NURS660 HEMATOLOGY EXAM TEST
BANK 100+ QUESTIONS AND CORRECT
DETAILED ANSWERS WITH
RATIONALES ALREADY GRADED A+
How do you treat IDA in adults? Med education? - Answer-oral elemental iron 150-
200mg in divided doses until anemia resolves
take 30 min BEFORE food
can cause black tarry stools
Avoid dairy, ok to take with acidic things like absorbic acid/Vit C
GI upset is common
Continue for 4-6 months until Ferritin >50
What labs are most helpful in distinguishing an IDA from an anemia of chronic disease?
- Answer-TBIC + ferritin
TBIC
will be LOW in anemia of chronic disease, elevated in IDA
ferritin could also be helpful because it is normal or increased
most of the other labs look pretty similar
Name the normal range of WBCs for an adult/peds patient - Answer-Adult: 4,500-
10,500
Peds age 6-18: 4,800-10,800
Your patient's WBC come back between 11-15k but they have no symptoms. What
should you do next? - Answer-order a smear/diff on that sample and then repeat in 1
week and see what's going, look at risk factors, etc
Your patient's WBC comes back >20k but they have no symptoms. What should you
do? - Answer-recheck in 1 week
heme referral if persistent
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
BANK 100+ QUESTIONS AND CORRECT
DETAILED ANSWERS WITH
RATIONALES ALREADY GRADED A+
How do you treat IDA in adults? Med education? - Answer-oral elemental iron 150-
200mg in divided doses until anemia resolves
take 30 min BEFORE food
can cause black tarry stools
Avoid dairy, ok to take with acidic things like absorbic acid/Vit C
GI upset is common
Continue for 4-6 months until Ferritin >50
What labs are most helpful in distinguishing an IDA from an anemia of chronic disease?
- Answer-TBIC + ferritin
TBIC
will be LOW in anemia of chronic disease, elevated in IDA
ferritin could also be helpful because it is normal or increased
most of the other labs look pretty similar
Name the normal range of WBCs for an adult/peds patient - Answer-Adult: 4,500-
10,500
Peds age 6-18: 4,800-10,800
Your patient's WBC come back between 11-15k but they have no symptoms. What
should you do next? - Answer-order a smear/diff on that sample and then repeat in 1
week and see what's going, look at risk factors, etc
Your patient's WBC comes back >20k but they have no symptoms. What should you
do? - Answer-recheck in 1 week
heme referral if persistent
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
