Med Surg Chapter 31: Hematologic Problems
Questions with Correct Answers
A 62-year old man with chronic anemia is experiencing increased
fatigue and occasional palpitations at rest. The nurse would expect the
patient's laboratory findings to include
a. a hematocrit (Hct) of 38%.
b. an RBC count of 4,500,000/L.
c. normal red blood cell (RBC) indices.
d. a hemoglobin (Hgb) of 8.6 g/dL (86 g/L). Correct Answer-ANS: D
The patient's clinical manifestations indicate moderate anemia, which is
consistent with a Hgb of 6 to 10 g/dL. The other values are all within the
range of normal.
Which menu choice indicates that the patient understands the nurse's
teaching about best dietary choices for iron-deficiency anemia?
a. Omelet and whole wheat toast
b. Cantaloupe and cottage cheese
c. Strawberry and banana fruit plate
d. Cornmeal muffin and orange juice Correct Answer-ANS: A
Eggs and whole grain breads are high in iron. The other choices are
appropriate for other nutritional deficiencies but are not the best choice
for a patient with iron-deficiency anemia.
A patient who is receiving methotrexate for severe rheumatoid arthritis
develops a megaloblastic anemia. The nurse will anticipate teaching the
patient about increasing oral intake of
,a. iron.
b. folic acid.
c. cobalamin (vitamin B12).
d. ascorbic acid (vitamin C). Correct Answer-ANS: B
Methotrexate use can lead to folic acid deficiency. Supplementation with
oral folic acid supplements is the usual treatment. The other nutrients
would not correct folic acid deficiency, although they would be used to
treat other types of anemia.
A 52-year-old patient has a new diagnosis of pernicious anemia. The
nurse determines that the patient understands the teaching about the
disorder when the patient states, "I
a. need to start eating more red meat and liver."
b. will stop having a glass of wine with dinner."
c. could choose nasal spray rather than injections of vitamin B12."
d. will need to take a proton pump inhibitor like omeprazole (Prilosec)."
Correct Answer-ANS: C
Because pernicious anemia prevents the absorption of vitamin B12, this
patient requires injections or intranasal administration of cobalamin.
Alcohol use does not cause cobalamin deficiency. Proton pump
inhibitors decrease the absorption of vitamin B12. Eating more foods
rich in vitamin B12 is not helpful because the lack of intrinsic factor
prevents absorption of the vitamin.
An appropriate nursing intervention for a hospitalized patient with
severe hemolytic anemia is to
a. provide a diet high in vitamin K.
, b. alternate periods of rest and activity.
c. teach the patient how to avoid injury.
d. place the patient on protective isolation. Correct Answer-ANS: B
Nursing care for patients with anemia should alternate periods of rest
and activity to encourage activity without causing undue fatigue. There
is no indication that the patient has a bleeding disorder, so a diet high in
vitamin K or teaching about how to avoid injury is not needed.
Protective isolation might be used for a patient with aplastic anemia, but
it is not indicated for hemolytic anemia.
Which patient statement to the nurse indicates a need for additional
instruction about taking oral ferrous sulfate?
a. "I will call my health care provider if my stools turn black."
b. "I will take a stool softener if I feel constipated occasionally."
c. "I should take the iron with orange juice about an hour before eating."
d. "I should increase my fluid and fiber intake while I am taking iron
tablets." Correct Answer-ANS: A
It is normal for the stools to appear black when a patient is taking iron,
and the patient should not call the doctor about this. The other patient
statements are correct.
Which collaborative problem will the nurse include in a care plan for a
patient admitted to the hospital with idiopathic aplastic anemia?
a. Potential complication: seizures
b. Potential complication: infection
c. Potential complication: neurogenic shock
Questions with Correct Answers
A 62-year old man with chronic anemia is experiencing increased
fatigue and occasional palpitations at rest. The nurse would expect the
patient's laboratory findings to include
a. a hematocrit (Hct) of 38%.
b. an RBC count of 4,500,000/L.
c. normal red blood cell (RBC) indices.
d. a hemoglobin (Hgb) of 8.6 g/dL (86 g/L). Correct Answer-ANS: D
The patient's clinical manifestations indicate moderate anemia, which is
consistent with a Hgb of 6 to 10 g/dL. The other values are all within the
range of normal.
Which menu choice indicates that the patient understands the nurse's
teaching about best dietary choices for iron-deficiency anemia?
a. Omelet and whole wheat toast
b. Cantaloupe and cottage cheese
c. Strawberry and banana fruit plate
d. Cornmeal muffin and orange juice Correct Answer-ANS: A
Eggs and whole grain breads are high in iron. The other choices are
appropriate for other nutritional deficiencies but are not the best choice
for a patient with iron-deficiency anemia.
A patient who is receiving methotrexate for severe rheumatoid arthritis
develops a megaloblastic anemia. The nurse will anticipate teaching the
patient about increasing oral intake of
,a. iron.
b. folic acid.
c. cobalamin (vitamin B12).
d. ascorbic acid (vitamin C). Correct Answer-ANS: B
Methotrexate use can lead to folic acid deficiency. Supplementation with
oral folic acid supplements is the usual treatment. The other nutrients
would not correct folic acid deficiency, although they would be used to
treat other types of anemia.
A 52-year-old patient has a new diagnosis of pernicious anemia. The
nurse determines that the patient understands the teaching about the
disorder when the patient states, "I
a. need to start eating more red meat and liver."
b. will stop having a glass of wine with dinner."
c. could choose nasal spray rather than injections of vitamin B12."
d. will need to take a proton pump inhibitor like omeprazole (Prilosec)."
Correct Answer-ANS: C
Because pernicious anemia prevents the absorption of vitamin B12, this
patient requires injections or intranasal administration of cobalamin.
Alcohol use does not cause cobalamin deficiency. Proton pump
inhibitors decrease the absorption of vitamin B12. Eating more foods
rich in vitamin B12 is not helpful because the lack of intrinsic factor
prevents absorption of the vitamin.
An appropriate nursing intervention for a hospitalized patient with
severe hemolytic anemia is to
a. provide a diet high in vitamin K.
, b. alternate periods of rest and activity.
c. teach the patient how to avoid injury.
d. place the patient on protective isolation. Correct Answer-ANS: B
Nursing care for patients with anemia should alternate periods of rest
and activity to encourage activity without causing undue fatigue. There
is no indication that the patient has a bleeding disorder, so a diet high in
vitamin K or teaching about how to avoid injury is not needed.
Protective isolation might be used for a patient with aplastic anemia, but
it is not indicated for hemolytic anemia.
Which patient statement to the nurse indicates a need for additional
instruction about taking oral ferrous sulfate?
a. "I will call my health care provider if my stools turn black."
b. "I will take a stool softener if I feel constipated occasionally."
c. "I should take the iron with orange juice about an hour before eating."
d. "I should increase my fluid and fiber intake while I am taking iron
tablets." Correct Answer-ANS: A
It is normal for the stools to appear black when a patient is taking iron,
and the patient should not call the doctor about this. The other patient
statements are correct.
Which collaborative problem will the nurse include in a care plan for a
patient admitted to the hospital with idiopathic aplastic anemia?
a. Potential complication: seizures
b. Potential complication: infection
c. Potential complication: neurogenic shock
