©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
Ch. 30: Hematologic Problems Lewis: Medical-
Surgical Nursing, 10th Edition Exam Study Questions
and 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 test findings to include
a. an RBC count of 4,500,000/L.
b. a hematocrit (Hct) value of 38%.
c. normal red blood cell (RBC) indices.
d. a hemoglobin (Hgb) of 8.6 g/dL (86 g/L). - Ans:✔✔-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.
DIF: Cognitive Level: Understand (comprehension) REF: 607
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
Which menu choice indicates that the patient understands the nurse's teaching about
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FIRST PUBLISH OCTOBER 2024
recommended 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 - Ans:✔✔-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.
DIF: Cognitive Level: Apply (application) REF: 610
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
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.
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c. cobalamin (vitamin B12).
d. ascorbic acid (vitamin C). - Ans:✔✔-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.
DIF: Cognitive Level: Apply (application) REF: 612
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
A 52-yr-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,
a. "I need to start eating more red meat and liver."
b. "I will stop having a glass of wine with dinner."
c. "I could choose nasal spray rather than injections of vitamin B12."
d. "I will need to take a proton pump inhibitor such as omeprazole (Prilosec)." - Ans:✔✔-ANS: C
Because pernicious anemia prevents the absorption of vitamin B12, this patient requires
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FIRST PUBLISH OCTOBER 2024
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.
DIF: Cognitive Level: Apply (application) REF: 612
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
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. - Ans:✔✔-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
Page 4/44
FIRST PUBLISH OCTOBER 2024
Ch. 30: Hematologic Problems Lewis: Medical-
Surgical Nursing, 10th Edition Exam Study Questions
and 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 test findings to include
a. an RBC count of 4,500,000/L.
b. a hematocrit (Hct) value of 38%.
c. normal red blood cell (RBC) indices.
d. a hemoglobin (Hgb) of 8.6 g/dL (86 g/L). - Ans:✔✔-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.
DIF: Cognitive Level: Understand (comprehension) REF: 607
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
Which menu choice indicates that the patient understands the nurse's teaching about
Page 1/44
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
recommended 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 - Ans:✔✔-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.
DIF: Cognitive Level: Apply (application) REF: 610
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
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.
Page 2/44
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
c. cobalamin (vitamin B12).
d. ascorbic acid (vitamin C). - Ans:✔✔-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.
DIF: Cognitive Level: Apply (application) REF: 612
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
A 52-yr-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,
a. "I need to start eating more red meat and liver."
b. "I will stop having a glass of wine with dinner."
c. "I could choose nasal spray rather than injections of vitamin B12."
d. "I will need to take a proton pump inhibitor such as omeprazole (Prilosec)." - Ans:✔✔-ANS: C
Because pernicious anemia prevents the absorption of vitamin B12, this patient requires
Page 3/44
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
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.
DIF: Cognitive Level: Apply (application) REF: 612
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
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. - Ans:✔✔-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
Page 4/44
