Deck 20: Alterations of Hematologic Function

Question 1

A 45-year-old male 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

Answer 1

Defective DNA synthesis

Question 2

A 20-year-old female undergoes lab testing for anemia.Results show high iron,bilirubin,and transferrin and low hemoglobin and hematocrit.Which of the following is the most likely diagnosis to be documented on the chart?

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

Answer 2

Sideroblastic anemia

Question 3

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 anemia
B) Pernicious anemia
C) Sideroblastic anemia
D) Hemolytic anemia

Answer 3

Pernicious anemia

Question 4

A patient's anemia is described as having erythrocytes that demonstrate anisocytosis.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 5

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

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

Question 6

A 65-year-old male experienced loss of appetite,weight loss,lemon-yellow skin,liver enlargement,and a beefy red tongue shortly before his 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 7

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 8

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 9

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 10

A 40-year-old male vegetarian is diagnosed with folate deficiency anemia.He reports that he is an alcoholic.Which of the following factors put him at greatest risk for developing his disease?

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

Question 11

A 35-year-old female is diagnosed with vitamin B₁₂ deficiency anemia (pernicious anemia).How should the nurse respond when the patient asks what causes pernicious anemia? A decrease in ______ is the most likely cause.

A) Ferritin
B) Gastric enzymes
C) Intrinsic factor
D) Erythropoietin

Question 12

A 58-year-old female presents in the clinic presenting 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 13

A 2-year-old malnourished child has vitamin B?? 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 14

A 60-year-old female emphysema patient experiences a rapid and pounding heart,dizziness,and fatigue with exertion.Which of the following 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 15

How should the nurse prepare a patient who is to receive a Schilling test for pernicious anemia?

A) Administer radioactive cobalamin and measure its excretion in the urine.
B) Measure antigen-antibody immune complexes.
C) Measure serum ferritin and total iron-binding capacity.
D) Administer folate and evaluate folate content in a blood serum sample.

Question 16

A 34-year-old male presents in the emergency room with extreme fatigue and shortness of breath.His skin and sclera appear to have a yellowish discoloration.These assessment findings are consistent with which type of anemia?

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

Question 17

When a patient wants to know why vitamin B?? and folate deficiencies cause anemia,how should the nurse respond?

A) Red blood cells are unable to differentiate into erythrocytes.
B) Red blood cells have malformed hemoglobin molecules.
C) Red blood cells have decreased O2-carrying capacity.
D) Red blood cells have a shorter life span.

Question 18

Which of the following individuals should the nurse assess first for a vitamin B₁₂ deficiency anemia?

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

Question 19

A 67-year-old female has chronic gastrointestinal bleeding.A nurse recalls the primary cause of her anemia is:

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

Question 20

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 21

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 to 5 days
C) A few weeks
D) Six months

Question 22

A 70-year-old male 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 23

A 20-year-old female has an increase in eosinophils.When the patient wants to know the most likely cause of the eosinophilia.What is the nurse's best response?

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

Question 24

A 15-year-old male is diagnosed with infectious mononucleosis.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 25

A 10-year-old male 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 26

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 27

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 28

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

Question 29

A 68-year-old female 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 30

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 31

A nurse recalls posthemorrhagic anemia can result in death when a patient's blood loss is in excess of:

A) 20% to 29%
B) 30% to 39%
C) 40% to 49%
D) 50% to 59%

Question 32

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 33

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 34

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 35

A 5-year-old female is diagnosed with acute leukemia.The nurse will most likely treat this patient with:

A) Bone marrow transplant
B) Immunotherapy
C) Chemotherapy
D) Localized radiation therapy

Question 36

A staff member asks what leukocytosis means.How should the nurse respond? 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 37

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 38

A nurse is preparing to teach the staff about aplastic anemia.Which information should the nurse include? Aplastic anemia is caused by:

A) Iron deficiency
B) Excess levels of erythropoietin
C) Hemolysis
D) Stem cell deficiency

Question 39

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 40

A 67-year-old female 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 41

A 62-year-old female tells her health care provider she has been experiencing regular night sweats that cause her to wake up drenched.She also remarks that she has been unintentionally losing weight.Physical exam reveals enlarged lymph nodes on her neck that do not appear to be painful.She should be screened for which of the following cancers?

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

Question 42

A 65-year-old male is diagnosed with multiple myeloma.He 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

Question 43

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

A) United States
B) Japan
C) Denmark
D) Great Britain

Question 44

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 45

A 22-year-old female just delivered a healthy baby girl.She suffered from eclampsia during her pregnancy,and on the second postpartum day she complained of bleeding gums and bruising on her arms and legs.Hematology lab tests indicate that she had disseminated intravascular coagulation (DIC).Further review of lab tests by the nurse revealed an increase in:

A) Platelets
B) Hematocrit
C) Fibrin degradation products (FDPs)
D) Protein C

Question 46

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 47

A 10-year-old male 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 48

A nurse is teaching the staff about disseminated intravascular coagulation (DIC).Which information should the nurse include? The sequence of events in DIC is initiated by the release of:

A) Histamine
B) Fibrin
C) Tissue factor
D) Plasmin

Question 49

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

A) Proliferated
B) Activated
C) Sequestered
D) Infected

Question 50

A 30-year-old female presents with hematuria,menorrhagia,and bleeding gums.She 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 51

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 52

A 50-year-old female is diagnosed with primary thrombocythemia.A nurse would expect the blood smear to reveal _____ platelets.

A) Defective
B) Fragmented
C) Consumed
D) Overproduced

Question 53

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

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

Question 54

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 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

Thrombocytopenia may be:

A) Transient or consistent
B) Normal or abnormal
C) Congenital or acquired
D) Active or inactive

Question 57

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 58

An oncologist is discussing multiple myeloma.Which information should the oncologist include? Multiple myeloma can be defined as a neoplasm of:

A) T cells
B) B cells
C) Immature plasma cells
D) Mature red blood cells

Question 59

A 52-year-old male IV drug user was diagnosed with hepatitis C 5 years ago.He 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 60

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 61

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 62

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

Question 63

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