Deck 23: Alterations of Hematologic Function

Question 1

A newborn is diagnosed with congenital intrinsic factor deficiency.Which of the following types of anemia will the nurse see documented on the chart?

A) Iron deficiency
B) Pernicious
C) Sideroblastic
D) Hemolytic

Answer 1

Pernicious

Question 2

Which individual should the nurse assess initially for a vitamin B₁₂ deficiency anemia?

A) A 3-year-old female who is a fussy eater
B) A 26-year-old female in the second trimester of her first pregnancy
C) A 47-year-old male who had a gastrectomy procedure
D) A 64-year-old male with a history of duodenal ulcers

Answer 2

A 47-year-old male who had a gastrectomy procedure

Question 3

A 21-year-old woman was recently diagnosed with iron deficiency anemia.Her hematocrit is 32%.Which of the following treatments would the nurse expect to be prescribed for her?

A) Iron replacement
B) Splenectomy
C) A bone marrow transplant
D) No treatment is necessary

Answer 3

Iron replacement

Question 4

A patient who demonstrates chronic gastrointestinal bleeding is diagnosed with anemia.What is the primary cause of the patient's anemia?

A) Vitamin B₁₂ deficiency
B) Iron deficiency
C) Folate deficiency
D) Bone marrow failure

Question 5

When a nurse is reviewing lab results and notices that the erythrocytes contain an abnormally low concentration of hemoglobin, the nurse calls these erythrocytes:

A) hyperchromic.
B) hypochromic.
C) macrocytic.
D) microcytic.

Question 6

A 45-year-old male is diagnosed with sideroblastic anemia.When he asks what the most likely cause of this disease is, what is the nurse's best response?

A) Ineffective iron uptake and abnormal hemoglobin production
B) Misshapen erythrocytes with low hemoglobin
C) Decreased levels of tissue iron with megaloblastic erythrocytes
D) Premature erythrocyte destruction and erythropoietin deficiency

Question 7

A 35-year-old female is diagnosed with vitamin B₁₂ deficiency anemia (pernicious anemia).The most likely cause is a decrease in:

A) ferritin.
B) gastric enzymes.
C) intrinsic factor.
D) erythropoietin.

Question 8

A 45 year old is diagnosed with macrocytic, normochromic anemia.The nurse suspects the most likely cause of this condition is:

A) defective DNA synthesis.
B) abnormal synthesis of hemoglobin.
C) defective use of vitamin C.
D) blocked protein synthesis.

Question 9

A 5 year old was diagnosed with normocytic-normochromic anemia.Which type of anemia does the nurse suspect the patient has?

A) Sideroblastic
B) Hemolytic
C) Pernicious
D) Iron deficiency

Question 10

A 60-year-old patient diagnosed with emphysema experiences a rapid and pounding heart, dizziness, and fatigue with exertion.Which respiratory assessment findings indicate the respiratory system is compensating for the increased oxygen demand?

A) Bronchoconstriction
B) Increased rate and depth of breathing
C) Dyspnea
D) Activation of the renin-angiotensin response

Question 11

A 21-year-old female was recently diagnosed with iron deficiency anemia.In addition to fatigue and weakness, which of the following clinical signs and symptoms would she most likely exhibit?

A) Hyperactivity
B) Spoon-shaped nails
C) Gait problems
D) Petechiae

Question 12

A patient's anemia is described as having erythrocytes that demonstrate poikilocytosis.The nurse would recognize the erythrocytes would be:

A) pale in color.
B) present in various sizes.
C) able to assume various shapes.
D) live only a few days.

Question 13

A 58-year-old female presents in the clinic with fatigue, weight loss, and tingling in her fingers.Laboratory findings show low hemoglobin and hematocrit, a high mean corpuscular volume, and normal plasma iron.These assessment findings are consistent with which type of anemia?

A) Hemolytic anemia
B) Pernicious anemia
C) Iron deficiency anemia
D) Aplastic anemia

Question 14

A 40-year-old male's history includes being a vegetarian and abusing alcohol.Which of the following factors put him at greatest risk for developing folate deficiency anemia?

A) Being vegetarian
B) Being alcoholic
C) Age
D) Gender

Question 15

A 50-year-old female was diagnosed with sideroblastic anemia.Which of the following assessment findings would most likely occur?

A) Bronze-colored skin
B) Decreased iron
C) Normochromic erythrocytes
D) Aplastic bone marrow

Question 16

After initial compensation, what hemodynamic change should the nurse monitor for in a patient who has a reduction in the number of circulating erythrocytes?

A) Increased viscosity of blood
B) Decreased cardiac output
C) Altered coagulation
D) Hyperdynamic circulatory state

Question 17

A 25-year-old female has a heavy menses during which she loses a profuse amount of blood.Which of the following adaptations should the nurse expect?

A) Movement of fluid into the cell
B) Decreased cardiac output
C) Decreased oxygen release from hemoglobin
D) Peripheral vasoconstriction

Question 18

A 65 year old experienced loss of appetite, weight loss, lemon-yellow skin, liver enlargement, and a beefy red tongue shortly before her death.Autopsy suggested pernicious anemia, and the cause of death would most likely reveal:

A) brain hypoxia.
B) liver hypoxia.
C) heart failure.
D) kidney failure.

Question 19

A 2-year-old malnourished child is diagnosed with vitamin B₁₂ and folate deficiencies.A blood smear suggests the deficiency is macrocytic and normochromic.The nurse would expect the hemoglobin to be:

A) normal.
B) sporadic.
C) low.
D) high.

Question 20

The nurse will check which of the following tests to directly measure iron stores?

A) Serum ferritin
B) Transferrin saturation
C) Bone marrow biopsy
D) Total iron-binding capacity

Question 21

A 70 year old is brought to the emergency department, where he dies shortly thereafter.Autopsy reveals polycythemia vera (PV).His death was most likely the result of:

A) acute renal failure.
B) cerebral thrombosis.
C) sepsis.
D) acute leukemia.

Question 22

When the nurse sees a diagnosis of hereditary hemochromatosis on the chart, the nurse knows this is a disorder of:

A) intravascular coagulation.
B) iron overload.
C) leukocytosis.
D) granulocytosis.

Question 23

A 35-year-old female is diagnosed with lymphadenopathy.Which assessment finding will help confirm this diagnosis?

A) Small, hard lymph nodes
B) Disordered lymph nodes
C) Nonpalpable, nontender lymph nodes
D) Enlarged lymph nodes

Question 24

A 57-year-old male presents to his primary care provider for red face, hands, feet, ears, and headache and drowsiness.A blood smear reveals an increased number of erythrocytes, indicating:

A) polycythemia vera (PV).
B) leukemia.
C) sideroblastic anemia.
D) hemosiderosis.

Question 25

Considering anemia, what effect do vitamin B₁₂ and folate deficiencies have on red blood cells?

A) They are unable to differentiate into erythrocytes.
B) They contain malformed hemoglobin molecules.
C) O₂-carrying capacity is decreased.
D) Their life span is shorter.

Question 26

A 67-year-old female is admitted to the emergency department with a diagnosis of polycythemia vera.Upon taking the history, the patient will most likely report:

A) hyperactivity.
B) decreased blood pressure.
C) chest pain.
D) a pale skin color.

Question 27

A patient is admitted to the emergency department with a diagnosis of polycythemia vera (PV).Which treatment should the nurse discuss with the patient?

A) Therapeutic phlebotomy
B) Restoration of blood volume by plasma expanders
C) Administration of packed red blood cells
D) Iron replacement therapy

Question 28

A 15-year-old female presents with splenomegaly, hepatomegaly, and lymph node enlargement.She is diagnosed with infectious mononucleosis.What should the nurse tell the patient about the recovery time?

A) 72 hours
B) 3-5 days
C) A few weeks
D) 6 months

Question 29

A 5 year old is diagnosed with acute leukemia.The patient will mostly likely be treated with:

A) bone marrow transplant.
B) immunotherapy.
C) chemotherapy.
D) localized radiation therapy.

Question 30

What is the most likely cause of the eosinophilia?

A) Parasitic invasion and allergic reactions
B) Viral and bacterial infections
C) Stress and anxiety reactions
D) Fungal infections and delayed hypersensitivity

Question 31

A 10 year old is diagnosed with leukemia.The nurse assesses for which other condition that could be associated with his disease?

A) Down syndrome
B) Hemophilia
C) Hyperthyroidism
D) Pheochromocytoma

Question 32

Leukocytosis can be defined as:

A) a normal leukocyte count.
B) a high leukocyte count.
C) a low leukocyte count.
D) another term for leukopenia.

Question 33

A 15-year-old male with infectious mononucleosis is being given instructions on how to prevent the spread of this infection to others.Which statement represents a correct instruction?

A) Wear a surgical mask when others are in the room.
B) Do not share drinking glasses or eating utensils.
C) Avoid all contact with other people.
D) No precautions are necessary.

Question 34

A 15-year-old male is diagnosed with infectious mononucleosis (IM).When the patient asks how he got this disease, how should the nurse respond? The most likely cause is:

A) adenovirus.
B) Epstein-Barr virus (EBV).
C) cytomegalovirus (CMV).
D) Toxoplasma gondii.

Question 35

A 67-year-old male was diagnosed with polycythemia vera (PV) but refused treatment.His condition is at risk for converting to:

A) chronic lymphocytic leukemia.
B) Burkitt lymphoma.
C) multiple myeloma.
D) acute myeloid leukemia.

Question 36

A 35-year-old male has enlarged lymph nodes in the neck and a mediastinal mass.He was diagnosed with Hodgkin lymphoma.Which of the following abnormal cells would the nurse expect to find with this disease?

A) Merkel cell
B) Schwann cell
C) Reed-Sternberg cell
D) Kupffer cell

Question 37

A 68-year-old is admitted to the emergency department with a diagnosis of polycythemia vera (PV).A nurse realizes the patient's symptoms are mainly the result of:

A) a decreased erythrocyte count.
B) rapid blood flow to the major organs.
C) increased blood viscosity.
D) vessel injury.

Question 38

Lab results showing high iron, bilirubin, and transferrin and low hemoglobin and hematocrit would support a diagnosis of which form of anemia?

A) Pernicious
B) Folate deficiency
C) Iron deficiency
D) Sideroblastic

Question 39

A 35-year-old male with hyperthyroidism begins treatment to decrease thyroid activity.A nurse monitors for which of the following conditions that could result secondary to the treatment?

A) Eosinophilia
B) Basophilia
C) Monocytosis
D) Lymphocytosis

Question 40

Aplastic anemia is caused by:

A) iron deficiency.
B) excess levels of erythropoietin.
C) hemolysis.
D) stem cell deficiency.

Question 41

A 40 year old develops disseminated intravascular coagulation (DIC).Upon obtaining the history, which finding is the most likely cause of this condition?

A) Snakebite
B) Blood transfusion
C) Sepsis
D) Immune thrombocytopenic purpura (ITP)

Question 42

Thrombocytopenia may be:

A) transient or consistent.
B) normal or abnormal.
C) congenital or acquired.
D) active or inactive.

Question 43

A patient has microcytic hypochromic anemia.Which of the following pathogenic mechanisms may cause anemia in this patient? (Select all that apply.)

A) Decreased erythrocyte life span
B) Failure of mechanisms of compensatory erythropoiesis
C) Disturbances of the iron cycle
D) Increased basal metabolic rate
E) Swelling in the tissues

Question 44

A 15-year-old male is diagnosed with infectious mononucleosis.Which of the following assessment findings would he most likely demonstrate? (Select all that apply.)

A) Lymph node enlargement
B) Fever and sore throat
C) Rash on the trunk and extremities
D) Fatigue
E) Enlargement of liver and spleen

Question 45

A patient wants to know about risk factors for acute leukemia.Which of the following should the nurse include? (Select all that apply.)

A) Cytomegalovirus (CMV) infection
B) Eating genetically modified food
C) Chemotherapy treatment for other cancers
D) Excessive ultraviolet radiation exposure
E) Ovarian cancer

Question 46

For a patient experiencing hypersplenism, the nurse expects the erythrocytes to be:

A) proliferated.
B) activated.
C) sequestered.
D) infected.

Question 47

A 62 year old reports experiencing regular night sweats and unintentionally losing weight.Physical exam reveals enlarged neck lymph nodes that do not appear to be painful.These findings support a diagnosis of which type of cancer?

A) Epstein-Barr virus
B) Hodgkin lymphoma
C) Acute leukemia
D) Burkitt lymphoma

Question 48

An IV drug user was diagnosed with hepatitis C 5 years ago.The patient is now experiencing impaired blood clotting.The nurse suspects a decrease in which of the following vitamins?

A) K
B) D
C) E
D) B₁₂

Question 49

A nurse realizes a patient has thrombocytopenia when the platelet count is below _____ platelets per cubic millimeter.

Question 50

A 35-year-old male was diagnosed with hepatitis B.Further tests revealed neutropenia characterized by a neutrophil count less than _____ per milliliter.

Question 51

A patient is diagnosed with primary thrombocythemia.A nurse would expect the blood smear to reveal _____ platelets.

A) defective
B) fragmented
C) consumed
D) overproduced

Question 52

The people from which country have the lowest risk for Hodgkin lymphoma?

A) United States
B) Japan
C) Denmark
D) Netherlands

Question 53

A 10 year old presents with abdominal swelling, night sweats, fever, and weight loss.He is diagnosed with Burkitt lymphoma.Upon obtaining the history, which of the following is the most likely cause?

A) Cytomegalovirus (CMV)
B) Adenovirus
C) Human papillomavirus (HPV)
D) Epstein-Barr virus (EBV)

Question 54

In disseminated intravascular coagulation (DIC), the nurse assesses for active bleeding after intravascular clotting because:

A) prothrombin is activated.
B) clotting factors are depleted.
C) inflammatory mediators are released.
D) tissue factor (TF) is inactivated.

Question 55

A nurse checks individuals with liver disease for clotting problems because:

A) the liver is often the site of platelet pooling.
B) clotting factors are produced in the liver.
C) high levels of bilirubin interfere with the clotting system.
D) treatment medications for liver failure cause fibrinolysis.

Question 56

A 30 year old presents with hematuria, menorrhagia, and bleeding gums, and is diagnosed with immune thrombocytic purpura (ITP).A nurse realizes the most likely cause is:

A) allergy-induced platelet lysis.
B) an immune response to hypersplenism.
C) antibody destruction of platelets.
D) T-cell injury to megakaryocytes.

Question 57

A patient diagnosed with multiple myeloma reports severe pain.This pain can be attributed to:

A) neuropathic infiltrations.
B) destruction of bone tissue.
C) tissue hypoxia.
D) accumulation of toxic proteins.