Med Surg- NCLEX- Questions for
Hematologic with Complete Solutions
2026/2027 Update.
When assessing a patient's nutritional-metabolic pattern related to hematologic health, what
should the nurse do?
Inspect the skin for petechiae.
Ask the patient about joint pain.
Assess for vitamin C deficiency.
Determine if the patient can perform ADLs. - Answer A
When assessing laboratory values on a patient admitted with septicemia, what should the nurse
expect to find?
Increased platelets
Decreased red blood cells
Decreased erythrocyte sedimentation rate (ESR)
Increased bands in the white blood cell (WBC) differential (shift to the left) - Answer D
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?
Hypoxemia
An infection
A risk of hypocoagulation
An acute thrombotic event - Answer B
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)?
Impaired fibrinolysis
Increased platelet levels
Increased eosinophil levels
Fatigue and cold intolerance
Impaired immunologic function - Answer B, E
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?
,Thrombocytosis
Decreased hemoglobin
Decreased WBC count
Decreased blood volume - Answer B
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?
The patient can be transfused with type AB blood.
The patient may only receive a type A transfusion.
.The patient has A antigens on his red blood cells (RBCs).
Antibodies are present on the surface of the patient's RBCs. - Answer C
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)?
Increased homocysteine
Decreased reticulocyte count
Decreased cobalamin (vitamin B12)
Increased methylmalonic acid (MMA)
Elevated erythrocyte sedimentation rate (ESR) - Answer A, C, D
In assessing the patient, which abnormal finding should the nurse relate to hemostasis
abnormalities?
Purpura
Pruritus
Weakness
Pale conjunctiva - Answer A
During the admission assessment, the nurse discovers that the patient has used illicit drugs.
Related to the hematologic system, what question should the nurse next ask the patient?
"Do you have any blood in your stools?"
"What agent and when did you last use it?"
"Have you had any surgeries causing pain?"
"Do you have shortness of breath with activity?" - Answer B
, The thrombocytopenic patient has had a bone marrow biopsy taken from the posterior iliac
crest. What nursing care is the priority for this patient after this procedure?
Position the patient prone.
Apply a pressure dressing.
Administer analgesic for pain.
Return metal objects to the patient. - Answer B
When caring for a patient with metastatic cancer, the nurse notes a hemoglobin level of 8.7
g/dL and hematocrit of 26%. What should the nurse place highest priority on initiating
interventions to reduce?
Thirst
Fatigue
Headache
Abdominal pain - Answer B
The nurse is caring for a patient who is to receive a transfusion of two units of packed red blood
cells. After obtaining the first unit from the blood bank, the nurse would ask which health team
member in the nurses' station to assist in checking the unit before administration?
Unit secretary
A physician's assistant
Another registered nurse
An unlicensed assistive personnel - Answer C
Before starting a transfusion of packed red blood cells for an older anemic patient, the nurse
would arrange for a peer to monitor his or her other assigned patients for how many minutes
when the nurse begins the transfusion?
5
15
30
60 - Answer B
When preparing to administer an ordered blood transfusion, which IV solution does the nurse
use when priming the blood tubing?
Lactated Ringer's
5% dextrose in water
0.9% sodium chloride
0.45% sodium chloride - Answer C
Hematologic with Complete Solutions
2026/2027 Update.
When assessing a patient's nutritional-metabolic pattern related to hematologic health, what
should the nurse do?
Inspect the skin for petechiae.
Ask the patient about joint pain.
Assess for vitamin C deficiency.
Determine if the patient can perform ADLs. - Answer A
When assessing laboratory values on a patient admitted with septicemia, what should the nurse
expect to find?
Increased platelets
Decreased red blood cells
Decreased erythrocyte sedimentation rate (ESR)
Increased bands in the white blood cell (WBC) differential (shift to the left) - Answer D
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?
Hypoxemia
An infection
A risk of hypocoagulation
An acute thrombotic event - Answer B
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)?
Impaired fibrinolysis
Increased platelet levels
Increased eosinophil levels
Fatigue and cold intolerance
Impaired immunologic function - Answer B, E
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?
,Thrombocytosis
Decreased hemoglobin
Decreased WBC count
Decreased blood volume - Answer B
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?
The patient can be transfused with type AB blood.
The patient may only receive a type A transfusion.
.The patient has A antigens on his red blood cells (RBCs).
Antibodies are present on the surface of the patient's RBCs. - Answer C
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)?
Increased homocysteine
Decreased reticulocyte count
Decreased cobalamin (vitamin B12)
Increased methylmalonic acid (MMA)
Elevated erythrocyte sedimentation rate (ESR) - Answer A, C, D
In assessing the patient, which abnormal finding should the nurse relate to hemostasis
abnormalities?
Purpura
Pruritus
Weakness
Pale conjunctiva - Answer A
During the admission assessment, the nurse discovers that the patient has used illicit drugs.
Related to the hematologic system, what question should the nurse next ask the patient?
"Do you have any blood in your stools?"
"What agent and when did you last use it?"
"Have you had any surgeries causing pain?"
"Do you have shortness of breath with activity?" - Answer B
, The thrombocytopenic patient has had a bone marrow biopsy taken from the posterior iliac
crest. What nursing care is the priority for this patient after this procedure?
Position the patient prone.
Apply a pressure dressing.
Administer analgesic for pain.
Return metal objects to the patient. - Answer B
When caring for a patient with metastatic cancer, the nurse notes a hemoglobin level of 8.7
g/dL and hematocrit of 26%. What should the nurse place highest priority on initiating
interventions to reduce?
Thirst
Fatigue
Headache
Abdominal pain - Answer B
The nurse is caring for a patient who is to receive a transfusion of two units of packed red blood
cells. After obtaining the first unit from the blood bank, the nurse would ask which health team
member in the nurses' station to assist in checking the unit before administration?
Unit secretary
A physician's assistant
Another registered nurse
An unlicensed assistive personnel - Answer C
Before starting a transfusion of packed red blood cells for an older anemic patient, the nurse
would arrange for a peer to monitor his or her other assigned patients for how many minutes
when the nurse begins the transfusion?
5
15
30
60 - Answer B
When preparing to administer an ordered blood transfusion, which IV solution does the nurse
use when priming the blood tubing?
Lactated Ringer's
5% dextrose in water
0.9% sodium chloride
0.45% sodium chloride - Answer C
