WorksheetsAlterations of Hematologic Function
Total questions: 55
Worksheet time: 28mins
A patient’s anemia is described as having erythrocytes that demonstrate poikilocytosis. The nurse would recognize the erythrocytes would be:
pale in colour
present in various sizes
able to assume various shapes
live only a few days
A newborn is diagnosed with congenital intrinsic factor deficiency. Which of the following types of anemia will the nurse see documented on the chart?
iron deficiency
pernicious
sideroblastic
hemolytic
When a nurse is reviewing lab results and notices that the erythrocytes contain an abnormally low concentration of hemoglobin, the nurse calls these erythrocytes:
hyperchromic
hypochromic
macrocytic
microcytic
A 5-year-old was diagnosed with normocytic-normochromic anemia. Which type of anemia does the nurse suspect the patient has?
sideroblastic
hemolytic
pernicious
iron deficiency
After initial compensation, what hemodynamic change should the nurse monitor for in a patient who has a reduction in the number of circulating erythrocytes?
increased viscosity of blood
decreased cardiac output
altered coagulation
hyperdynamic circulatory state
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?
movement of fluid into the cell
decreased cardiac output
decreased oxygen release from hemoglobin
peripheral vasoconstriction
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?
bronchoconstriction
increased rate and depth of breathing
dyspnea
activation of the renin-angiotensin response
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:
normal
sporadic
low
high
A 45-year-old is diagnosed with macrocytic, normochromic anemia. The nurse suspects the most likely cause of this condition is:
defective DNA synthesis
abnormal synthesis of hemoglobin
defective use of vit. C
blocked protein synthesis
A 35-year-old female is diagnosed with vitamin B12 deficiency anemia (pernicious anemia). The most likely cause is a decrease in:
ferritin
gastric enzymes
intrinsic factor
erythropoietin
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?
hemolytic anemia
pernicious anemia
iron deficiency anemia
aplastic anemia
Which individual should the nurse assess initially for vit. B12 deficiency anemia?
A 3-year-old female who is a fussy eater
A 26-year-old female in the second trimester of her first pregnancy
A 47-year-old male who had a gastrectomy procedure
A 64-year-old male with a history of duodenal ulcers
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:
brain hypoxia
liver hypoxia
heart failure
kidney failure
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?
being vegetarian
being alcoholic
age
gender
A patient who demonstrates chronic gastrointestinal bleeding is diagnosed with anemia. What is the primary cause of the patient’s anemia?
vit. B12 deficiency
iron deficiency
folate deficiency
bone marrow failure
The nurse will check which of the following tests to directly measure iron stores?
serum ferritin
transferrin saturation
bone marrow biopsy
total iron-binding capacity
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?
hyperactivity
spoon-shaped nails
gait problems
petechiae
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?
iron replacement
splenectomy
a bone marrow transplant
no treatment is necessary
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?
ineffective iron uptake and abnormal hemoglobin production
misshapen erythrocytes with low hemoglobin
decreased levels of tissue iron with megaloblastic erythrocytes
premature erythrocyte destruction and erythropoietin deficiency
A 50-year-old female was diagnosed with sideroblastic anemia. Which of the following assessment findings would most likely occur?
bronze-coloured skin
decreased iron
normochromic erythrocytes
aplastic bone marrow
Lab results showing high iron, bilirubin, and transferrin and low hemoglobin and hematocrit would support a diagnosis of which form of anemia?
pernicious
folate deficiency
iron deficiency
sideroblastic
Considering anemia, what effect do vitamin B12 and folate deficiencies have on red blood cells?
they are unable to differentiate into erythrocytes
they contain malformed hemoglobin molecules
O2-carrying capacity is decreased
their life span is shorter
Aplastic anemia is cause by:
iron deficiency
excess levels of erythropoietin
hemolysis
stem cell deficiency
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:
polycythemia very (PV)
leukemia
sideroblastic anemia
hemosiderosis
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:
hyperactivity
decreased blood pressure
chest pain
a pale skin colour
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 decreased erythrocyte count
rapid blood flow to the major organs
increased blood viscosity
vessel injury
A patient is admitted to the emergency department with a diagnosis of polycythemia vera (PV). Which treatment should the nurse discuss with the patient?
therapeutic phlebotomy
restoration of blood volume by plasma expanders
administration of packed red blood cells
iron replacement therapy
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:
acute renal failure
cerebral thrombosis
sepsis
acute leukemia
When the nurse sees a diagnosis of hereditary hemochromatosis on the chart, the nurse knows this is a disorder of:
intravascular coagulation
iron overload
leukocytosis
granulocytosis
A 67-year-old male was diagnosed with polycythemia vera (PV) but refused treatment. His condition is at risk for converting to:
chronic lymphocytic leukemia
Burkitt lymphoma
multiple myeloma
acute myeloid leukemia
Leukocytosis can be defined as:
a normal leukocyte count
a high leukocyte count
a low leukocyte count
another term for leukopenia
What is the most likely cause of the eosinophilia?
parasitic invasion and allergic reactions
viral and bacterial infections
stress and anxiety reactions
fungal infections and delayed hypersensitivity
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?
72 hours
3-5 days
a few weeks
6 months
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?
eosinophilia
basophilia
monocytosis
lymphocytosis
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:
adenovirus
Epstein-Barr virus (EBV)
cytomegalovirus (CMV)
Toxoplasma gondii
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?
wear a surgical mask when others are around
do not share drinking glasses or eating utensils
avoid all contact with other people
no precautions are necessary
A 10-year-old is diagnosed with leukemia. The nurse assesses for which other condition that could be associated with his disease?
Down syndrome
hemophilia
hyperthyroidism
pheochromocytoma
A 5-year-old is diagnosed with acute leukemia. The patient will mostly likely be treated with:
bone marrow transplant
immunotherapy
chemotherapy
localized radiation therapy
A 35-year-old female is diagnosed with lymphadenopathy. Which assessment finding will help confirm this diagnosis?
small, hard lymph nodes
disordered lymph nodes
nonpalpable, nontender lymph nodes
enlarged lymph nodes
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?
Merkel cell
Schwann cell
Reed-Sternberg cell
Kupffer cell
The people from which country have the lowest risk for Hodgkin lymphoma?
United States
Japan
Denmark
Netherlands
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?
Epstein-Barr virus
Hodgkin lymphoma
acute leukemia
Burkitt lymphoma
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?
Cytomegalovirus (CMV)
Adenovirus
Human papillomavirus (HPV)
Epstein-Barr virus (EBV)
A patient diagnosed with multiple myeloma reports severe pain. This pain can be attributed to:
neuropathic infliltrations
destruction of bone tissue
tissue hypoxia
accumulation of toxic proteins
For a patient experiencing hypersplenism, the nurse expects the erythrocytes to be:
proliferated
activated
sequestered
infected
Thrombocytopenia may be:
transient or consistent
normal or abnormal
congenital or acquired
active or inactive
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:
allergy-induced platelet lysis
an immune response to hypersplenism
antibody destruction of platelets
T-cell injury to megakaryocytes
A patient is diagnosed with primary thrombocythemia. A nurse would expect the blood smear to reveal _____ platelets.
defective
fragmented
consumed
overproduced
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?
K
D
E
B12
A nurse checks individuals with liver disease for clotting problems because:
the liver is often the site of platelet pooling
clotting factors are produced in the liver
high levels of bilirubin interfere with the clotting system
treatment medications. for liver failure cause fibrinolysis
40-year-old develops disseminated intravascular coagulation (DIC). Upon obtaining the history, which finding is the most likely cause of this condition?
snakebite
blood transfusion
sepsis
immune throbocytopenic purpura (ITP)
In disseminated intravascular coagulation (DIC), the nurse assesses for active bleeding after
prothrombin is activated
clotting factors are depleted
inflammatory mediators are released
tissue factor (TF) is inactivated
A patient has microcytic hypochromic anemia. Which of the following pathogenic mechanisms may cause anemia in this patient? (select all that apply)
decreased erythrocyte life span
failure of mechanisms of compensatory erythropoiesis
distrubances of the iron cycle
increased basal metabolic rate
swelling in the tissues
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)
lymph node enlargement
fever and sore throat
rash. onthe trunk and extremities
fatigue
enlargement of liver and spleen
A patient wants to know about risk factors for acute leukemia. Which of the following should the nurse include? (select all that apply)
Cytomegalovirus (CMV) infection
Eating genetically modified food
Chemotherapy treatment for other cancers
Excessive ultraviolet radiation exposure
Ovarian cancer
