ATI Medical-Surgical Hematology Exam
Questions with Correct Answers
(VerifiedAnswers) Plus Rationales 2026 Q&A
Instant Download PDF
1. A nurse is assessing a client with iron-deficiency anemia.
Which finding should the nurse expect?
A. Bradycardia
B. Fatigue and weakness
C. Increased oxygen saturation
D. Severe hypertension
Rationale: Iron-deficiency anemia reduces the amount of
hemoglobin available to transport oxygen to tissues. The
resulting reduced oxygen delivery commonly produces fatigue,
weakness, decreased exercise tolerance, pallor, and shortness of
breath. Bradycardia and hypertension are not expected
hallmark findings. The nurse should also assess for the
underlying cause, particularly chronic blood loss or inadequate
dietary iron.
2. Which laboratory finding is most consistent with iron-
deficiency anemia?
A. Increased mean corpuscular volume
B. Increased serum ferritin
,C. Low hemoglobin and microcytic, hypochromic red blood
cells
D. Increased vitamin B12 level
Rationale: Iron deficiency typically produces microcytic,
hypochromic erythrocytes because insufficient iron limits
hemoglobin synthesis. Hemoglobin and hematocrit are usually
decreased, and iron stores reflected by ferritin are commonly
reduced. Macrocytosis is more characteristic of vitamin B12 or
folate deficiency.
3. A nurse is teaching a client who is taking oral ferrous
sulfate. Which instruction is appropriate?
A. Take the medication with an antacid.
B. Take the medication only when fatigue occurs.
C. Take the medication with vitamin C or orange juice if
tolerated.
D. Stop the medication when stools become dark.
Rationale: Vitamin C can enhance intestinal absorption of
nonheme iron. Antacids can reduce iron absorption and should
generally be separated from iron administration. Dark or
greenish stools are an expected effect of oral iron and do not
usually indicate gastrointestinal bleeding by themselves.
Therapy should be continued as prescribed because replenishing
iron stores takes time.
,4. A client has pernicious anemia related to vitamin B12
deficiency. Which treatment should the nurse anticipate?
A. Oral calcium supplementation
B. Vitamin B12 replacement therapy
C. High-dose vitamin K
D. Platelet transfusion
Rationale: Pernicious anemia results from impaired absorption
of vitamin B12, commonly because of inadequate intrinsic
factor. Treatment requires vitamin B12 replacement, often by
parenteral administration depending on the client's condition
and treatment plan. Calcium, vitamin K, and platelets do not
correct the underlying vitamin B12 deficiency.
5. Which finding distinguishes vitamin B12 deficiency from
folate deficiency?
A. Fatigue
B. Pallor
C. Macrocytic erythrocytes
D. Neurologic manifestations such as paresthesias
Rationale: Both vitamin B12 and folate deficiencies can produce
megaloblastic, macrocytic anemia. Vitamin B12 deficiency can
additionally cause neurologic manifestations, including
paresthesias, impaired proprioception, gait disturbances, and
cognitive changes. Folate deficiency does not typically cause
, these neurologic abnormalities, making neurologic assessment
particularly important.
6. A nurse is caring for a client experiencing a sickle cell vaso-
occlusive crisis. Which intervention is the priority?
A. Restrict fluids
B. Apply cold packs to painful areas
C. Administer prescribed analgesia and maintain adequate
hydration
D. Encourage strenuous exercise
Rationale: During a vaso-occlusive crisis, sickled erythrocytes
obstruct microcirculation, producing tissue ischemia and severe
pain. Adequate hydration helps reduce blood viscosity and
supports circulation, while timely analgesia is essential for
controlling severe pain. Cold exposure and dehydration can
promote sickling, and strenuous activity can increase oxygen
demand.
7. A client with sickle cell disease reports sudden chest pain,
fever, and dyspnea. What complication should the nurse
suspect?
A. Iron-deficiency anemia
B. Acute chest syndrome
C. Pernicious anemia
D. Chronic venous insufficiency
Questions with Correct Answers
(VerifiedAnswers) Plus Rationales 2026 Q&A
Instant Download PDF
1. A nurse is assessing a client with iron-deficiency anemia.
Which finding should the nurse expect?
A. Bradycardia
B. Fatigue and weakness
C. Increased oxygen saturation
D. Severe hypertension
Rationale: Iron-deficiency anemia reduces the amount of
hemoglobin available to transport oxygen to tissues. The
resulting reduced oxygen delivery commonly produces fatigue,
weakness, decreased exercise tolerance, pallor, and shortness of
breath. Bradycardia and hypertension are not expected
hallmark findings. The nurse should also assess for the
underlying cause, particularly chronic blood loss or inadequate
dietary iron.
2. Which laboratory finding is most consistent with iron-
deficiency anemia?
A. Increased mean corpuscular volume
B. Increased serum ferritin
,C. Low hemoglobin and microcytic, hypochromic red blood
cells
D. Increased vitamin B12 level
Rationale: Iron deficiency typically produces microcytic,
hypochromic erythrocytes because insufficient iron limits
hemoglobin synthesis. Hemoglobin and hematocrit are usually
decreased, and iron stores reflected by ferritin are commonly
reduced. Macrocytosis is more characteristic of vitamin B12 or
folate deficiency.
3. A nurse is teaching a client who is taking oral ferrous
sulfate. Which instruction is appropriate?
A. Take the medication with an antacid.
B. Take the medication only when fatigue occurs.
C. Take the medication with vitamin C or orange juice if
tolerated.
D. Stop the medication when stools become dark.
Rationale: Vitamin C can enhance intestinal absorption of
nonheme iron. Antacids can reduce iron absorption and should
generally be separated from iron administration. Dark or
greenish stools are an expected effect of oral iron and do not
usually indicate gastrointestinal bleeding by themselves.
Therapy should be continued as prescribed because replenishing
iron stores takes time.
,4. A client has pernicious anemia related to vitamin B12
deficiency. Which treatment should the nurse anticipate?
A. Oral calcium supplementation
B. Vitamin B12 replacement therapy
C. High-dose vitamin K
D. Platelet transfusion
Rationale: Pernicious anemia results from impaired absorption
of vitamin B12, commonly because of inadequate intrinsic
factor. Treatment requires vitamin B12 replacement, often by
parenteral administration depending on the client's condition
and treatment plan. Calcium, vitamin K, and platelets do not
correct the underlying vitamin B12 deficiency.
5. Which finding distinguishes vitamin B12 deficiency from
folate deficiency?
A. Fatigue
B. Pallor
C. Macrocytic erythrocytes
D. Neurologic manifestations such as paresthesias
Rationale: Both vitamin B12 and folate deficiencies can produce
megaloblastic, macrocytic anemia. Vitamin B12 deficiency can
additionally cause neurologic manifestations, including
paresthesias, impaired proprioception, gait disturbances, and
cognitive changes. Folate deficiency does not typically cause
, these neurologic abnormalities, making neurologic assessment
particularly important.
6. A nurse is caring for a client experiencing a sickle cell vaso-
occlusive crisis. Which intervention is the priority?
A. Restrict fluids
B. Apply cold packs to painful areas
C. Administer prescribed analgesia and maintain adequate
hydration
D. Encourage strenuous exercise
Rationale: During a vaso-occlusive crisis, sickled erythrocytes
obstruct microcirculation, producing tissue ischemia and severe
pain. Adequate hydration helps reduce blood viscosity and
supports circulation, while timely analgesia is essential for
controlling severe pain. Cold exposure and dehydration can
promote sickling, and strenuous activity can increase oxygen
demand.
7. A client with sickle cell disease reports sudden chest pain,
fever, and dyspnea. What complication should the nurse
suspect?
A. Iron-deficiency anemia
B. Acute chest syndrome
C. Pernicious anemia
D. Chronic venous insufficiency
