MCA 2: Hematology Test Questions and
Correct Answers
Question 1
The nurse is assessing a patient with sickle cell anemia. Which clinical manifestations
should the nurse anticipate? (Select all that apply)
A. Chronic anemia
B. Severe pain
C. Jaundice
D. Cholelithiasis
E. Bradycardia
Correct Answer
A, B, C, D
Rationale: Patients often present with chronic anemia, severe pain, jaundice, and
cholelithiasis due to hemolysis and bilirubin buildup. Bradycardia is not a typical
manifestation.
Question 2
The nurse is reviewing a neutropenic patient's plan of care. Which interventions are
appropriate?
• A. Collect blood cultures x2 before starting antibiotics
• B. Initiate broad-spectrum antibiotics immediately after cultures
• C. Delay antifungal therapy until discharge
• D. Monitor closely for subtle signs of infection
• E. Withhold Neupogen until fever resolves
Correct Answer
A, B, D
Rationale: Infection must be aggressively evaluated and treated—cultures (A),
immediate antibiotics (B), and close monitoring for infection (D). Antifungals may be
needed during hospitalization, not delayed until discharge (C). Neupogen is used to
stimulate WBCs regardless of fever (E).
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,Question 3
The nurse is reviewing laboratory results for a patient with suspected iron deficiency
anemia. Which set of findings is most consistent with this diagnosis?
A. ↑ Hemoglobin, ↑ Serum ferritin, ↑ Iron
B. ↓ Hemoglobin, ↓ Serum ferritin, ↑ TIBC
C. ↓ Hemoglobin, ↑ Serum ferritin, ↓ TIBC
D. ↑ Hemoglobin, ↓ Serum iron, ↑ Ferritin
Correct Answer
B
Rationale:
• Iron deficiency anemia typically presents with low hemoglobin, low serum ferritin
(storage form of iron), and elevated TIBC because the body increases its ability to
bind available iron.
• The other options do not match this diagnostic pattern.
Question 4
A patient presents with weakness, confusion, and a sore red tongue. Laboratory
testing confirms a lack of intrinsic factor. Which condition does the nurse anticipate?
A. Iron deficiency anemia
B. Pernicious anemia
C. Aplastic anemia
D. Thalassemia
Correct Answer
B. Pernicious anemia
Rationale: Pernicious anemia results from lack of intrinsic factor (IF), which is
necessary for B12 absorption. This causes neurological issues (confusion,
paresthesia), weakness, and characteristic tongue changes. Iron deficiency and
thalassemia are unrelated to IF, while aplastic anemia involves decreased production
of all blood cell types.
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, Question 5
A patient with immune thrombocytopenic purpura (ITP) is being treated. Which
nursing management intervention is most appropriate?
A. Platelet transfusion when counts drop below 10,000
B. Administration of factor Xa inhibitor (Arixtra)
C. Avoidance of corticosteroid therapy
D. Initiation of heparin infusion to increase platelet counts
Correct Answer
A
Rationale: In ITP, treatment includes corticosteroids, IV immunoglobulins,
splenectomy, and platelet transfusion if <10,000. Factor Xa inhibitors and heparin
are used in HIT, not ITP. Corticosteroids are a cornerstone of ITP therapy, so
avoiding them would be incorrect
Question 6
The nurse recognizes which of the following as clinical manifestations of
thrombocytopenia?
A. Petechiae and purpura
B. Epistaxis and gum bleeding
C. Tachycardia and dizziness
D. Hypertension and bradycardia
E. Intracranial bleeding
Correct Answer
A, B, C, E
Rationale: Thrombocytopenia presents with mucocutaneous bleeding (epistaxis,
gums), petechiae, purpura, ecchymosis, prolonged bleeding, dizziness, tachycardia,
faintness, and potentially intracranial bleeding. Hypertension and bradycardia are
not typical signs.
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Correct Answers
Question 1
The nurse is assessing a patient with sickle cell anemia. Which clinical manifestations
should the nurse anticipate? (Select all that apply)
A. Chronic anemia
B. Severe pain
C. Jaundice
D. Cholelithiasis
E. Bradycardia
Correct Answer
A, B, C, D
Rationale: Patients often present with chronic anemia, severe pain, jaundice, and
cholelithiasis due to hemolysis and bilirubin buildup. Bradycardia is not a typical
manifestation.
Question 2
The nurse is reviewing a neutropenic patient's plan of care. Which interventions are
appropriate?
• A. Collect blood cultures x2 before starting antibiotics
• B. Initiate broad-spectrum antibiotics immediately after cultures
• C. Delay antifungal therapy until discharge
• D. Monitor closely for subtle signs of infection
• E. Withhold Neupogen until fever resolves
Correct Answer
A, B, D
Rationale: Infection must be aggressively evaluated and treated—cultures (A),
immediate antibiotics (B), and close monitoring for infection (D). Antifungals may be
needed during hospitalization, not delayed until discharge (C). Neupogen is used to
stimulate WBCs regardless of fever (E).
Page 1 of 20
,Question 3
The nurse is reviewing laboratory results for a patient with suspected iron deficiency
anemia. Which set of findings is most consistent with this diagnosis?
A. ↑ Hemoglobin, ↑ Serum ferritin, ↑ Iron
B. ↓ Hemoglobin, ↓ Serum ferritin, ↑ TIBC
C. ↓ Hemoglobin, ↑ Serum ferritin, ↓ TIBC
D. ↑ Hemoglobin, ↓ Serum iron, ↑ Ferritin
Correct Answer
B
Rationale:
• Iron deficiency anemia typically presents with low hemoglobin, low serum ferritin
(storage form of iron), and elevated TIBC because the body increases its ability to
bind available iron.
• The other options do not match this diagnostic pattern.
Question 4
A patient presents with weakness, confusion, and a sore red tongue. Laboratory
testing confirms a lack of intrinsic factor. Which condition does the nurse anticipate?
A. Iron deficiency anemia
B. Pernicious anemia
C. Aplastic anemia
D. Thalassemia
Correct Answer
B. Pernicious anemia
Rationale: Pernicious anemia results from lack of intrinsic factor (IF), which is
necessary for B12 absorption. This causes neurological issues (confusion,
paresthesia), weakness, and characteristic tongue changes. Iron deficiency and
thalassemia are unrelated to IF, while aplastic anemia involves decreased production
of all blood cell types.
Page 2 of 20
, Question 5
A patient with immune thrombocytopenic purpura (ITP) is being treated. Which
nursing management intervention is most appropriate?
A. Platelet transfusion when counts drop below 10,000
B. Administration of factor Xa inhibitor (Arixtra)
C. Avoidance of corticosteroid therapy
D. Initiation of heparin infusion to increase platelet counts
Correct Answer
A
Rationale: In ITP, treatment includes corticosteroids, IV immunoglobulins,
splenectomy, and platelet transfusion if <10,000. Factor Xa inhibitors and heparin
are used in HIT, not ITP. Corticosteroids are a cornerstone of ITP therapy, so
avoiding them would be incorrect
Question 6
The nurse recognizes which of the following as clinical manifestations of
thrombocytopenia?
A. Petechiae and purpura
B. Epistaxis and gum bleeding
C. Tachycardia and dizziness
D. Hypertension and bradycardia
E. Intracranial bleeding
Correct Answer
A, B, C, E
Rationale: Thrombocytopenia presents with mucocutaneous bleeding (epistaxis,
gums), petechiae, purpura, ecchymosis, prolonged bleeding, dizziness, tachycardia,
faintness, and potentially intracranial bleeding. Hypertension and bradycardia are
not typical signs.
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