HEMATOLOGY MED-SURG PRACTICE EXAM (100
ITEMS)
1. A nurse reviews a client’s CBC and notes a hemoglobin of 7.8 g/dL.
Which assessment finding is most expected?
A. Bounding peripheral pulses
B. Shortness of breath on exertion
C. Bradycardia
D. Warm, flushed skin
Rationale: Low hemoglobin reduces oxygen-carrying capacity, causing
dyspnea on exertion as the body compensates for hypoxia.
2. A client with iron-deficiency anemia reports craving ice. This finding
is known as:
A. Dysgeusia
B. Pica
C. Cheilosis
D. Glossitis
Rationale: Pica is the craving for non-nutritive substances such as ice,
clay, or starch, commonly associated with iron-deficiency anemia.
3. Which food would the nurse recommend for a client with
pernicious anemia?
A. Citrus fruits
B. Leafy greens
C. Meat and dairy products
,D. Whole grains
Rationale: Pernicious anemia results from vitamin B12 deficiency; B12
is primarily found in animal products including meat and dairy.
4. A client with sickle cell crisis is admitted with severe pain. The
priority action is:
A. Apply cold compresses
B. Administer IV opioids
C. Encourage ambulation
D. Restrict fluids
Rationale: Pain in sickle cell crisis is severe due to vaso-occlusion; IV
opioids are the priority for immediate relief.
5. Which laboratory value is most concerning in a client receiving
heparin therapy?
A. Hemoglobin 12 g/dL
B. Platelets 200,000/mm³
C. Platelets 40,000/mm³
D. aPTT 60 seconds
Rationale: A platelet count <50,000 may indicate heparin-induced
thrombocytopenia, a serious complication requiring discontinuation.
6. A client with polycythemia vera needs which priority teaching?
A. Increase dairy intake
B. Drink at least 3 L of fluids daily
C. Avoid all exercise
D. Limit sodium intake
,Rationale: Adequate hydration reduces blood viscosity and decreases
the risk of thrombosis in polycythemia vera.
7. Which symptom is expected in a client with hemophilia A?
A. Excessive platelet aggregation
B. Prolonged bleeding after injury
C. Decreased RBC destruction
D. Frequent infections
Rationale: Hemophilia A is due to factor VIII deficiency, causing
delayed clotting and prolonged bleeding.
8. A nurse caring for a neutropenic client should prioritize:
A. Encouraging raw vegetable intake
B. Allowing fresh flowers at the bedside
C. Room temperature humidification
D. Strict hand hygiene by all visitors
Rationale: Neutropenic clients are highly susceptible to infection;
hand hygiene is the most effective prevention.
9. A client with DIC (disseminated intravascular coagulation) is at risk
for:
A. Hypercoagulation only
B. Both bleeding and clotting
C. No clotting activity
D. Only bleeding
Rationale: DIC involves widespread clotting that consumes clotting
factors, leading to simultaneous thrombosis and bleeding.
, 10. Which finding indicates effective treatment of iron-deficiency
anemia?
A. Decreased reticulocyte count
B. Persistent fatigue
C. Pale nail beds
D. Increased hemoglobin levels
Rationale: Improvement in hemoglobin confirms iron therapy
effectiveness.
11. A client with aplastic anemia has pancytopenia. Which assessment
finding is most likely?
A. Hypertension
B. Jaundice
C. Petechiae and ecchymosis
D. Hyperactive reflexes
Rationale: Pancytopenia results in thrombocytopenia, causing easy
bruising and petechiae.
12. Which laboratory test is most useful in monitoring vitamin B12
therapy?
A. Serum iron
B. Ferritin
C. Methylmalonic acid (MMA)
D. Reticulocyte count
Rationale: MMA levels are elevated in B12 deficiency; effective
therapy normalizes them.
ITEMS)
1. A nurse reviews a client’s CBC and notes a hemoglobin of 7.8 g/dL.
Which assessment finding is most expected?
A. Bounding peripheral pulses
B. Shortness of breath on exertion
C. Bradycardia
D. Warm, flushed skin
Rationale: Low hemoglobin reduces oxygen-carrying capacity, causing
dyspnea on exertion as the body compensates for hypoxia.
2. A client with iron-deficiency anemia reports craving ice. This finding
is known as:
A. Dysgeusia
B. Pica
C. Cheilosis
D. Glossitis
Rationale: Pica is the craving for non-nutritive substances such as ice,
clay, or starch, commonly associated with iron-deficiency anemia.
3. Which food would the nurse recommend for a client with
pernicious anemia?
A. Citrus fruits
B. Leafy greens
C. Meat and dairy products
,D. Whole grains
Rationale: Pernicious anemia results from vitamin B12 deficiency; B12
is primarily found in animal products including meat and dairy.
4. A client with sickle cell crisis is admitted with severe pain. The
priority action is:
A. Apply cold compresses
B. Administer IV opioids
C. Encourage ambulation
D. Restrict fluids
Rationale: Pain in sickle cell crisis is severe due to vaso-occlusion; IV
opioids are the priority for immediate relief.
5. Which laboratory value is most concerning in a client receiving
heparin therapy?
A. Hemoglobin 12 g/dL
B. Platelets 200,000/mm³
C. Platelets 40,000/mm³
D. aPTT 60 seconds
Rationale: A platelet count <50,000 may indicate heparin-induced
thrombocytopenia, a serious complication requiring discontinuation.
6. A client with polycythemia vera needs which priority teaching?
A. Increase dairy intake
B. Drink at least 3 L of fluids daily
C. Avoid all exercise
D. Limit sodium intake
,Rationale: Adequate hydration reduces blood viscosity and decreases
the risk of thrombosis in polycythemia vera.
7. Which symptom is expected in a client with hemophilia A?
A. Excessive platelet aggregation
B. Prolonged bleeding after injury
C. Decreased RBC destruction
D. Frequent infections
Rationale: Hemophilia A is due to factor VIII deficiency, causing
delayed clotting and prolonged bleeding.
8. A nurse caring for a neutropenic client should prioritize:
A. Encouraging raw vegetable intake
B. Allowing fresh flowers at the bedside
C. Room temperature humidification
D. Strict hand hygiene by all visitors
Rationale: Neutropenic clients are highly susceptible to infection;
hand hygiene is the most effective prevention.
9. A client with DIC (disseminated intravascular coagulation) is at risk
for:
A. Hypercoagulation only
B. Both bleeding and clotting
C. No clotting activity
D. Only bleeding
Rationale: DIC involves widespread clotting that consumes clotting
factors, leading to simultaneous thrombosis and bleeding.
, 10. Which finding indicates effective treatment of iron-deficiency
anemia?
A. Decreased reticulocyte count
B. Persistent fatigue
C. Pale nail beds
D. Increased hemoglobin levels
Rationale: Improvement in hemoglobin confirms iron therapy
effectiveness.
11. A client with aplastic anemia has pancytopenia. Which assessment
finding is most likely?
A. Hypertension
B. Jaundice
C. Petechiae and ecchymosis
D. Hyperactive reflexes
Rationale: Pancytopenia results in thrombocytopenia, causing easy
bruising and petechiae.
12. Which laboratory test is most useful in monitoring vitamin B12
therapy?
A. Serum iron
B. Ferritin
C. Methylmalonic acid (MMA)
D. Reticulocyte count
Rationale: MMA levels are elevated in B12 deficiency; effective
therapy normalizes them.
