NURS660 HEMATOLOGY ACTUAL EXAM
100+ QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) ALREADY GRADED A+
(NEWEST VERSION)
Neutriphilia refers to an ANC count of > than what? - Answer-7700
Any time you have to repeat a CBC with diff due to abnormal numbers, make sure you
order what with it? - Answer-a smear, esp if you didnt get the first time
Lymphocytosis refers to an ALC of ? - Answer->4000-5000
An ALC of >30-50k is concerning for... - Answer-leukemia
What absolute eosinophil count would be concerning and warrant referral? - Answer-
>1500
Your patient's ANC comes back <500. What should you do? - Answer-immediate ED
referral, critical low, no way to fight off bacterial infections
In general, when you have a WBC value come back abnormal (high or low) what should
you do? - Answer-repeat in 1 week w/ smear, look at risk factors/patient symptoms
left shift - Answer-increased WBCs, neutrophils, bands
often indicates a bacterial infection
What is a degenerative left shift and what is is indicative of? - Answer-when your left
shift is not improving over 24-48 hours
poor prognosis
metas are usually recruited bc WBCs are exhausted
Name the normal percentages of the WBCs you will see on your diff. - Answer-
Neutrophils: 30-70%
Lymphs: 15-40%
Monocytes: 2-8%
Eosinophils: 0-5%
Bands: 0-4%
Basophils: 0-3%
What age group is most susceptible to IDA (peds)? - Answer-<5 years
, there is another spike in menstruating adolescent girls
Why are full term infants at less risk for IDA? - Answer-maternal iron transfer occurs
mostly in the 3rd trimester
usually will have enough to get through the first 4-6 months of life
What population requires at iron supplementation at birth? - Answer-preterm
Breastfed babies require what supplementation at 4 months? - Answer-iron
they are often deficient even if they are good solid eaters at 6 months
Differentiate between heme and non-heme iron sources. - Answer-Heme > non-heme
for absorption
Heme: fish, poultry, meat
Non-heme: veggies, cereals, breads, fruits
How could you encourage your vegetarian family to increase their iron absorption of
non-heme iron sources? - Answer-eat w/ absorbic acid, vitamin c
avoid eating w/ foods with phosphates or phytates aka plant fiber, seeds, grains
When should cow's milk be initiated and why? What is the recommended intake? -
Answer-1 year old d/t risk of intestinal blood loss
no greater than 24 oz
You are screening your peds patient for IDA and get a Hgb. What values for the
following age limits would be concerning?
6 months-<5 years
5 years-<12 years
12 years-<15 years
15+ - Answer-6 months-<5 years: two standard deviations below 11
5 years-<12 years: two standard deviations below 11.5
12-<15 years: two standard deviations below 12
>15: two standard deviations below 13
In order to officially diagnose IDA in peds, what two values need to be low? - Answer-
ferritin <15 AND
hgb < whatever is 2 below the standard deviation of the mean for their age (often <11)
When should you screen pediatrics for IDA? - Answer-1 year for everybody
w/ suspicion, more often if many risk factors
Name some risk factors for IDA that is not prematurity. - Answer-Asian or hispanic
At or below the poverty level
Recent immigration from another country
Vegetarian, vegan
100+ QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) ALREADY GRADED A+
(NEWEST VERSION)
Neutriphilia refers to an ANC count of > than what? - Answer-7700
Any time you have to repeat a CBC with diff due to abnormal numbers, make sure you
order what with it? - Answer-a smear, esp if you didnt get the first time
Lymphocytosis refers to an ALC of ? - Answer->4000-5000
An ALC of >30-50k is concerning for... - Answer-leukemia
What absolute eosinophil count would be concerning and warrant referral? - Answer-
>1500
Your patient's ANC comes back <500. What should you do? - Answer-immediate ED
referral, critical low, no way to fight off bacterial infections
In general, when you have a WBC value come back abnormal (high or low) what should
you do? - Answer-repeat in 1 week w/ smear, look at risk factors/patient symptoms
left shift - Answer-increased WBCs, neutrophils, bands
often indicates a bacterial infection
What is a degenerative left shift and what is is indicative of? - Answer-when your left
shift is not improving over 24-48 hours
poor prognosis
metas are usually recruited bc WBCs are exhausted
Name the normal percentages of the WBCs you will see on your diff. - Answer-
Neutrophils: 30-70%
Lymphs: 15-40%
Monocytes: 2-8%
Eosinophils: 0-5%
Bands: 0-4%
Basophils: 0-3%
What age group is most susceptible to IDA (peds)? - Answer-<5 years
, there is another spike in menstruating adolescent girls
Why are full term infants at less risk for IDA? - Answer-maternal iron transfer occurs
mostly in the 3rd trimester
usually will have enough to get through the first 4-6 months of life
What population requires at iron supplementation at birth? - Answer-preterm
Breastfed babies require what supplementation at 4 months? - Answer-iron
they are often deficient even if they are good solid eaters at 6 months
Differentiate between heme and non-heme iron sources. - Answer-Heme > non-heme
for absorption
Heme: fish, poultry, meat
Non-heme: veggies, cereals, breads, fruits
How could you encourage your vegetarian family to increase their iron absorption of
non-heme iron sources? - Answer-eat w/ absorbic acid, vitamin c
avoid eating w/ foods with phosphates or phytates aka plant fiber, seeds, grains
When should cow's milk be initiated and why? What is the recommended intake? -
Answer-1 year old d/t risk of intestinal blood loss
no greater than 24 oz
You are screening your peds patient for IDA and get a Hgb. What values for the
following age limits would be concerning?
6 months-<5 years
5 years-<12 years
12 years-<15 years
15+ - Answer-6 months-<5 years: two standard deviations below 11
5 years-<12 years: two standard deviations below 11.5
12-<15 years: two standard deviations below 12
>15: two standard deviations below 13
In order to officially diagnose IDA in peds, what two values need to be low? - Answer-
ferritin <15 AND
hgb < whatever is 2 below the standard deviation of the mean for their age (often <11)
When should you screen pediatrics for IDA? - Answer-1 year for everybody
w/ suspicion, more often if many risk factors
Name some risk factors for IDA that is not prematurity. - Answer-Asian or hispanic
At or below the poverty level
Recent immigration from another country
Vegetarian, vegan
