Medical-Surgical Nursing: Hematology and
Oncology
Comprehensive Exam Preparation Pack with Verified
Answers
Course Code: NURS 3250 | Latest Edition - 2025
SECTION 1: HEMATOLOGIC SYSTEM ANATOMY
AND PHYSIOLOGY
Question 1: Which blood cell component is primarily responsible for oxygen transport
throughout the body?
A) Leukocytes
B) Thrombocytes
C) Erythrocytes
D) Plasma proteins
Answer: C) Erythrocytes
Rationale: Erythrocytes (red blood cells) contain hemoglobin, which binds to oxygen in the
lungs and transports it to tissues. Normal RBC count is 4.5-5.5 million/mm³ for males and
4.0-5.0 million/mm³ for females.
Question 2: What is the normal lifespan of a red blood cell?
A) 30 days
B) 60 days
C) 120 days
D) 180 days
Answer: C) 120 days
Rationale: Erythrocytes live approximately 120 days (4 months). After this time, they are
removed by the spleen and liver, and their components are recycled to produce new RBCs in
the bone marrow.
Question 3: Which organ is primarily responsible for the production of erythropoietin?
,A) Liver
B) Spleen
C) Kidneys
D) Bone marrow
Answer: C) Kidneys
Rationale: The kidneys produce erythropoietin (EPO) in response to hypoxia. EPO stimulates
the bone marrow to increase red blood cell production, making it essential for maintaining
adequate oxygen-carrying capacity.
Question 4: What is the primary function of platelets (thrombocytes)?
A) Fighting infection
B) Oxygen transport
C) Blood clotting
D) Immune response
Answer: C) Blood clotting
Rationale: Platelets are essential for hemostasis and blood clotting. Normal platelet count is
150,000-400,000/mm³. They aggregate at injury sites to form platelet plugs and initiate the
coagulation cascade.
Question 5: Which type of white blood cell is most abundant in the bloodstream?
A) Lymphocytes
B) Neutrophils
C) Monocytes
D) Eosinophils
Answer: B) Neutrophils
Rationale: Neutrophils comprise 55-70% of total WBCs and are the first responders to
bacterial infection. They are phagocytic cells that engulf and destroy pathogens.
SECTION 2: ANEMIA - GENERAL CONCEPTS
Question 6: What is the primary clinical manifestation of anemia?
A) Hypertension
B) Fatigue and weakness
,C) Bradycardia
D) Weight gain
Answer: B) Fatigue and weakness
Rationale: Anemia reduces oxygen-carrying capacity, leading to tissue hypoxia. This causes
fatigue, weakness, dyspnea on exertion, pallor, tachycardia, and dizziness. Severity of
symptoms depends on the degree and rapidity of hemoglobin decrease.
Question 7: Which laboratory value is the definitive indicator of anemia?
A) Low hematocrit
B) Low hemoglobin
C) Low red blood cell count
D) All of the above
Answer: D) All of the above
Rationale: Anemia is defined by decreased hemoglobin (< 12 g/dL in women, < 14 g/dL in
men), hematocrit (< 36% in women, < 42% in men), and/or RBC count. All three values
typically decrease together in anemia.
Question 8: What dietary instruction should the nurse provide to a client with anemia?
A) Increase calcium-rich foods
B) Increase iron-rich foods like red meat and leafy greens
C) Decrease protein intake
D) Avoid all dairy products
Answer: B) Increase iron-rich foods like red meat and leafy greens
Rationale: Iron is essential for hemoglobin synthesis. Iron-rich foods include red meat, organ
meats, fortified cereals, dark leafy greens, beans, and dried fruits. Vitamin C enhances iron
absorption.
Question 9: A client with anemia reports cold intolerance and brittle nails. These findings are
most consistent with:
A) Acute blood loss
B) Chronic iron deficiency anemia
C) Pernicious anemia
D) Hemolytic anemia
Answer: B) Chronic iron deficiency anemia
, Rationale: Chronic iron deficiency causes systemic effects beyond anemia, including cold
intolerance, brittle nails (koilonychia), glossitis, angular cheilitis, and pica (craving non-food
items like ice or dirt).
Question 10: Which assessment finding would the nurse expect in a client with severe
anemia?
A) Bradycardia
B) Tachycardia and systolic murmur
C) Hypertension
D) Decreased respiratory rate
Answer: B) Tachycardia and systolic murmur
Rationale: The heart compensates for decreased oxygen-carrying capacity by increasing heart
rate and cardiac output. A systolic flow murmur may be heard due to increased blood flow
velocity through the heart valves.
SECTION 3: IRON DEFICIENCY ANEMIA
Question 11: What is the most common cause of iron deficiency anemia in adults?
A) Inadequate dietary intake
B) Chronic blood loss
C) Malabsorption
D) Increased iron requirements
Answer: B) Chronic blood loss
Rationale: In adults, chronic blood loss (especially from GI bleeding or menstruation) is the
most common cause. In children and pregnant women, inadequate intake or increased
requirements are more common. Always investigate the source of blood loss.
Question 12: A client is prescribed ferrous sulfate 325 mg PO daily. What instruction should
the nurse provide?
A) "Take this medication with milk for better absorption"
B) "Take this on an empty stomach with orange juice"
C) "Take this medication with antacids to prevent upset stomach"
D) "Crush the tablet for easier swallowing"
Answer: B) "Take this on an empty stomach with orange juice"
Oncology
Comprehensive Exam Preparation Pack with Verified
Answers
Course Code: NURS 3250 | Latest Edition - 2025
SECTION 1: HEMATOLOGIC SYSTEM ANATOMY
AND PHYSIOLOGY
Question 1: Which blood cell component is primarily responsible for oxygen transport
throughout the body?
A) Leukocytes
B) Thrombocytes
C) Erythrocytes
D) Plasma proteins
Answer: C) Erythrocytes
Rationale: Erythrocytes (red blood cells) contain hemoglobin, which binds to oxygen in the
lungs and transports it to tissues. Normal RBC count is 4.5-5.5 million/mm³ for males and
4.0-5.0 million/mm³ for females.
Question 2: What is the normal lifespan of a red blood cell?
A) 30 days
B) 60 days
C) 120 days
D) 180 days
Answer: C) 120 days
Rationale: Erythrocytes live approximately 120 days (4 months). After this time, they are
removed by the spleen and liver, and their components are recycled to produce new RBCs in
the bone marrow.
Question 3: Which organ is primarily responsible for the production of erythropoietin?
,A) Liver
B) Spleen
C) Kidneys
D) Bone marrow
Answer: C) Kidneys
Rationale: The kidneys produce erythropoietin (EPO) in response to hypoxia. EPO stimulates
the bone marrow to increase red blood cell production, making it essential for maintaining
adequate oxygen-carrying capacity.
Question 4: What is the primary function of platelets (thrombocytes)?
A) Fighting infection
B) Oxygen transport
C) Blood clotting
D) Immune response
Answer: C) Blood clotting
Rationale: Platelets are essential for hemostasis and blood clotting. Normal platelet count is
150,000-400,000/mm³. They aggregate at injury sites to form platelet plugs and initiate the
coagulation cascade.
Question 5: Which type of white blood cell is most abundant in the bloodstream?
A) Lymphocytes
B) Neutrophils
C) Monocytes
D) Eosinophils
Answer: B) Neutrophils
Rationale: Neutrophils comprise 55-70% of total WBCs and are the first responders to
bacterial infection. They are phagocytic cells that engulf and destroy pathogens.
SECTION 2: ANEMIA - GENERAL CONCEPTS
Question 6: What is the primary clinical manifestation of anemia?
A) Hypertension
B) Fatigue and weakness
,C) Bradycardia
D) Weight gain
Answer: B) Fatigue and weakness
Rationale: Anemia reduces oxygen-carrying capacity, leading to tissue hypoxia. This causes
fatigue, weakness, dyspnea on exertion, pallor, tachycardia, and dizziness. Severity of
symptoms depends on the degree and rapidity of hemoglobin decrease.
Question 7: Which laboratory value is the definitive indicator of anemia?
A) Low hematocrit
B) Low hemoglobin
C) Low red blood cell count
D) All of the above
Answer: D) All of the above
Rationale: Anemia is defined by decreased hemoglobin (< 12 g/dL in women, < 14 g/dL in
men), hematocrit (< 36% in women, < 42% in men), and/or RBC count. All three values
typically decrease together in anemia.
Question 8: What dietary instruction should the nurse provide to a client with anemia?
A) Increase calcium-rich foods
B) Increase iron-rich foods like red meat and leafy greens
C) Decrease protein intake
D) Avoid all dairy products
Answer: B) Increase iron-rich foods like red meat and leafy greens
Rationale: Iron is essential for hemoglobin synthesis. Iron-rich foods include red meat, organ
meats, fortified cereals, dark leafy greens, beans, and dried fruits. Vitamin C enhances iron
absorption.
Question 9: A client with anemia reports cold intolerance and brittle nails. These findings are
most consistent with:
A) Acute blood loss
B) Chronic iron deficiency anemia
C) Pernicious anemia
D) Hemolytic anemia
Answer: B) Chronic iron deficiency anemia
, Rationale: Chronic iron deficiency causes systemic effects beyond anemia, including cold
intolerance, brittle nails (koilonychia), glossitis, angular cheilitis, and pica (craving non-food
items like ice or dirt).
Question 10: Which assessment finding would the nurse expect in a client with severe
anemia?
A) Bradycardia
B) Tachycardia and systolic murmur
C) Hypertension
D) Decreased respiratory rate
Answer: B) Tachycardia and systolic murmur
Rationale: The heart compensates for decreased oxygen-carrying capacity by increasing heart
rate and cardiac output. A systolic flow murmur may be heard due to increased blood flow
velocity through the heart valves.
SECTION 3: IRON DEFICIENCY ANEMIA
Question 11: What is the most common cause of iron deficiency anemia in adults?
A) Inadequate dietary intake
B) Chronic blood loss
C) Malabsorption
D) Increased iron requirements
Answer: B) Chronic blood loss
Rationale: In adults, chronic blood loss (especially from GI bleeding or menstruation) is the
most common cause. In children and pregnant women, inadequate intake or increased
requirements are more common. Always investigate the source of blood loss.
Question 12: A client is prescribed ferrous sulfate 325 mg PO daily. What instruction should
the nurse provide?
A) "Take this medication with milk for better absorption"
B) "Take this on an empty stomach with orange juice"
C) "Take this medication with antacids to prevent upset stomach"
D) "Crush the tablet for easier swallowing"
Answer: B) "Take this on an empty stomach with orange juice"
