight loss of 10 pounds in 2 weeks, is abnormal but is not seen in pernicious
anemia. Numbness and tingling, in answer B, can be associated with anemia but
A. A weight loss of 10 pounds in 2 weeks are not particular to pernicious anemia. This is more likely associated with
B. Complaints of numbness and tingling in the extremities peripheral vascular diseases involving vasculature. In answer D, the hemoglobin is
C. A red, beefy tongue below normal.
D. A hemoglobin level of 12.0gm/dL
A client with lung cancer is admitted with a 2.
new diagnosis of acute disseminated
intravascular coagulation (DIC). Which of the Acute disseminated intravascular coagulation
following actions is a priority? (DIC) is a serious disorder resulting in bleeding
1. Obtain a diet history from the client for the and clotting. It is a priority that the client must
last 3 days be assessed frequently by the nurse for
2. Assess the client for any indications of bleeding. After ensuring that there is no active
internal or external bleeding bleeding, the nurse may obtain a detailed diet
3. Take the family to the family lounge and history or implement family teaching. A delay
discuss home care for a client with DIC to do family teaching away from the client or to
4. Call the dialysis unit to determine when the dwell on diet history would not be appropriate.
client may be transferred Some clients with chronic DIC may eventually
require dialysis.
A client has been receiving cyanocobalamine (B12) Answer D is correct.
injections for
the past 6 weeks. Which laboratory finding indicates that Cyanocolamine is a B12 medication that is used for pernicious anemia, and a
the medication is having the desired effect? reticulocyte count of 1% indicates that it is having the desired effect.
A. Neutrophil count of 60% Answers A, B, and C are white blood cells and have nothing to do with this
B. Basophil count of 0.5% medication.
C. Monocyte count of 2%
D. Reticulocyte count of 1%
A client with sickle cell anemia is admitted to the labor and Answer A is correct.
delivery
unit during the first phase of labor. The nurse should Clients with sickle cell crises are treated with heat, hydration, oxygen, and pain
anticipate relief. Fluids are increased, not decreased, so answer B is incorrect. Answer C is
the client's need for: incorrect because blood transfusions are usually not required. Answer D is incorrect
A. Supplemental oxygen because these clients can be delivered vaginally.
B. Fluid restriction
C. Blood transfusion
D. Delivery by Caesarean section
, A client with rheumatoid arthritis is receiving Methotrexate. Answer D is correct.
After
reviewing the client's chart, the physician orders Methotrexate is a folic acid antagonist. Leucovorin is the drug given for toxicity to
Wellcovorin (leucovorin calcium). The rationale for this drug. Answers A, B, and C are incorrect because the drug is not used to treat
administering leucovorin calcium to a client receiving iron-deficiency anemia, create a synergistic effects, or increase the number of
Methotrexate is to: circulating neutrophils.
❍ A. Treat iron-deficiency anemia caused by
chemotherapeutic
agents
❍ B. Create a synergistic effect that shortens treatment
time
❍ C. Increase the number of circulating neutrophils
❍ D. Reverse drug toxicity and prevent tissue damage
The nurse is providing dietary instructions for a client with Answer A is correct.
iron-deficiency anemia. Which food is a poor source of
iron? Tomatoes are a poor source of iron, although they are an excellent source of
❍ A. Tomatoes vitamin C, which increases iron absorption. Answers B, C, and D are good sources
❍ B. Legumes of iron; therefore, they are incorrect.
❍ C. Dried fruits
❍ D. Nuts
The nurse is completing an assessment history of a client Answer B is correct.
with
pernicious anemia. Which complaint differentiates Numbness and tingling in the extremities is common in the client with pernicious
pernicious anemia anemia, but not those with other types of anemia. Answers A, C, and D are incorrect
from other types of anemia? because they are symptoms of all types of anemia.
❍ A. Difficulty in breathing after exertion
❍ B. Numbness and tingling in the extremities
❍ C. A faster-than-usual heart rate
❍ D. Feelings of lightheadedness
The primary cause of anemia in a client with chronic renal Answer D is correct.
failure
is: Insufficient erythropoietin production is the primary cause of anemia in the client
❍ A. Poor iron absorption with chronic renal failure. Answers A, B, and C do not relate to the anemia seen in
❍ B. Destruction of red blood cells the client with chronic renal failure; therefore, they are incorrect.
❍ C. Lack of intrinsic factor
❍ D. Insufficient erythropoietin
The doctor has prescribed a diet high in vitamin B12 for a Answer A is correct.
client
with pernicious anemia. Which foods are highest in B12? Meat, eggs, and dairy products are foods high in vitamin B12. Answer B is incorrect
❍ A. Meat, eggs, dairy products because peanut butter, raisins, and molasses are sources rich in
❍ B. Peanut butter, raisins, molasses iron. Answer C is incorrect because broccoli, cauliflower, and cabbage are all
sources rich in vitamin K. Answer D is incorrect because shrimp, legumes, and bran
❍ C. Broccoli, cauliflower, cabbage
cereals are high in magnesium.
❍ D. Shrimp, legumes, bran cereals
A client with iron deficiency anemia is taking an oral iron Answer A is correct.
supplement.
The nurse should tell the client to take the medication with: Iron is better absorbed when taken with ascorbic acid. Orange juice is an excellent
❍ A. Orange juice source of ascorbic acid. Answer B is incorrect because the medication should be
❍ B. Water only taken with orange juice or tomato juice. Answer C is incorrect because iron should
not be taken with milk because it interferes with absorption.
❍ C. Milk
Answer D is incorrect because apple juice does not contain high amounts of
❍ D. Apple juice ascorbic acid.
A hospitalized client with severe anemia is to receive a unit Answer B is correct.
of
blood. Which facet of care is most appropriate for the The most appropriate facet of care for the newly licensed practical nurse is the
newly monitoring of the client's vital signs. Answers A and C are incorrect because
licensed practical nurse? initiation of IV fluids and administration of blood is the responsibility of the registered
❍ A. Initiating the IV of normal saline nurse. Answer D is incorrect because in the hospital setting, the registered
❍ B. Monitoring the client's vital signs nurse would be responsible for notifying the physician of a reaction.
❍ C. Initiating the blood transfusion
❍ D. Notifying the physician of a reaction
