Lewis Chapter 30: Hematologic
Problems Practice Questions & 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). - Correct Answers
✅✅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
recommended dietary choices for iron-deficiency anemia?
a. Omelet and whole wheat toast c. Strawberry and banana fruit plate
b. Cantaloupe and cottage cheese d. Cornmeal muffin and orange juice
- Correct Answers ✅✅ANS: A
,Lewis Chapter 30: Hematologic
Problems Practice Questions & Answers
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.
c. cobalamin (vitamin B12).
d. ascorbic acid (vitamin C). - Correct Answers ✅✅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
,Lewis Chapter 30: Hematologic
Problems Practice Questions & Answers
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)." - Correct Answers ✅✅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.
DIF: Cognitive Level: Apply (application) REF: 612
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
, Lewis Chapter 30: Hematologic
Problems Practice Questions & Answers
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 Answers
✅✅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.
DIF: Cognitive Level: Apply (application) REF: 608
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological
Integrity
Problems Practice Questions & 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). - Correct Answers
✅✅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
recommended dietary choices for iron-deficiency anemia?
a. Omelet and whole wheat toast c. Strawberry and banana fruit plate
b. Cantaloupe and cottage cheese d. Cornmeal muffin and orange juice
- Correct Answers ✅✅ANS: A
,Lewis Chapter 30: Hematologic
Problems Practice Questions & Answers
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.
c. cobalamin (vitamin B12).
d. ascorbic acid (vitamin C). - Correct Answers ✅✅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
,Lewis Chapter 30: Hematologic
Problems Practice Questions & Answers
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)." - Correct Answers ✅✅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.
DIF: Cognitive Level: Apply (application) REF: 612
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
, Lewis Chapter 30: Hematologic
Problems Practice Questions & Answers
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 Answers
✅✅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.
DIF: Cognitive Level: Apply (application) REF: 608
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological
Integrity
