Nclex Questions...Good...Hematology Nursing
III sickle Cell Anemia, Anemia,
Thrombocytopenia, IVS Exam Latest Update
A child is suspected of having sickle cell disease is seen in a clinic, and
laboratory studies are performed. A nurse checks the laboratory results,
knowing that which of the following would be increased in this disease?
1. platelet count
2. hematocrit level
3. reticulocyte count
4. Hemoglobin level - ANSWER answer: 3
Rationale: A diagnosis is established based on a complete blood count,
examination for sickled red blood cells in the peripheral smear, and
hemoglobin electrophoresis. Laboratory studies will show decreased
hemoglobin and hematocrit levels and a decreased platelet count, an
INCREASED reticulocyte count and the presence of nucleated red blood
cells. Increased reticulocyte counts occur in children with sickle cell disease
because the life span of their sickled red blood cells is shortened.
A pediatric nursing instructor asks a nursing student to describe the cause
of the clinical manifestations that occur in sickle cell disease. The student
responds correctly by telling the instructor that
1. Sickled cells increase the blood flow through the body and cause a great
deal of pain.
2. sickled cells mix with the unsickled cells and cause the immune system
to become depressed.
3. bone marrow depression occurs because of the development of sickled
cells.
4. sickled cells are unable to flow easily through the microvasculature and
their clumping obstructs blood flow. - ANSWER Answer: 4
,Rationale: all of the clinical manifestations of sickle cell disease result from
the sickled cells being unable to flow easily through the microvasculature,
and their clumping obstructs blood flow. With re-oxygenation, most of the
sickled red blood cells resume their normal shape. Options 1, 2, and 3 are
incorrect statements.
A clinic nurse instructs the mother of a child with sickle cell disease about
the precipitating factors related to pain crisis. Which of the following, if
identified by the mother as e precipitating factor, indicates the need for
further instructions?
1. infection
2. trauma
3. fluid overload
4. stress - ANSWER answer: 3
Pain crisis may be precipitated by infection, dehydration, hypoxia, trauma,
or physical or emotional stress. THe mother of a child with sickle cell
disease should encourage fluid intake of 1.5-2 times the daily requirement
to prevent dehydration!
Laboratory studies are performed for a child suspected of having iron
deficiency anemia. THe nurse reviews the laboratory results, knowing that
which of the following results would indicate this type of anemia?
1. An elevated hemoglobin level
2. a decreased reticulocyte count
3. an elevated rbc count
4. rbc that are microcytic and hypochromic - ANSWER Answer: 4
The results of a cbc in children with iron deficiency anemia will show a
decreased hemoglobin level and and microcytic and hypochromic rbc the
rbc count is decreased, the reticulocyte count is usually normal or elevated.
A home care nurse is instructing the parents of a child with iron deciciency
anemia regarding the administration of a liquid oral iron supplement. The
nurse tells the mother to
1. administer the iron through a straw
2. administer iron at meal times
3. add the iron to the formula for easy administration
4. mix the iron with cereal to administer - ANSWER answer: 1
Iron should be administered through the straw or with a medicine dropper
placed at the back of the mouth because the iron will stain the teeth. the
parent should be instructed to brush or wipe the teeth after administration.
,Iron is administered between meals because absorption is decreased if
there is food in the stomach. Iron requires an acid environment to facilitate
its absorption in duodenum. Iron is not added to formula or mixed with
cereal or other food items.
A client with anemia has a nursing diagnosis of activity intolerance. Which
of the following interventions will the nurse plan for this client?
1.Promote active and passive range-of-motion activities.
2.Space activities and plan rest periods.
3.Teach the client to change position slowly to prevent dizziness.
4. Teach the client the basics of good nutrition. - ANSWER answer: Space
activities and plan rest periods.
Rationale:
The client with activity intolerance tires easily, so it is best for the nurse to
plan care and activities around periods of rest. Teaching good nutrition will
not help the client to be less tired. Promoting range of motion does not
address the issue of fatigue, nor does teaching the client to change position
slowly.
The nurse notes that the client has a low red blood cell count and
anticipates which of the following subjective manifestations on
assessment?
1.Chest pain
2.Nausea
3.Sore throat
4. Fatigue - ANSWER Answer:Fatigue
Rationale:
Fatigue would signify that the body's tissues are not receiving enough
oxygenation. Sore throat is a sign of infection. Chest pain may indicate an
impending myocardial infarction. Nausea is a symptom for many disease
processes, but is not typical for anemia.
The nurse is reviewing laboratory findings for a 2-year-old being treated for
anemia. Which of the findings is the best indication that goals for this client
have been met?
1.The child is no longer cyanotic.
2.The reticulocyte count is rising.
, 3.The child is more active.
4.Stools are black, indicating iron intake. - ANSWER Answer:
The reticulocyte count is rising.
Rationale:
An increase in the reticulocyte number means that the body is producing
new RBC's. While improved oxygenation, increased activity, and
indications of iron intake are desirable outcomes for the child with anemia,
they are not laboratory data.
The nurse has admitted a child newly diagnosed with anemia of unknown
origin. Which of the following is a priority intervention for the nurse to
initiate?
1. Administer fluids to increase cardiac output.
2. Plan for safe care due to weakness.
3.Teach the client about foods with iron.
4. Assess pain level. - ANSWER Answer:Plan for safe care due to
weakness.
Rationale:
The client with anemia is weak and the nurse would address safe care due
to weakness. Since the cause of the anemia is undetermined, the nurse
would not administer fluids or complete nutritional teaching without
additional information. Clients with anemia do not normally have pain; pain
is assessed in every client, but is not the priority of care in this client.
The nurse following a client after a gastric resection observes carefully for
evidence of nutritional deficiency anemia related to malabsorption including
which of the following?
1.Bone pain
2.Dark yellow or bronze skin
3.Numbness and tingling of extremities
4. Steatorrhea - ANSWER Correct Answer:
Numbness and tingling of extremities
Rationale:
The client who has had a gastric resection is at risk for anemia because
intrinsic factor may decrease, leading to vitamin B12 deficiency anemia
with associated neurologic deficits such as numbness and tingling of
III sickle Cell Anemia, Anemia,
Thrombocytopenia, IVS Exam Latest Update
A child is suspected of having sickle cell disease is seen in a clinic, and
laboratory studies are performed. A nurse checks the laboratory results,
knowing that which of the following would be increased in this disease?
1. platelet count
2. hematocrit level
3. reticulocyte count
4. Hemoglobin level - ANSWER answer: 3
Rationale: A diagnosis is established based on a complete blood count,
examination for sickled red blood cells in the peripheral smear, and
hemoglobin electrophoresis. Laboratory studies will show decreased
hemoglobin and hematocrit levels and a decreased platelet count, an
INCREASED reticulocyte count and the presence of nucleated red blood
cells. Increased reticulocyte counts occur in children with sickle cell disease
because the life span of their sickled red blood cells is shortened.
A pediatric nursing instructor asks a nursing student to describe the cause
of the clinical manifestations that occur in sickle cell disease. The student
responds correctly by telling the instructor that
1. Sickled cells increase the blood flow through the body and cause a great
deal of pain.
2. sickled cells mix with the unsickled cells and cause the immune system
to become depressed.
3. bone marrow depression occurs because of the development of sickled
cells.
4. sickled cells are unable to flow easily through the microvasculature and
their clumping obstructs blood flow. - ANSWER Answer: 4
,Rationale: all of the clinical manifestations of sickle cell disease result from
the sickled cells being unable to flow easily through the microvasculature,
and their clumping obstructs blood flow. With re-oxygenation, most of the
sickled red blood cells resume their normal shape. Options 1, 2, and 3 are
incorrect statements.
A clinic nurse instructs the mother of a child with sickle cell disease about
the precipitating factors related to pain crisis. Which of the following, if
identified by the mother as e precipitating factor, indicates the need for
further instructions?
1. infection
2. trauma
3. fluid overload
4. stress - ANSWER answer: 3
Pain crisis may be precipitated by infection, dehydration, hypoxia, trauma,
or physical or emotional stress. THe mother of a child with sickle cell
disease should encourage fluid intake of 1.5-2 times the daily requirement
to prevent dehydration!
Laboratory studies are performed for a child suspected of having iron
deficiency anemia. THe nurse reviews the laboratory results, knowing that
which of the following results would indicate this type of anemia?
1. An elevated hemoglobin level
2. a decreased reticulocyte count
3. an elevated rbc count
4. rbc that are microcytic and hypochromic - ANSWER Answer: 4
The results of a cbc in children with iron deficiency anemia will show a
decreased hemoglobin level and and microcytic and hypochromic rbc the
rbc count is decreased, the reticulocyte count is usually normal or elevated.
A home care nurse is instructing the parents of a child with iron deciciency
anemia regarding the administration of a liquid oral iron supplement. The
nurse tells the mother to
1. administer the iron through a straw
2. administer iron at meal times
3. add the iron to the formula for easy administration
4. mix the iron with cereal to administer - ANSWER answer: 1
Iron should be administered through the straw or with a medicine dropper
placed at the back of the mouth because the iron will stain the teeth. the
parent should be instructed to brush or wipe the teeth after administration.
,Iron is administered between meals because absorption is decreased if
there is food in the stomach. Iron requires an acid environment to facilitate
its absorption in duodenum. Iron is not added to formula or mixed with
cereal or other food items.
A client with anemia has a nursing diagnosis of activity intolerance. Which
of the following interventions will the nurse plan for this client?
1.Promote active and passive range-of-motion activities.
2.Space activities and plan rest periods.
3.Teach the client to change position slowly to prevent dizziness.
4. Teach the client the basics of good nutrition. - ANSWER answer: Space
activities and plan rest periods.
Rationale:
The client with activity intolerance tires easily, so it is best for the nurse to
plan care and activities around periods of rest. Teaching good nutrition will
not help the client to be less tired. Promoting range of motion does not
address the issue of fatigue, nor does teaching the client to change position
slowly.
The nurse notes that the client has a low red blood cell count and
anticipates which of the following subjective manifestations on
assessment?
1.Chest pain
2.Nausea
3.Sore throat
4. Fatigue - ANSWER Answer:Fatigue
Rationale:
Fatigue would signify that the body's tissues are not receiving enough
oxygenation. Sore throat is a sign of infection. Chest pain may indicate an
impending myocardial infarction. Nausea is a symptom for many disease
processes, but is not typical for anemia.
The nurse is reviewing laboratory findings for a 2-year-old being treated for
anemia. Which of the findings is the best indication that goals for this client
have been met?
1.The child is no longer cyanotic.
2.The reticulocyte count is rising.
, 3.The child is more active.
4.Stools are black, indicating iron intake. - ANSWER Answer:
The reticulocyte count is rising.
Rationale:
An increase in the reticulocyte number means that the body is producing
new RBC's. While improved oxygenation, increased activity, and
indications of iron intake are desirable outcomes for the child with anemia,
they are not laboratory data.
The nurse has admitted a child newly diagnosed with anemia of unknown
origin. Which of the following is a priority intervention for the nurse to
initiate?
1. Administer fluids to increase cardiac output.
2. Plan for safe care due to weakness.
3.Teach the client about foods with iron.
4. Assess pain level. - ANSWER Answer:Plan for safe care due to
weakness.
Rationale:
The client with anemia is weak and the nurse would address safe care due
to weakness. Since the cause of the anemia is undetermined, the nurse
would not administer fluids or complete nutritional teaching without
additional information. Clients with anemia do not normally have pain; pain
is assessed in every client, but is not the priority of care in this client.
The nurse following a client after a gastric resection observes carefully for
evidence of nutritional deficiency anemia related to malabsorption including
which of the following?
1.Bone pain
2.Dark yellow or bronze skin
3.Numbness and tingling of extremities
4. Steatorrhea - ANSWER Correct Answer:
Numbness and tingling of extremities
Rationale:
The client who has had a gastric resection is at risk for anemia because
intrinsic factor may decrease, leading to vitamin B12 deficiency anemia
with associated neurologic deficits such as numbness and tingling of
