UNIT 8 CHAPTER 33: ASSESSMENT OF THE HEMATOLOGIC SYSTEM IGNATAVICIUS MEDICAL-
SURGICAL NURSING 11TH EDITION STUDY GUIDE 2026/2027 | PRACTICE QUESTIONS,
VERIFIED ANSWERS & COMPLETE REVIEW
The nurse is assessing an older client for any potential hematologic health problem. Which
assessment finding is the most significant and would be reported to the primary health care
provider?
a. Poor skin turgor on both forearms
b. Multiple petechiae and large bruises
c. Dry, flaky skin on arms and legs
d. Decreased body hair distribution - correct answer ✔✔ANS: B
The presence of multiple petechiae and large bruises indicate a possible problem with blood
clotting. Older adults typically have poor skin turgor and dry, flaky skin due to decreased body
fluid as a result of aging. They also lose body hair or have thinning hair as a normal
change of aging.
A nurse is assessing a dark-skinned client for pallor. What nursing assessment is best to
assess for pallor in this client?
a. Assess the conjunctiva of the eye.
b. Have the patient open the hand widely.
c. Look at the roof of the patient's mouth.
d. Palpate for areas of mild swelling. - correct answer ✔✔ANS: A
To assess pallor in dark-skinned people, assess the conjunctiva of the eye or the mucous
membranes. Looking at the roof of the mouth can reveal jaundice. Opening the hand widely is
not related to pallor, nor is palpating for mild swelling.
A hospitalized client has a platelet count of 58,000/mm3 (58 x 109/L). What action by the
nurse is most appropriate?
, a. Encourage high-protein foods.
b. Institute neutropenic precautions.
c. Limit visitors to healthy adults.
d. Place the client on safety precautions. - correct answer ✔✔ANS: D
With a platelet count between 40,000 and 80,000/mm3
(40 and 80 x 109/L), clients are at risk of prolonged bleeding even after minor trauma. The nurse
would place the client on safety or bleeding precautions as the most appropriate action. High-
protein foods, while healthy, are not the priority. Neutropenic precautions are not needed as
the patient's white blood cell count is not low. Limiting visitors would also be more likely related
to a low white blood cell count.
A client is having a bone marrow aspiration and biopsy. What action by the nurse takes
priority?
a. Administer pain medication first.
b. Ensure that valid consent is in the medical record.
c. Have the client shower in the morning.
d. Premedicate the client with sedatives. - correct answer ✔✔ANS: B
A bone marrow aspiration and biopsy is an invasive procedure that requires informed consent.
Pain medication and sedation are important components of care for this client but do not take
priority. The client may or may not need or be able to shower.
What is the nurse's priority when caring for a client who just completed a bone marrow
aspiration and biopsy?
a. Teach the client to avoid activity for 24 to 48 hours to prevent infection.
b. Administer a nonsteroidal anti-inflammatory drug (NSAID) to promote comfort.
c. Check the pressure dressing frequently for signs of excessive or active bleeding.
d. Report the laboratory results to the primary health care provider. - correct answer ✔✔ANS: C
The client having a bone marrow aspiration and biopsy has a puncture wound from the large
SURGICAL NURSING 11TH EDITION STUDY GUIDE 2026/2027 | PRACTICE QUESTIONS,
VERIFIED ANSWERS & COMPLETE REVIEW
The nurse is assessing an older client for any potential hematologic health problem. Which
assessment finding is the most significant and would be reported to the primary health care
provider?
a. Poor skin turgor on both forearms
b. Multiple petechiae and large bruises
c. Dry, flaky skin on arms and legs
d. Decreased body hair distribution - correct answer ✔✔ANS: B
The presence of multiple petechiae and large bruises indicate a possible problem with blood
clotting. Older adults typically have poor skin turgor and dry, flaky skin due to decreased body
fluid as a result of aging. They also lose body hair or have thinning hair as a normal
change of aging.
A nurse is assessing a dark-skinned client for pallor. What nursing assessment is best to
assess for pallor in this client?
a. Assess the conjunctiva of the eye.
b. Have the patient open the hand widely.
c. Look at the roof of the patient's mouth.
d. Palpate for areas of mild swelling. - correct answer ✔✔ANS: A
To assess pallor in dark-skinned people, assess the conjunctiva of the eye or the mucous
membranes. Looking at the roof of the mouth can reveal jaundice. Opening the hand widely is
not related to pallor, nor is palpating for mild swelling.
A hospitalized client has a platelet count of 58,000/mm3 (58 x 109/L). What action by the
nurse is most appropriate?
, a. Encourage high-protein foods.
b. Institute neutropenic precautions.
c. Limit visitors to healthy adults.
d. Place the client on safety precautions. - correct answer ✔✔ANS: D
With a platelet count between 40,000 and 80,000/mm3
(40 and 80 x 109/L), clients are at risk of prolonged bleeding even after minor trauma. The nurse
would place the client on safety or bleeding precautions as the most appropriate action. High-
protein foods, while healthy, are not the priority. Neutropenic precautions are not needed as
the patient's white blood cell count is not low. Limiting visitors would also be more likely related
to a low white blood cell count.
A client is having a bone marrow aspiration and biopsy. What action by the nurse takes
priority?
a. Administer pain medication first.
b. Ensure that valid consent is in the medical record.
c. Have the client shower in the morning.
d. Premedicate the client with sedatives. - correct answer ✔✔ANS: B
A bone marrow aspiration and biopsy is an invasive procedure that requires informed consent.
Pain medication and sedation are important components of care for this client but do not take
priority. The client may or may not need or be able to shower.
What is the nurse's priority when caring for a client who just completed a bone marrow
aspiration and biopsy?
a. Teach the client to avoid activity for 24 to 48 hours to prevent infection.
b. Administer a nonsteroidal anti-inflammatory drug (NSAID) to promote comfort.
c. Check the pressure dressing frequently for signs of excessive or active bleeding.
d. Report the laboratory results to the primary health care provider. - correct answer ✔✔ANS: C
The client having a bone marrow aspiration and biopsy has a puncture wound from the large
