FNP CERTIFICATION EXAM 2026/2027
QUESTIONS AND CORRECT ANSWERS GRADED
A+
A WBC morphology report relates toxic granulation. This is most often seen in:
a. Pathogenic conditions are caused by intracellular organisms.
b. Viral illness.
c. Recovery stage from protozoan infestation.
d. Serious bacterial infection.
D. Serious bacterial infection.
Toxic granulation refers to a morphology observed in granulocytes, such as
neutrophils, that is characterized by the presence of dark, coarse granules. This
condition is commonly observed in patients during inflammation or acute
infection. Granulocytes are involved in the phagocytosis of bacterial or fungal
pathogens and, thus, toxic granulation is most likely a result of a serious bacterial
infection. Topic: Assessment and Intervention in Select Hematologic Disorders
Which of the following is consistent with neutrophilia?
a. TWBC=8,000 mm3, 45% neuts
,b. TWBC=13,500 mm3, 35% neuts
c. TWBC=10,100 mm3, 81% neuts
d. TWBC=12,000 mm3, 40% neuts
C. TWBC=10,100 mm3, 81% neuts.
Neutrophils are involved in the degradation of pathogens, generation of oxidants,
and tissue degradation. Neutrophilia can occur from acute infections and is
characterized by an elevated number of neutrophils (>70% TWBC [NL=50%-70%
TWBC in adults]). Leukocytosis with neutrophilia is characterized by elevated
levels of WBCs (NL = 6,000-10,000 per mm3 in adults). Topic: Assessment and
Intervention in Select Hematologic Disorders
The use of which of the following medications is a common cause of drug-induced
thrombocytopenia?
a. Warfarin
b. Aspirin
c. Ibuprofen
d. Unfractionated heparin
,D. Unfractionated heparin.
Drug-induced thrombocytopenia is commonly caused by accelerated platelet
destruction by drug-dependent, platelet-reactive antibodies. Medications associated
with drug-induced thrombocytopenia include UF heparin, sulfonamides, thiazide
diuretics, cimetidine, quinine, vancomycin, phenytoin, carbamazepine, beta-
lactams, digoxin, and valproic acid. Upon discontinuation of the agent, an increase
in platelet count typically occurs within 2-7 days. Topic: Assessment and
Intervention in Select Hematologic Disorders
Which of the following is most consistent with a hemogram finding in vitamin B12
deficiency that can occasionally be found with long-term metformin use?
a. Low MCV, elevated MCHC
b. Elevated MCV, normal MCHC
c. Low MCV, low MCHC
d. Normal MCV, elevated MCHC
B. Elevated MCV, normal MCHC.
Pernicious anemia is caused by a deficiency in vitamin B12 which is needed for
RBC production. The most common cause of pernicious anemia is an inability to
absorb vitamin B12 from food due to reduced production of intrinsic factors in the
stomach but has also been attributed to long-term metformin use in a dose-
, dependent manner. The characteristics of vitamin B12 deficiency are an elevated
MCV with a normal MCHC. Treatment of pernicious anemia involves vitamin B12
replacement therapy. Topic: Assessment and Intervention in Select Hematologic
Disorders
In the person with reactive thrombocytosis, clotting risk is typically absent until a
platelet count of:
a. ≥400,000 mm3
b. ≥800,000 mm3.
c. ≥1 million mm3.
d. ≥2 million mm3.
C. ≥1 million mm3.
Reactive thrombocytosis is an increase in platelet count in response to a stimulus.
There are several causes of reactive thrombocytosis, including acute bleeding and
blood loss, allergic reactions, cancer, infections, some types of anemia, major
surgery, splenectomy, and some types of medications. Treatment of reactive
thrombocytosis is directed at the underlying cause and platelet counts usually
return to normal once the underlying condition is brought under control. An
increased risk of blood clots can occur once the platelet count is ≥1 million mm3
(NL = 150,000-450,000 mm3). Topic: Assessment and Intervention in Select
Hematologic Disorders
QUESTIONS AND CORRECT ANSWERS GRADED
A+
A WBC morphology report relates toxic granulation. This is most often seen in:
a. Pathogenic conditions are caused by intracellular organisms.
b. Viral illness.
c. Recovery stage from protozoan infestation.
d. Serious bacterial infection.
D. Serious bacterial infection.
Toxic granulation refers to a morphology observed in granulocytes, such as
neutrophils, that is characterized by the presence of dark, coarse granules. This
condition is commonly observed in patients during inflammation or acute
infection. Granulocytes are involved in the phagocytosis of bacterial or fungal
pathogens and, thus, toxic granulation is most likely a result of a serious bacterial
infection. Topic: Assessment and Intervention in Select Hematologic Disorders
Which of the following is consistent with neutrophilia?
a. TWBC=8,000 mm3, 45% neuts
,b. TWBC=13,500 mm3, 35% neuts
c. TWBC=10,100 mm3, 81% neuts
d. TWBC=12,000 mm3, 40% neuts
C. TWBC=10,100 mm3, 81% neuts.
Neutrophils are involved in the degradation of pathogens, generation of oxidants,
and tissue degradation. Neutrophilia can occur from acute infections and is
characterized by an elevated number of neutrophils (>70% TWBC [NL=50%-70%
TWBC in adults]). Leukocytosis with neutrophilia is characterized by elevated
levels of WBCs (NL = 6,000-10,000 per mm3 in adults). Topic: Assessment and
Intervention in Select Hematologic Disorders
The use of which of the following medications is a common cause of drug-induced
thrombocytopenia?
a. Warfarin
b. Aspirin
c. Ibuprofen
d. Unfractionated heparin
,D. Unfractionated heparin.
Drug-induced thrombocytopenia is commonly caused by accelerated platelet
destruction by drug-dependent, platelet-reactive antibodies. Medications associated
with drug-induced thrombocytopenia include UF heparin, sulfonamides, thiazide
diuretics, cimetidine, quinine, vancomycin, phenytoin, carbamazepine, beta-
lactams, digoxin, and valproic acid. Upon discontinuation of the agent, an increase
in platelet count typically occurs within 2-7 days. Topic: Assessment and
Intervention in Select Hematologic Disorders
Which of the following is most consistent with a hemogram finding in vitamin B12
deficiency that can occasionally be found with long-term metformin use?
a. Low MCV, elevated MCHC
b. Elevated MCV, normal MCHC
c. Low MCV, low MCHC
d. Normal MCV, elevated MCHC
B. Elevated MCV, normal MCHC.
Pernicious anemia is caused by a deficiency in vitamin B12 which is needed for
RBC production. The most common cause of pernicious anemia is an inability to
absorb vitamin B12 from food due to reduced production of intrinsic factors in the
stomach but has also been attributed to long-term metformin use in a dose-
, dependent manner. The characteristics of vitamin B12 deficiency are an elevated
MCV with a normal MCHC. Treatment of pernicious anemia involves vitamin B12
replacement therapy. Topic: Assessment and Intervention in Select Hematologic
Disorders
In the person with reactive thrombocytosis, clotting risk is typically absent until a
platelet count of:
a. ≥400,000 mm3
b. ≥800,000 mm3.
c. ≥1 million mm3.
d. ≥2 million mm3.
C. ≥1 million mm3.
Reactive thrombocytosis is an increase in platelet count in response to a stimulus.
There are several causes of reactive thrombocytosis, including acute bleeding and
blood loss, allergic reactions, cancer, infections, some types of anemia, major
surgery, splenectomy, and some types of medications. Treatment of reactive
thrombocytosis is directed at the underlying cause and platelet counts usually
return to normal once the underlying condition is brought under control. An
increased risk of blood clots can occur once the platelet count is ≥1 million mm3
(NL = 150,000-450,000 mm3). Topic: Assessment and Intervention in Select
Hematologic Disorders
