LEWIS CH 29 ASSESSMENT OF
HEMATOLOGIC SYSTEM EXAM 2025
QUESTIONS AND ANSWERS
The nurse is caring for a patient who is being discharged after an emergency splenectomy
following a motor vehicle crash. Which instructions should the nurse include in the discharge
teaching?
a. Check often for swollen lymph nodes.
b. Watch for excess bleeding or bruising.
c. Take iron supplements to prevent anemia.
d. Wash hands and avoid persons who are ill. - ANS ANS: D. Wash hands and avoid persons
who are ill.
Splenectomy increases the risk for infection, especially with gram-positive bacteria. The risks
for lymphedema, bleeding, and anemia are not increased after a person has a splenectomy.
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,The nurse assesses a patient who has numerous petechiae on both arms. Which question
should the nurse ask the patient?
a. "Are you taking any oral contraceptives?"
b. "Have you been prescribed antiseizure drugs?"
c. "Do you take medication containing salicylates?"
d. "How long have you taken antihypertensive drugs?" - ANS ANS: C. "Do you take
medication containing salicylates?"
Salicylates interfere with platelet function and can lead to petechiae and ecchymoses.
Antiseizure drugs may cause anemia but not clotting disorders or bleeding. Oral contraceptives
increase a person's clotting risk. Antihypertensives do not usually cause problems with
decreased clotting.
A nurse reviews the laboratory data for an older patient. The nurse would be most concerned
about which finding?
a. Hematocrit of 35%
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,b. Hemoglobin of 11.8 g/dL
c. Platelet count of 400,000/µL
d. White blood cell (WBC) count of 2800/µL - ANS ANS: D. White blood cell (WBC) count of
2800/µL
Because the total WBC count is not usually affected by aging, the low WBC count in this patient
would indicate that the patient's immune function may be compromised and the underlying
cause of the problem needs to be investigated. The platelet count is normal. The slight decrease
in hemoglobin and hematocrit are not unusual for an older patient.
A patient with pancytopenia has a bone marrow aspiration from the left posterior iliac crest.
Which action would be important for the nurse to take after the procedure?
a. Elevate the head of the bed to 45 degrees.
b. Have the patient lie on the left side for 1 hour.
c. Apply a sterile 2-inch gauze dressing to the site.
d. Use a half-inch sterile gauze to pack the wound. - ANS ANS: B. Have the patient lie on the
left side for 1 hour.
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, To decrease the risk for bleeding, the patient should lie on the left side for 30 to 60 minutes.
After a bone marrow biopsy, the wound is small and will not be packed with gauze. A pressure
dressing is used to cover the aspiration site. There is no indication to elevate the patient's head.
The nurse assesses a patient with pernicious anemia. Which assessment finding would the
nurse expect?
a. Yellow-tinged sclerae
b. Shiny, smooth tongue
c. Numbness of the extremities
d. Gum bleeding and tenderness - ANS ANS: C. Numbness of the extremities
Extremity numbness is associated with cobalamin (vitamin B12) deficiency or pernicious
anemia. Loss of the papillae of the tongue occurs with chronic iron deficiency. Yellow-tinged
sclera is associated with hemolytic anemia and the resulting jaundice. Gum bleeding and
tenderness occur with thrombocytopenia or neutropenia.
A patient's complete blood count (CBC) shows a hemoglobin of 19 g/dL and a hematocrit of
54%. Which question should the nurse ask to determine possible causes of this finding?
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HEMATOLOGIC SYSTEM EXAM 2025
QUESTIONS AND ANSWERS
The nurse is caring for a patient who is being discharged after an emergency splenectomy
following a motor vehicle crash. Which instructions should the nurse include in the discharge
teaching?
a. Check often for swollen lymph nodes.
b. Watch for excess bleeding or bruising.
c. Take iron supplements to prevent anemia.
d. Wash hands and avoid persons who are ill. - ANS ANS: D. Wash hands and avoid persons
who are ill.
Splenectomy increases the risk for infection, especially with gram-positive bacteria. The risks
for lymphedema, bleeding, and anemia are not increased after a person has a splenectomy.
1 Copyright ©2025 FYNDLAY ALL RIGHTS RESERVED.
,The nurse assesses a patient who has numerous petechiae on both arms. Which question
should the nurse ask the patient?
a. "Are you taking any oral contraceptives?"
b. "Have you been prescribed antiseizure drugs?"
c. "Do you take medication containing salicylates?"
d. "How long have you taken antihypertensive drugs?" - ANS ANS: C. "Do you take
medication containing salicylates?"
Salicylates interfere with platelet function and can lead to petechiae and ecchymoses.
Antiseizure drugs may cause anemia but not clotting disorders or bleeding. Oral contraceptives
increase a person's clotting risk. Antihypertensives do not usually cause problems with
decreased clotting.
A nurse reviews the laboratory data for an older patient. The nurse would be most concerned
about which finding?
a. Hematocrit of 35%
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,b. Hemoglobin of 11.8 g/dL
c. Platelet count of 400,000/µL
d. White blood cell (WBC) count of 2800/µL - ANS ANS: D. White blood cell (WBC) count of
2800/µL
Because the total WBC count is not usually affected by aging, the low WBC count in this patient
would indicate that the patient's immune function may be compromised and the underlying
cause of the problem needs to be investigated. The platelet count is normal. The slight decrease
in hemoglobin and hematocrit are not unusual for an older patient.
A patient with pancytopenia has a bone marrow aspiration from the left posterior iliac crest.
Which action would be important for the nurse to take after the procedure?
a. Elevate the head of the bed to 45 degrees.
b. Have the patient lie on the left side for 1 hour.
c. Apply a sterile 2-inch gauze dressing to the site.
d. Use a half-inch sterile gauze to pack the wound. - ANS ANS: B. Have the patient lie on the
left side for 1 hour.
3 Copyright ©2025 FYNDLAY ALL RIGHTS RESERVED.
, To decrease the risk for bleeding, the patient should lie on the left side for 30 to 60 minutes.
After a bone marrow biopsy, the wound is small and will not be packed with gauze. A pressure
dressing is used to cover the aspiration site. There is no indication to elevate the patient's head.
The nurse assesses a patient with pernicious anemia. Which assessment finding would the
nurse expect?
a. Yellow-tinged sclerae
b. Shiny, smooth tongue
c. Numbness of the extremities
d. Gum bleeding and tenderness - ANS ANS: C. Numbness of the extremities
Extremity numbness is associated with cobalamin (vitamin B12) deficiency or pernicious
anemia. Loss of the papillae of the tongue occurs with chronic iron deficiency. Yellow-tinged
sclera is associated with hemolytic anemia and the resulting jaundice. Gum bleeding and
tenderness occur with thrombocytopenia or neutropenia.
A patient's complete blood count (CBC) shows a hemoglobin of 19 g/dL and a hematocrit of
54%. Which question should the nurse ask to determine possible causes of this finding?
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