HEMATOLOGY NCLEX QUESTIONS
WITH CORRECT ANSWERS
When assessing a patient's nutritional-metabolic pattern related to hematologic
health, what should the nurse do?
A. Inspect the skin for petechiae.
B. Ask the patient about joint pain.
C. Assess for vitamin C deficiency.
D. Determine if the patient can perform ADLs. - Answer- A. Inspect the skin for
petechiae.
Any changes in the skin's texture or color should be explored when assessing the
patient's nutritional-metabolic pattern related to hematologic health. The presence of
petechiae or ecchymotic areas could be indicative of hematologic deficiencies
related to poor nutritional intake or related causes. The other options are not specific
to the nutritional-metabolic pattern related to hematologic health.
When assessing laboratory values on a patient admitted with septicemia, what
should the nurse expect to find?
A. Increased platelets
B. Decreased red blood cells
C. Decreased erythrocyte sedimentation rate (ESR)
D. Increased bands in the white blood cell (WBC) differential (shift to the left) -
Answer- D. Increased bands in the white blood cell (WBC) differential (shift to the
left)
When infections are severe, such as in septicemia, more granulocytes are released
from the bone marrow as a compensatory mechanism. To meet the increased
demand, many young, immature polymorphonuclear neutrophils (bands) are
released into circulation. WBCs are usually reported in order of maturity (initially with
the less mature forms on the left side of a written report). Hence, the term "shift to
the left" is used to denote an increase in the number of bands. Thrombocytosis
occurs with inflammation and some malignant disorders. Decreased red blood cells
indicate anemia. Decreased ESR is not indicative of septicemia.
Results of a patient's most recent blood work indicate an elevated neutrophil level.
The nurse should recognize that this diagnostic finding most likely suggests which
problem?
A. Hypoxemia
B. An infection
C. A risk of hypocoagulation
D. An acute thrombotic event - Answer- B. An infection
An increase in the neutrophil count most commonly occurs in response to infection
or inflammation. Hypoxemia and coagulation do not directly affect neutrophil
production.
, A 30-year-old patient has undergone a splenectomy as a result of injuries suffered in
a motor vehicle accident. Which phenomena are likely to result from the absence of
the patient's spleen (select all that apply)?
A. Impaired fibrinolysis
B. Increased platelet levels
C. Increased eosinophil levels
D. Fatigue and cold intolerance
E. Impaired immunologic function - Answer- B. Increased platelet levels
E. Impaired immunologic function
Splenectomy can result in increased platelet levels and impaired immunologic
function as a consequence of the loss of storage and immunologic functions of the
spleen. Fibrinolysis, fatigue, and cold intolerance are less likely to result from the
loss of the spleen since coagulation and oxygenation are not primary responsibilities
of the spleen.
The nurse is providing care for older adults on a subacute, geriatric medicine unit.
What effect is aging likely to have on hematologic function of older adults?
A. Thrombocytosis
B. Decreased hemoglobin
C. Decreased WBC count
D. Decreased blood volume - Answer- B. Decreased hemoglobin
Older adults frequently experience decreased hemoglobin levels as a result of
changes in erythropoiesis. Decreased blood volume, decreased WBCs, and
alterations in platelet number are not considered to be normal, age-related
hematologic changes.
A blood type and cross-match has been ordered for a male patient who is
experiencing an upper gastrointestinal bleed. The results of the blood work indicate
that the patient has type A blood. Which description explains what this means?
A. The patient can be transfused with type AB blood.
B. The patient may only receive a type A transfusion.
C. The patient has A antigens on his red blood cells (RBCs).
D. Antibodies are present on the surface of the patient's RBCs. - Answer- C. The
patient has A antigens on his red blood cells (RBCs).
An individual with type A blood has A antigens, not A antibodies, on his RBCs. An
AB transfusion would result in agglutination, but he may be transfused with either
type A or type O blood.
The patient has anemia and has had laboratory tests done to diagnose the cause.
Which results should the nurse know indicates a lack of nutrients needed to produce
new red blood cells (select all that apply)?
A. Increased homocysteine
B. Decreased reticulocyte count
C. Decreased cobalamin (vitamin B12)
D. Increased methylmalonic acid (MMA)
E. Elevated erythrocyte sedimentation rate (ESR) - Answer- A. Increased
homocysteine
WITH CORRECT ANSWERS
When assessing a patient's nutritional-metabolic pattern related to hematologic
health, what should the nurse do?
A. Inspect the skin for petechiae.
B. Ask the patient about joint pain.
C. Assess for vitamin C deficiency.
D. Determine if the patient can perform ADLs. - Answer- A. Inspect the skin for
petechiae.
Any changes in the skin's texture or color should be explored when assessing the
patient's nutritional-metabolic pattern related to hematologic health. The presence of
petechiae or ecchymotic areas could be indicative of hematologic deficiencies
related to poor nutritional intake or related causes. The other options are not specific
to the nutritional-metabolic pattern related to hematologic health.
When assessing laboratory values on a patient admitted with septicemia, what
should the nurse expect to find?
A. Increased platelets
B. Decreased red blood cells
C. Decreased erythrocyte sedimentation rate (ESR)
D. Increased bands in the white blood cell (WBC) differential (shift to the left) -
Answer- D. Increased bands in the white blood cell (WBC) differential (shift to the
left)
When infections are severe, such as in septicemia, more granulocytes are released
from the bone marrow as a compensatory mechanism. To meet the increased
demand, many young, immature polymorphonuclear neutrophils (bands) are
released into circulation. WBCs are usually reported in order of maturity (initially with
the less mature forms on the left side of a written report). Hence, the term "shift to
the left" is used to denote an increase in the number of bands. Thrombocytosis
occurs with inflammation and some malignant disorders. Decreased red blood cells
indicate anemia. Decreased ESR is not indicative of septicemia.
Results of a patient's most recent blood work indicate an elevated neutrophil level.
The nurse should recognize that this diagnostic finding most likely suggests which
problem?
A. Hypoxemia
B. An infection
C. A risk of hypocoagulation
D. An acute thrombotic event - Answer- B. An infection
An increase in the neutrophil count most commonly occurs in response to infection
or inflammation. Hypoxemia and coagulation do not directly affect neutrophil
production.
, A 30-year-old patient has undergone a splenectomy as a result of injuries suffered in
a motor vehicle accident. Which phenomena are likely to result from the absence of
the patient's spleen (select all that apply)?
A. Impaired fibrinolysis
B. Increased platelet levels
C. Increased eosinophil levels
D. Fatigue and cold intolerance
E. Impaired immunologic function - Answer- B. Increased platelet levels
E. Impaired immunologic function
Splenectomy can result in increased platelet levels and impaired immunologic
function as a consequence of the loss of storage and immunologic functions of the
spleen. Fibrinolysis, fatigue, and cold intolerance are less likely to result from the
loss of the spleen since coagulation and oxygenation are not primary responsibilities
of the spleen.
The nurse is providing care for older adults on a subacute, geriatric medicine unit.
What effect is aging likely to have on hematologic function of older adults?
A. Thrombocytosis
B. Decreased hemoglobin
C. Decreased WBC count
D. Decreased blood volume - Answer- B. Decreased hemoglobin
Older adults frequently experience decreased hemoglobin levels as a result of
changes in erythropoiesis. Decreased blood volume, decreased WBCs, and
alterations in platelet number are not considered to be normal, age-related
hematologic changes.
A blood type and cross-match has been ordered for a male patient who is
experiencing an upper gastrointestinal bleed. The results of the blood work indicate
that the patient has type A blood. Which description explains what this means?
A. The patient can be transfused with type AB blood.
B. The patient may only receive a type A transfusion.
C. The patient has A antigens on his red blood cells (RBCs).
D. Antibodies are present on the surface of the patient's RBCs. - Answer- C. The
patient has A antigens on his red blood cells (RBCs).
An individual with type A blood has A antigens, not A antibodies, on his RBCs. An
AB transfusion would result in agglutination, but he may be transfused with either
type A or type O blood.
The patient has anemia and has had laboratory tests done to diagnose the cause.
Which results should the nurse know indicates a lack of nutrients needed to produce
new red blood cells (select all that apply)?
A. Increased homocysteine
B. Decreased reticulocyte count
C. Decreased cobalamin (vitamin B12)
D. Increased methylmalonic acid (MMA)
E. Elevated erythrocyte sedimentation rate (ESR) - Answer- A. Increased
homocysteine
