NURS 498 PHARM MIDTERM 2 HEMATOLOGY AND RENAL
QUESTIONS AND ANSWERS | STUDY GUIDE & PRACTICE TEST
2026/2027
What are some causes of anemia? - correct answer ✔✔blood loss, impaired production of RBC, or
destruction of RBC.
What are some examples of acute blood loss? - correct answer ✔✔Trauma, GI Bleed
What are some examples of chronic blood loss? - correct answer ✔✔Gastritis, Heavy Menstrual Cycle
What are some intrinsic factors which increase destruction (lysis) of red blood cells? - correct answer
✔✔Abnormal hub or enzyme deficiency, sickle cell anemia
What are some extrinsic factors which increase destruction (lysis) of red blood cells? - correct answer
✔✔trauma, antibodies, toxins, infectious agents, heart valve replacements, bypass machines
Who is at highest risk of iron deficiency anemia? - correct answer ✔✔pre-menopausal women
pregnant women
older adults
children on milk diet
What is the most common type of anemia? - correct answer ✔✔Iron Deficiency
Do you need to report black tarry stool when a patient is taking iron supplements? - correct answer
✔✔NO, this is a normal side effect of iron. Occult blood tests may be done to assure patient doesn't
have underlying Melina or GI bleed.
What are some iron rich foods? - correct answer ✔✔red/white meat, eggs, broccoli, dried fruit, grains,
legumes, green leafy vegetables.
Why may oral iron be taken with citrus foods? - correct answer ✔✔Citrus foods add to the absorption of
iron
When is a RBC transfusion used? - correct answer ✔✔RBC transfusions are limited to the use in patients
with hgb levels <70, or if a patient is experiencing shortness of breath and decreased energy.
When should you take iron supplements? - correct answer ✔✔30 minutes before eating
What are some adverse effects of iron supplements? - correct answer ✔✔GI Upset, Black Tarry Stool,
Iron Toxicity, Iron Overdose (leading cause of childhood poisoning), temporary discolouration of the
teeth.
What type of anemia would you refrain the use of iron supplements? - correct answer ✔✔Hemolytic
anemia - in this type of anemia the destruction of red blood cells releases iron.
, Thalassemia
What is primary hemochromatosis caused by? - correct answer ✔✔This is caused through inheritance.
What is secondary hemochromatosis caused by? - correct answer ✔✔This is caused by too many blood
transfusion or liver disease.
Why are transfusions used in patients with thalassemia? - correct answer ✔✔to keep the hgb levels over
100. this can be used in combination with IV deferoxamine, zinc and ascorbic acid can also be added for
major thalassemia.
When can erythropoiesis agents (eprex) be started on anemic patients? - correct answer ✔✔When
hemoglobin levels are <110g/L.
When must erythropoiesis stimulating agents (Eprex) be stopped in anemic patients? (On EXAM) -
correct answer ✔✔When hemoglobin levels are >120g/L.
Why do you need to monitor potassium levels with the use of ACE inhibitors?* - correct answer
✔✔These medications may cause the body to retain potassium. Monitor potassium levels closely and
monitor for cardiac irregularities.
Why is IV insulin and glucose given together for hyperkalemia? - correct answer ✔✔Rapid reduction of
potassium levels. If insulin is given at the same time as glucose it will temporarily reduce K+ levels.
What medication is used in treatment of metabolic acidosis? - correct answer ✔✔sodium bicarbonate
Why should patients with chronic kidney disease avoid the use of NSAIDS? - correct answer ✔✔They
block the prostaglandin response leading to decreased blood flow to the kidneys.
When should metformin be held? - correct answer ✔✔Within 48 hours of any diagnostic test using
contrast dye.
What is the use of antifibrinolytic drugs/hemostatic drugs (aprotinin and tranexamic acid)? - correct
answer ✔✔They are used in prevention and treatment of excess bleeding resulting from
hyperfibrinolysis or surgical complications. They promote clot formation and typically used in surgery to
stop bleeding/ prevent the lysis of fibrin.
What is desmopressin used for? - correct answer ✔✔Used as a quick clotting method to control bleeding
(only lasts a few minutes)
Also used for mild hemophilia A and VWD.
What medications are used for volume overload in CKD patients? - correct answer ✔✔Thiazide Diuretics
(Hydrochlorothiazide)
Loop Diuretics (Lasix) - used in excessive fluid overload because it works faster.
What is phlebotomy? - correct answer ✔✔Removal of too many RBC's.
Why may folic acid be used with anemia? - correct answer ✔✔To help mature the RBC's
QUESTIONS AND ANSWERS | STUDY GUIDE & PRACTICE TEST
2026/2027
What are some causes of anemia? - correct answer ✔✔blood loss, impaired production of RBC, or
destruction of RBC.
What are some examples of acute blood loss? - correct answer ✔✔Trauma, GI Bleed
What are some examples of chronic blood loss? - correct answer ✔✔Gastritis, Heavy Menstrual Cycle
What are some intrinsic factors which increase destruction (lysis) of red blood cells? - correct answer
✔✔Abnormal hub or enzyme deficiency, sickle cell anemia
What are some extrinsic factors which increase destruction (lysis) of red blood cells? - correct answer
✔✔trauma, antibodies, toxins, infectious agents, heart valve replacements, bypass machines
Who is at highest risk of iron deficiency anemia? - correct answer ✔✔pre-menopausal women
pregnant women
older adults
children on milk diet
What is the most common type of anemia? - correct answer ✔✔Iron Deficiency
Do you need to report black tarry stool when a patient is taking iron supplements? - correct answer
✔✔NO, this is a normal side effect of iron. Occult blood tests may be done to assure patient doesn't
have underlying Melina or GI bleed.
What are some iron rich foods? - correct answer ✔✔red/white meat, eggs, broccoli, dried fruit, grains,
legumes, green leafy vegetables.
Why may oral iron be taken with citrus foods? - correct answer ✔✔Citrus foods add to the absorption of
iron
When is a RBC transfusion used? - correct answer ✔✔RBC transfusions are limited to the use in patients
with hgb levels <70, or if a patient is experiencing shortness of breath and decreased energy.
When should you take iron supplements? - correct answer ✔✔30 minutes before eating
What are some adverse effects of iron supplements? - correct answer ✔✔GI Upset, Black Tarry Stool,
Iron Toxicity, Iron Overdose (leading cause of childhood poisoning), temporary discolouration of the
teeth.
What type of anemia would you refrain the use of iron supplements? - correct answer ✔✔Hemolytic
anemia - in this type of anemia the destruction of red blood cells releases iron.
, Thalassemia
What is primary hemochromatosis caused by? - correct answer ✔✔This is caused through inheritance.
What is secondary hemochromatosis caused by? - correct answer ✔✔This is caused by too many blood
transfusion or liver disease.
Why are transfusions used in patients with thalassemia? - correct answer ✔✔to keep the hgb levels over
100. this can be used in combination with IV deferoxamine, zinc and ascorbic acid can also be added for
major thalassemia.
When can erythropoiesis agents (eprex) be started on anemic patients? - correct answer ✔✔When
hemoglobin levels are <110g/L.
When must erythropoiesis stimulating agents (Eprex) be stopped in anemic patients? (On EXAM) -
correct answer ✔✔When hemoglobin levels are >120g/L.
Why do you need to monitor potassium levels with the use of ACE inhibitors?* - correct answer
✔✔These medications may cause the body to retain potassium. Monitor potassium levels closely and
monitor for cardiac irregularities.
Why is IV insulin and glucose given together for hyperkalemia? - correct answer ✔✔Rapid reduction of
potassium levels. If insulin is given at the same time as glucose it will temporarily reduce K+ levels.
What medication is used in treatment of metabolic acidosis? - correct answer ✔✔sodium bicarbonate
Why should patients with chronic kidney disease avoid the use of NSAIDS? - correct answer ✔✔They
block the prostaglandin response leading to decreased blood flow to the kidneys.
When should metformin be held? - correct answer ✔✔Within 48 hours of any diagnostic test using
contrast dye.
What is the use of antifibrinolytic drugs/hemostatic drugs (aprotinin and tranexamic acid)? - correct
answer ✔✔They are used in prevention and treatment of excess bleeding resulting from
hyperfibrinolysis or surgical complications. They promote clot formation and typically used in surgery to
stop bleeding/ prevent the lysis of fibrin.
What is desmopressin used for? - correct answer ✔✔Used as a quick clotting method to control bleeding
(only lasts a few minutes)
Also used for mild hemophilia A and VWD.
What medications are used for volume overload in CKD patients? - correct answer ✔✔Thiazide Diuretics
(Hydrochlorothiazide)
Loop Diuretics (Lasix) - used in excessive fluid overload because it works faster.
What is phlebotomy? - correct answer ✔✔Removal of too many RBC's.
Why may folic acid be used with anemia? - correct answer ✔✔To help mature the RBC's
