HEMATOLOGY NCLEX QUESTIONS
AND ANSWERS
A nurse in a clinic is caring for a client who has suspected anemia. Which of the
following laboratory test results should the nurse expect?
A. Iron 90 mcg/dL
B. RBC 6.5 million/uL
C. WBC 4,800 mm3
D. Hgb 10 g/dL - Answer- A. An iron level of 90 mcg/dL is within the expected
reference
range and is not an expected finding of anemia.
B. RBC count of 6.5 million/uL is above the expected reference
range. A decreased RBC count is an expected finding of anemia.
C. WBC count of 4800 mm3
is below the expected reference
range and is not an expected finding of anemia.
D. CORRECT: Hgb of 10 g/dL is below the expected
reference range and is an expected finding of anemia.
A nurse is caring for a client who is receiving warfarin for anticoagulation therapy.
Which of the following laboratory test results indicates to the nurse that the client
needs an increase in the dosage?
A. aPTT 38 seconds
B. INR 1.1
C. PT 22 seconds
D. D-dimer negative - Answer- A. aPTT is monitored for clients receiving heparin
therapy. An aPTT of 38 seconds is within the expected reference range for clients
not receiving heparin therapy.
B. CORRECT: INR of 1.1 is within the expected reference range for a client who is
not receiving warfarin. However, this value is subtherapeutic for anticoagulation
therapy. The nurse should expect the client to receive an increased dosage of
warfarin until the INR is 2 to 3.
C. PT of 22 seconds is above the expected reference range for a client receiving
warfarin therapy. This result indicates the client is at an increased risk for bleeding.
D. A negative D-dimer test indicates the absence of a pulmonary embolus or deep
vein thrombosis and is not used to determine the dosage needs for warfarin therapy.
A nurse is providing teaching for a client who is scheduled for a bone marrow biopsy
of the iliac crest. Which of the following statements made by the client indicates an
understanding of the teaching?
A. "This test will be performed while I am lying flat on my back."
B. "I will need to stay in bed for about an hour after the test."
C."This test will determine which antibiotic I should take for treatment."
D."I will receive general anesthesia for the test." - Answer- A. The nurse should
inform the client that he will be placed in a prone or side-lying position during the test
in order to expose the iliac crest.
,B. CORRECT: The nurse should inform the client of the need to stay on bed rest for
30 to 60 min following the test to reduce the risk for bleeding.
C. The nurse should inform the client that a culture and sensitivity test determines
the type of antibiotics needed to treat an infection.
D. The nurse should inform the client that he will receive a sedative prior to the test
and that a local anesthetic will be used at the site.
1. A nurse is preparing to administer
packed RBCs to a client who
has a Hgb of 8 g/dL. Which of
the following actions should the
nurse plan to take during the
first 15 min of the transfusion?
A. Obtain consent from the
client for the transfusion.
B. Assess for an acute
hemolytic reaction.
C. Explain the transfusion
procedure to the client.
D. Obtain blood culture
specimens to send to the lab - Answer- A. The nurse should obtain consent from the
client for
the transfusion prior to initiating the transfusion.
B. CORRECT: The nurse should assess for an acute hemolytic reaction
during the first 15 min of the transfusion. This form of a reaction can
occur following the transfusion of as little as 10 mL of blood product.
C. The nurse should explain the transfusion procedure
to the client prior to initiating the transfusion.
D. The nurse should obtain blood culture specimens
2. A nurse is caring for a client who
is receiving a blood transfusion.
Which of the following actions
should the nurse expect if an
allergic transfusion reaction is
suspected? (Select all that apply.)
A. Stop the transfusion.
B. Monitor for hypertension.
C. Maintain an IV infusion with
0.9% sodium chloride.
D. Position the client in an
upright position with the
feet lower than the heart.
E. Administer diphenhydramine. - Answer- A. CORRECT: The nurse should
immediately stop the infusion if an allergic transfusion reaction is suspected.
B. The nurse should monitor for hypotension if an allergic transfusion reaction is
suspected due to the risk for shock.
C. CORRECT: The nurse should administer 0.9% sodium chloride solution through
new IV tubing if an allergic transfusion reaction is suspected.
, D. The nurse should position the client in an upright position with the feet lower than
the level of the heart if a circulatory overload is suspected.
E. CORRECT: The nurse should administer an antihistamine, such as
diphenhydramine, if an allergic transfusion reaction is suspected.
3. A nurse is monitoring a client
who began receiving a unit
of packed RBCs 10 min ago.
Which of the following findings
should the nurse identify as an
indication of a febrile transfusion
reaction? (Select all that apply.)
A. Temperature change from
37° C (98.6° F) pretransfusion
to 37.2° C (99.0° F)
B. Current blood pressure
178/90 mm Hg
C. Heart rate change from 88/min
pretransfusion to 120/min
D. Client report of itching
E. Client appears flushed - Answer- A. A temperature increase of 1° F (0.5° C) is an
indication of a febrile transfusion reaction.
B. Hypotension is an indication of a febrile transfusion reaction.
C. CORRECT: Tachycardia is an indication of a febrile transfusion reaction.
D. The client's report of itching is an indication of an allergic transfusion reaction.
E. CORRECT: A flushed appearance of the client can indicate a febrile transfusion
reaction
4. A nurse is providing preoperative
teaching for a client who requests
autologous donation in preparation
for a scheduled orthopedic
surgical procedure. Which of the
following statements should the
nurse include in the teaching?
A. "You should make an
appointment to donate blood
8 weeks prior to the surgery."
B. "If you need an autologous
transfusion, the blood your
brother donates can be used."
C."You can donate blood
each week if your
hemoglobin is stable."
D."Any unused blood that
is donated can be us - Answer- A. The client should donate blood for an autologous
transfusion no sooner than 6 weeks prior to surgery.
B. An autologous donation refers to the client's
donation of blood for his own personal use.
C. CORRECT: Beginning 6 weeks prior to surgery, the
AND ANSWERS
A nurse in a clinic is caring for a client who has suspected anemia. Which of the
following laboratory test results should the nurse expect?
A. Iron 90 mcg/dL
B. RBC 6.5 million/uL
C. WBC 4,800 mm3
D. Hgb 10 g/dL - Answer- A. An iron level of 90 mcg/dL is within the expected
reference
range and is not an expected finding of anemia.
B. RBC count of 6.5 million/uL is above the expected reference
range. A decreased RBC count is an expected finding of anemia.
C. WBC count of 4800 mm3
is below the expected reference
range and is not an expected finding of anemia.
D. CORRECT: Hgb of 10 g/dL is below the expected
reference range and is an expected finding of anemia.
A nurse is caring for a client who is receiving warfarin for anticoagulation therapy.
Which of the following laboratory test results indicates to the nurse that the client
needs an increase in the dosage?
A. aPTT 38 seconds
B. INR 1.1
C. PT 22 seconds
D. D-dimer negative - Answer- A. aPTT is monitored for clients receiving heparin
therapy. An aPTT of 38 seconds is within the expected reference range for clients
not receiving heparin therapy.
B. CORRECT: INR of 1.1 is within the expected reference range for a client who is
not receiving warfarin. However, this value is subtherapeutic for anticoagulation
therapy. The nurse should expect the client to receive an increased dosage of
warfarin until the INR is 2 to 3.
C. PT of 22 seconds is above the expected reference range for a client receiving
warfarin therapy. This result indicates the client is at an increased risk for bleeding.
D. A negative D-dimer test indicates the absence of a pulmonary embolus or deep
vein thrombosis and is not used to determine the dosage needs for warfarin therapy.
A nurse is providing teaching for a client who is scheduled for a bone marrow biopsy
of the iliac crest. Which of the following statements made by the client indicates an
understanding of the teaching?
A. "This test will be performed while I am lying flat on my back."
B. "I will need to stay in bed for about an hour after the test."
C."This test will determine which antibiotic I should take for treatment."
D."I will receive general anesthesia for the test." - Answer- A. The nurse should
inform the client that he will be placed in a prone or side-lying position during the test
in order to expose the iliac crest.
,B. CORRECT: The nurse should inform the client of the need to stay on bed rest for
30 to 60 min following the test to reduce the risk for bleeding.
C. The nurse should inform the client that a culture and sensitivity test determines
the type of antibiotics needed to treat an infection.
D. The nurse should inform the client that he will receive a sedative prior to the test
and that a local anesthetic will be used at the site.
1. A nurse is preparing to administer
packed RBCs to a client who
has a Hgb of 8 g/dL. Which of
the following actions should the
nurse plan to take during the
first 15 min of the transfusion?
A. Obtain consent from the
client for the transfusion.
B. Assess for an acute
hemolytic reaction.
C. Explain the transfusion
procedure to the client.
D. Obtain blood culture
specimens to send to the lab - Answer- A. The nurse should obtain consent from the
client for
the transfusion prior to initiating the transfusion.
B. CORRECT: The nurse should assess for an acute hemolytic reaction
during the first 15 min of the transfusion. This form of a reaction can
occur following the transfusion of as little as 10 mL of blood product.
C. The nurse should explain the transfusion procedure
to the client prior to initiating the transfusion.
D. The nurse should obtain blood culture specimens
2. A nurse is caring for a client who
is receiving a blood transfusion.
Which of the following actions
should the nurse expect if an
allergic transfusion reaction is
suspected? (Select all that apply.)
A. Stop the transfusion.
B. Monitor for hypertension.
C. Maintain an IV infusion with
0.9% sodium chloride.
D. Position the client in an
upright position with the
feet lower than the heart.
E. Administer diphenhydramine. - Answer- A. CORRECT: The nurse should
immediately stop the infusion if an allergic transfusion reaction is suspected.
B. The nurse should monitor for hypotension if an allergic transfusion reaction is
suspected due to the risk for shock.
C. CORRECT: The nurse should administer 0.9% sodium chloride solution through
new IV tubing if an allergic transfusion reaction is suspected.
, D. The nurse should position the client in an upright position with the feet lower than
the level of the heart if a circulatory overload is suspected.
E. CORRECT: The nurse should administer an antihistamine, such as
diphenhydramine, if an allergic transfusion reaction is suspected.
3. A nurse is monitoring a client
who began receiving a unit
of packed RBCs 10 min ago.
Which of the following findings
should the nurse identify as an
indication of a febrile transfusion
reaction? (Select all that apply.)
A. Temperature change from
37° C (98.6° F) pretransfusion
to 37.2° C (99.0° F)
B. Current blood pressure
178/90 mm Hg
C. Heart rate change from 88/min
pretransfusion to 120/min
D. Client report of itching
E. Client appears flushed - Answer- A. A temperature increase of 1° F (0.5° C) is an
indication of a febrile transfusion reaction.
B. Hypotension is an indication of a febrile transfusion reaction.
C. CORRECT: Tachycardia is an indication of a febrile transfusion reaction.
D. The client's report of itching is an indication of an allergic transfusion reaction.
E. CORRECT: A flushed appearance of the client can indicate a febrile transfusion
reaction
4. A nurse is providing preoperative
teaching for a client who requests
autologous donation in preparation
for a scheduled orthopedic
surgical procedure. Which of the
following statements should the
nurse include in the teaching?
A. "You should make an
appointment to donate blood
8 weeks prior to the surgery."
B. "If you need an autologous
transfusion, the blood your
brother donates can be used."
C."You can donate blood
each week if your
hemoglobin is stable."
D."Any unused blood that
is donated can be us - Answer- A. The client should donate blood for an autologous
transfusion no sooner than 6 weeks prior to surgery.
B. An autologous donation refers to the client's
donation of blood for his own personal use.
C. CORRECT: Beginning 6 weeks prior to surgery, the
