MCCANCE CHAPTER 36 PULMONARY
TEST BANK EXAM QUESTIONS WITH
CORRECT ANSWERS
The nurse is assessing a new patient with complaints of overwhelming fatigue and a
sore tongue that is visibly smooth and beefy red. This patient is demonstrating signs
and symptoms associated with what form of what hematologic disorder?
A) Sickle cell anemia
B) Hemophilia
C) Megaloblastic anemia
D) Thrombocytopenia - Answer-C) Megaloblastic anemia
A red, smooth, sore tongue is a symptom associated with megaloblastic anemia. Sickle
cell disease, hemophilia, and thrombocytopenia do not have symptoms involving the
tongue.
A patient with renal failure has decreased erythropoietin production. Upon analysis of
the patients complete blood count, the nurse will expect which of the following results?
A) An increased hemoglobin and decreased hematocrit
B) A decreased hemoglobin and hematocrit
C) A decreased mean corpuscular volume (MCV) and red cell distribution width (RDW)
D) An increased MCV and RDW - Answer-B) A decreased hemoglobin and hematocrit
The decreased production of erythropoietin will result in a decreased hemoglobin and
hematocrit. The patient will have normal MCV and RDW because the erythrocytes are
normal in appearance.
A patient comes to the clinic complaining of fatigue and the health interview is
suggestive of pica. Laboratory findings reveal a low serum iron level and a low ferritin
level. With what would the nurse suspect that the patient will be diagnosed?
A) Iron deficiency anemia
B) Pernicious anemia
,C) Sickle cell anemia
D) Hemolytic anemia - Answer-A) Iron deficiency anemia
A low serum iron level, a low ferritin level, and symptoms of pica are associated with
iron deficiency anemia. TIBC may also be elevated. None of the other anemias are
associated with pica.
A patient comes into the clinic complaining of fatigue. Blood work shows an increased
bilirubin concentration and an increased reticulocyte count. What would the nurse
suspect the patient has?
A) A hypoproliferative anemia
B) A leukemia
C) Thrombocytopenia
D) A hemolytic anemia - Answer-D) A hemolytic anemia
In hemolytic anemias, premature destruction of erythrocytes results in the liberation of
hemoglobin from the erythrocytes into the plasma; the released hemoglobin is
converted in large part to bilirubin, and therefore the bilirubin concentration rises. The
increased erythrocyte destruction leads to tissue hypoxia, which in turn stimulates
erythropoietin production. This increased production is reflected in an increased
reticulocyte count as the bone marrow responds to the loss of erythrocytes.
Hypoproliferative anemias, leukemia, and thrombocytopenia lack this pathology and
presentation.
A nurse is caring for a patient with severe anemia. The patient is tachycardic and
complains of dizziness and exertional dyspnea. The nurse knows that in an effort to
deliver more blood to hypoxic tissue, the workload on the heart is increased. What signs
and symptoms might develop if this patient goes into heart failure?
A) Peripheral edema
B) Nausea and vomiting
C) Migraine
D) Fever - Answer-A) Peripheral edema
Cardiac status should be carefully assessed in patients with anemia. When the
hemoglobin level is low, the heart attempts to compensate by pumping faster and
harder in an effort to deliver more blood to hypoxic tissue. This increased cardiac
workload can result in such symptoms as tachycardia, palpitations, dyspnea, dizziness,
, orthopnea, and exertional dyspnea. Heart failure may eventually develop, as evidenced
by an enlarged heart (cardiomegaly) and liver (hepatomegaly), and by peripheral
edema. Nausea, migraine, and fever are not associated with heart failure.
A patient is admitted to the hospital with pernicious anemia. The nurse should prepare
to administer which of the following medications?
A) Folic acid
B) Vitamin B12
C) Lactulose
D) Magnesium sulfate - Answer-B) Vitamin B12
Pernicious anemia is characterized by vitamin B12 deficiency. Magnesium sulfate,
lactulose, and folic acid do not address the pathology of this type of anemia.
A patients blood work reveals a platelet level of 17,000/mm3 . When inspecting the
patients integumentary system, what finding would be most consistent with this platelet
level?
A) Dermatitis
B) Petechiae
C) Urticaria
D) Alopecia - Answer-B) Petechiae
When the platelet count drops to less than 20,000/mm3 , petechiae can appear. Low
platelet levels do not normally result in dermatitis, urticaria (hives), or alopecia (hair
loss).
A nurse is admitting a patient with immune thrombocytopenic purpura to the unit. In
completing the admission assessment, the nurse must be alert for what medications
that potentially alter platelet function? Select all that apply.
A) Antihypertensives
B) Penicillins
C) Sulfa-containing medications
D) Aspirin-based drugs
TEST BANK EXAM QUESTIONS WITH
CORRECT ANSWERS
The nurse is assessing a new patient with complaints of overwhelming fatigue and a
sore tongue that is visibly smooth and beefy red. This patient is demonstrating signs
and symptoms associated with what form of what hematologic disorder?
A) Sickle cell anemia
B) Hemophilia
C) Megaloblastic anemia
D) Thrombocytopenia - Answer-C) Megaloblastic anemia
A red, smooth, sore tongue is a symptom associated with megaloblastic anemia. Sickle
cell disease, hemophilia, and thrombocytopenia do not have symptoms involving the
tongue.
A patient with renal failure has decreased erythropoietin production. Upon analysis of
the patients complete blood count, the nurse will expect which of the following results?
A) An increased hemoglobin and decreased hematocrit
B) A decreased hemoglobin and hematocrit
C) A decreased mean corpuscular volume (MCV) and red cell distribution width (RDW)
D) An increased MCV and RDW - Answer-B) A decreased hemoglobin and hematocrit
The decreased production of erythropoietin will result in a decreased hemoglobin and
hematocrit. The patient will have normal MCV and RDW because the erythrocytes are
normal in appearance.
A patient comes to the clinic complaining of fatigue and the health interview is
suggestive of pica. Laboratory findings reveal a low serum iron level and a low ferritin
level. With what would the nurse suspect that the patient will be diagnosed?
A) Iron deficiency anemia
B) Pernicious anemia
,C) Sickle cell anemia
D) Hemolytic anemia - Answer-A) Iron deficiency anemia
A low serum iron level, a low ferritin level, and symptoms of pica are associated with
iron deficiency anemia. TIBC may also be elevated. None of the other anemias are
associated with pica.
A patient comes into the clinic complaining of fatigue. Blood work shows an increased
bilirubin concentration and an increased reticulocyte count. What would the nurse
suspect the patient has?
A) A hypoproliferative anemia
B) A leukemia
C) Thrombocytopenia
D) A hemolytic anemia - Answer-D) A hemolytic anemia
In hemolytic anemias, premature destruction of erythrocytes results in the liberation of
hemoglobin from the erythrocytes into the plasma; the released hemoglobin is
converted in large part to bilirubin, and therefore the bilirubin concentration rises. The
increased erythrocyte destruction leads to tissue hypoxia, which in turn stimulates
erythropoietin production. This increased production is reflected in an increased
reticulocyte count as the bone marrow responds to the loss of erythrocytes.
Hypoproliferative anemias, leukemia, and thrombocytopenia lack this pathology and
presentation.
A nurse is caring for a patient with severe anemia. The patient is tachycardic and
complains of dizziness and exertional dyspnea. The nurse knows that in an effort to
deliver more blood to hypoxic tissue, the workload on the heart is increased. What signs
and symptoms might develop if this patient goes into heart failure?
A) Peripheral edema
B) Nausea and vomiting
C) Migraine
D) Fever - Answer-A) Peripheral edema
Cardiac status should be carefully assessed in patients with anemia. When the
hemoglobin level is low, the heart attempts to compensate by pumping faster and
harder in an effort to deliver more blood to hypoxic tissue. This increased cardiac
workload can result in such symptoms as tachycardia, palpitations, dyspnea, dizziness,
, orthopnea, and exertional dyspnea. Heart failure may eventually develop, as evidenced
by an enlarged heart (cardiomegaly) and liver (hepatomegaly), and by peripheral
edema. Nausea, migraine, and fever are not associated with heart failure.
A patient is admitted to the hospital with pernicious anemia. The nurse should prepare
to administer which of the following medications?
A) Folic acid
B) Vitamin B12
C) Lactulose
D) Magnesium sulfate - Answer-B) Vitamin B12
Pernicious anemia is characterized by vitamin B12 deficiency. Magnesium sulfate,
lactulose, and folic acid do not address the pathology of this type of anemia.
A patients blood work reveals a platelet level of 17,000/mm3 . When inspecting the
patients integumentary system, what finding would be most consistent with this platelet
level?
A) Dermatitis
B) Petechiae
C) Urticaria
D) Alopecia - Answer-B) Petechiae
When the platelet count drops to less than 20,000/mm3 , petechiae can appear. Low
platelet levels do not normally result in dermatitis, urticaria (hives), or alopecia (hair
loss).
A nurse is admitting a patient with immune thrombocytopenic purpura to the unit. In
completing the admission assessment, the nurse must be alert for what medications
that potentially alter platelet function? Select all that apply.
A) Antihypertensives
B) Penicillins
C) Sulfa-containing medications
D) Aspirin-based drugs
