Question 1

Which of the following is a normal age-related change in hematological studies?&#10;A) MCV slightly decreased&#10;B) Hemoglobin slightly increased in men&#10;C) Ferritin level increased&#10;D) Erythrocyte sedimentation rate (ESR)decreased

Accepted Answer

Ferritin levels can increase as a normal age-related change, reflecting changes in iron metabolism or the presence of chronic diseases often seen with aging.

Question 2

During physical assessment of a patient,the nurse suspects a chronic,severe iron-deficiency anemia on finding which of the following?&#10;A) Yellowed sclera&#10;B) Shiny,smooth tongue&#10;C) Gum bleeding and tenderness&#10;D) Loss of position and vibratory sensation in the extremities

Accepted Answer

A shiny, smooth tongue (also known as a "beefy" tongue) is a common finding in iron-deficiency anemia. Yellowed sclera (the white part of the eye) can indicate jaundice, which may be a sign of liver disease, but is not specific to anemia. Gum bleeding and tenderness may be seen in various types of anemia, as well as in other conditions such as gingivitis. Loss of position and vibratory sensation in the extremities may indicate peripheral neuropathy, which can be caused by a variety of factors including nutritional deficiencies, but is not specific to iron-deficiency anemia.

Question 3

Which one of the following cells is a WBC?&#10;A) Myeloblast&#10;B) Band cell&#10;C) Basophil&#10;D) Megakaryocyte

Accepted Answer

Basophils are one type of white blood cell (WBC), also known as leukocytes. The other choices listed are not WBCs. Myeloblasts are immature cells that give rise to granulocytes (a type of WBC), while band cells are immature neutrophils (another type of WBC). Megakaryocytes are large precursor cells that give rise to platelets, which are not considered WBCs.

Question 4

While examining the lymph nodes during physical assessment,about which of the following findings would the nurse be most concerned?&#10;A) Firm inguinal nodes in a patient with an infected foot&#10;B) Inability to palpate any superficial lymph nodes&#10;C) 1-cm mobile and nontender axillary node&#10;D) 2-cm nonpainful supraclavicular node

Accepted Answer

A 2-cm nonpainful supraclavicular node is of particular concern as it can indicate possible malignancy or infection in the thorax, abdomen, or pelvis. The other options are not as concerning as they can be attributed to infections or normal variation.

Question 5

Approximately what percentage of the composition of blood is plasma?&#10;A) 30%&#10;B) 45%&#10;C) 55%&#10;D) 75%

Accepted Answer

Plasma makes up approximately 55% of the composition of blood, while the other 45% is made up of red and white blood cells and platelets.

Question 6

The nurse reviews the results of coagulation testing for a patient with a bleeding disorder.Which of the following diagnostic tests is most valuable in evaluating the intrinsic coagulation process?&#10;A) Bleeding time&#10;B) Prothrombin time&#10;C) Fibrin split products&#10;D) Activated partial thromboplastin time (aPTT)

Accepted Answer

The activated partial thromboplastin time (aPTT) evaluates the intrinsic coagulation pathway and is used to monitor heparin therapy. Bleeding time evaluates the primary hemostatic plug, prothrombin time evaluates the extrinsic and common pathways, and fibrin split products are breakdown products of fibrin and not a test of coagulation.

Question 7

How would the nurse document a physical assessment finding of a small group of conditions characterized by ecchymosis on the skin and mucous membranes?&#10;A) Excoriation&#10;B) Angioma&#10;C) Purpura&#10;D) Spider nevus

Accepted Answer

The small group of conditions characterized by ecchymosis on the skin and mucous membranes is purpura. Purpura refers to the purple or red discoloration of the skin or mucous membranes caused by hemorrhage into the tissues. Excoriation refers to the loss of the superficial layer of the skin, which is usually caused by scratching or rubbing. Angioma is a benign tumor of the blood vessels or lymph vessels. Spider nevus is a small, red, spider-like lesion with a central red dot and reddish extensions, and it usually occurs on the face.

Question 8

While obtaining a health history from a patient with numerous petechiae on the skin,the nurse asks the patient specifically about the patient's use of which of the following drugs?&#10;A) Antiseizure medications&#10;B) Oral contraceptives&#10;C) Aspirin compounds&#10;D) Antihypertensive agents

Accepted Answer

Aspirin compounds can lead to petechiae due to their antiplatelet effect, which can cause small blood vessels to bleed under the skin. Antiseizure medications, oral contraceptives, and antihypertensive agents are not typically associated with petechiae.

Question 9

The physician performs a bone marrow aspiration from the posterior iliac crest on a patient with pancytopenia.Following the procedure,what should the nurse do?&#10;A) Apply a topical antimicrobial agent to the site.&#10;B) Administer an analgesic to control pain at the site.&#10;C) Apply pressure over the site for 5 to 10 minutes.&#10;D) Position the patient supine with a small pillow at the aspiration site.

Accepted Answer

After a bone marrow aspiration, the nurse should apply pressure over the site for 5 to 10 minutes to prevent bleeding and promote clotting. The nurse should also monitor the patient for signs of bleeding or infection and administer analgesics as needed for pain. Topical antimicrobial agents are generally not recommended for bone marrow aspiration sites, as they can interfere with the healing process. Positioning the patient supine with a small pillow at the aspiration site may be done for comfort, but is not necessary for proper aftercare.

Question 10

A patient is found to have leukopenia,anemia,neutropenia,and thrombocytopenia.Which drug classification is known to exhibit these hematological alterations? A) Isoniazid B) Aminoglycosides C) H₂-receptor blockers D) Trimethoprim-sulfamethoxazole (Septra)

Accepted Answer

Trimethoprim-sulfamethoxazole (Septra) is known to result in hematological alterations such as leukopenia, anemia, neutropenia, and thrombocytopenia. This drug is a sulfonamide antibiotic that can cause bone marrow suppression, leading to these hematological changes.

Question 11

When evaluating the red blood cell (RBC)indices of a patient,what does the nurse know is indicated by a low mean corpuscular volume (MCV)?&#10;A) RBCs of small size&#10;B) A decrease in RBCs&#10;C) Decreased saturation of RBCs with hemoglobin&#10;D) Decreased weight of the amount of hemoglobin or RBCs

Accepted Answer

The answer of When evaluating the red blood cell (RBC)indices...

Question 12

The history and physical examination for a newly admitted patient states that the complete blood count shows a &#34;shift to the left.&#34; What is the priority nursing assessment?&#10;A) Elevated temperature&#10;B) Low oxygen saturation&#10;C) Pallor and weakness&#10;D) Cool extremities

Accepted Answer

The answer of The history and physical examination for a...

Question 13

Which one of the following hematological findings would the nurse question in a 78-year-old patient?&#10;A) White blood cell (WBC)count 3500 cells/microlitre&#10;B) Hematocrit 37%&#10;C) Platelets 450,000 cells/microlitre&#10;D) Hemoglobin 7.3 mmol/L (11.8 g/dL)

Accepted Answer

The answer of Which one of the following hematological findings...

Question 14

Which of the following cells function to provide protection from parasitic infections?&#10;A) Monocytes&#10;B) Basophils&#10;C) Eosinophils&#10;D) Neutrophils

Accepted Answer

The answer of Which of the following cells function to...

Deck 32: Nursing Assessment: Hematological System