Hematologic System Practice Questions

Systems of Care 3

NUR 4739 Hematologic System Med-Surg Practice Questions

1. When assessing a patient's nutritional-metabolic pattern related to hematologic health, the nurse would

A.

Inspect the skin for petechiae.

B.

Ask the patient about joint pain.

C.

Assess for vitamin C deficiency.

D.

Determine if the patient can perform ADLs.

A: Any changes in the skin's texture or color should be explored when assessing the patient's nutritional-metabolic nutritional-metabolic pattern related to hematologic health. The presence of  petechiae or ecchymotic areas could be indicative of hematologic deficiencies deficiencies related to poor nutritional intake or related causes. 2. When assessing lab values on a patient admitted with septicemia, the nurse would expect to find

A.

Increased platelets.

B.

Decreased red blood cells.

C.

Decreased erythrocyte sedimentation rate (ESR).

D.

Increased bands in the white blood cell (WBC) differential (shift to the left).

D: When infections are severe, such as in septicemia, more granulocytes are released from the bone marrow as a compensatory mechanism. mechanism. To meet the increased demand, many young, immature polymorphonuclear neutrophils (bands) are released into circulation. WBCs are usually reported in order of maturity, with the less mature forms on the left side of a written report. Hence, the term “shift to the left” is used to denote an increase in the number of bands. 3. Results of a patient’s most recent blood work indicate an elevated neutrophil level. You recognize that this diagnostic finding most likely suggests

A.

Hypoxemia.

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Systems of Care 3

NUR 4739

B.

An infection.

C.

A risk of hypocoagulation.

D.

An acute thrombotic event.

B: An increase in neutrophil count most commonly occurs in response to infection or inflammation. Hypoxemia and coagulation do not directly affect neutrophil production. 4. A 30-year-old patient has undergone a splenectomy as a result of injuries suffered in a motor vehicle accident. Which of the following phenomena is likely to result from the absence of the patient’s spleen (select all that apply)?

A.

Impaired fibrinolysis

B.

Increased platelet levels

C.

Increased eosinophil levels

D.

Fatigue and cold intolerance

E.

Impaired immunologic function

B, E: Splenectomy can result in increased platelet levels and impaired immunologic function as a consequence of the loss of storage and immunologic functions of the spleen. Fibrinolysis, fatigue, and cold intolerance are less likely to result from the loss of  the spleen since coagulation and oxygenation are not primary responsibilities of the spleen. 5. You are providing care for older adults on a subacute, geriatric medicine unit. Which of the following effects is aging likely to have on hematologic function of older adults?

A.

Hypercoagulability

B.

Decreased hemoglobin

C.

Decreased blood volume

D.

Decreased WBC count

B: Older adults frequently experience decreased hemoglobin levels as a result of changes to erythropoiesis. Decreased blood volume, decreased WBCs, and alterations in coagulation are not considered to be normal, age-related hematologic changes.

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NUR 4739

6. A blood type and cross-match has been ordered for a male patient who is experiencing an upper gastrointestinal bleed. The results of the blood work indicate that the patient has type A blood. This means that

A.

The patient has A antigens on his red blood cells (RBCs).

B.

The patient may only receive a type A transfusion.

C.

The patient can be transfused with type AB blood.

D.

Antibodies are present on the surface of the patient’s RBCs.

A: An individual with type A blood has A antigens, not A antibodies, on his RBCs. An AB transfusion would result in agglutination, but he may be transfused with either type A or type O.

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