NURP-532-Exam 3 Questions With Complete Solutions
WBC - (ANSWER)Total: 5,000-10,000
Neutrophils: first WBC to respond when there is an inflammatory or infectious response
Bands: if an acute infectious process is going on, there will be left shift which means there are more
bands than normal
Eosinophils: altered with an allergic reaction or a parasitic infection
Basophils: altered with an allergic reaction
Monocytes: responsible for finding and destroying germs
Lymphocytes: responsible for finding and destroying germs
RBCs - (ANSWER)Total RBC: 3.5-5
Hbg/Hct ratio is 1:3 so if your Hgb is 10, your Hct should be 30. If your Hct is running higher, you should
consider dehydration
Hgb: < 13 males, < 12 females, < 11 pregnant females
MCV: how big is the RBC? (volume)
MCH: what color is the RBC?
MCHC: how big and what color?
Retic count: is it hemolytic or not? Looks at how many juvenile RBCs are in the blood
RDW: red cell distribution width
PLT - (ANSWER)Total PLT: 150-400
,NURP-532-Exam 3 Questions With Complete Solutions
Drug Induced Thrombocytopenia:
- PLT < 20,000
- Quinine causes low PLT counts
- Onset is 5-10 days after starting the medication
- Tx: possible infusion, stop causative agent (should resolve one week after stopping medication)
Immune Thrombocytopenia:
- PLT < 100,000
- Diagnosis of exclusion
- Tx: refer to hematology, steroids, IVIG
Classifications of Anemia - (ANSWER)Hypoproliferative: not enough RBC production
Non-hypoproliferative: there is not an issue with production but an issue with RBCs dying or being lost
Microcytic: MCV < 80;
Macrocytic: MCV > 100
Generally will transfuse between a Hgb of 7-9
Hemolytic Anemia - (ANSWER)Anemia caused by the destruction of red blood cells
S&S: jaundice, scleral icterus, dark urine, hepatoslplenomegaly, fever, pallor, tachycardia, signs of HF,
hemoglobinuria
Microcytic Anemia - (ANSWER)Low Hgb and MCV
Iron deficiency anemia: normal retic count
,NURP-532-Exam 3 Questions With Complete Solutions
Thalassemia: high retic count
Macrocytic Anemia - (ANSWER)Folic acid vs. B12 deficiency
Aplastic Anemia - (ANSWER)Failure of blood cell production in the bone marrow
S&S: pancytopenia, low Hgb, low RBC
Tx in adults: immunosuppressants
Tx in children: bone marrow transplant
Sickle Cell Disease - (ANSWER)Genetic disorder in which red blood cells have abnormal hemoglobin
molecules and take on an abnormal shape.
Universal screening at birth
S&S (emerge around 6 months of age): fatigue, pain, bacterial infections
Labs: low HCT, Hgl, and high reticulocyte count
Tx: hydration, pain management, abx prophylaxis for infants and young children, referral to
hematologist, monitor growth and development
A complete blood count on a 12-month-old infant reveals microcytic, hypochromic anemia with a
hemoglobin of 9.5 g/dL. The infant has mild pallor with no hepatosplenomegaly. The primary care
pediatric nurse practitioner suspects what disorder? - (ANSWER)Iron-deficiency anemia
The primary care pediatric nurse practitioner sees a 12-month-old infant who is being fed goat's milk
and a vegetarian diet. The child is pale and has a beefy-red, with sore tongue and oral mucous
, NURP-532-Exam 3 Questions With Complete Solutions
membranes. Which tests will the nurse practitioner order to evaluate this child's condition? -
(ANSWER)RBC folate, iron, and B12 levels
The primary care pediatric nurse practitioner evaluates a 5-year-old child who presents with pallor and
obtains labs revealing a hemoglobin of 8.5 g/dL and a hematocrit of 31%. How will the nurse practitioner
manage this patient? - (ANSWER)The child has mild to moderate iron-deficiency anemia and will need
iron supplementation. The hemoglobin, hematocrit, and reticulocytes should be reevaluated in 4 weeks
after initiation of treatment.
A patient reports recent mild fatigue and palpitations. A complete blood count reveals a decreased
hemoglobin level and a normal ferritin level. What other findings are likely to be present? -
(ANSWER)Decreased hematocrit
Lead Poisoning in Adults - (ANSWER)S&S: asymptomatic, GI manifestations, GI manifestations, anemia,
HTN, nephropathy, peripheral neuropathy, spontaneous abortion, male infertility
Lead Poisoning in Children - (ANSWER)Lead level > 5
S&S: asymptomatic, learning disabilities, behavioral disorders, decreased hearing, decreased growth,
hypochromic microcytic anemia, HA, abdominal pain, seizure, coma
Childhood Leukemia - (ANSWER)S&S: pallor, fatigue, prolonged fever, petechiae, lymphadenopathy,
bone pain
Childhood Central Nervous System Tumors - (ANSWER)S&S: HA in the AM, N/V, ataxia, diplopia,
seizures, behavioral changes, increased ICP symptoms
Childhood Lymphoma - (ANSWER)S&S: lymphadenopathy, night sweats, fever, weight loss, epitrochlear
nodes on elbows, subclavicular nodes
Red Flags for Childhood Cancer - (ANSWER)Constitutional:
- Prolonged fever of unknown origin
WBC - (ANSWER)Total: 5,000-10,000
Neutrophils: first WBC to respond when there is an inflammatory or infectious response
Bands: if an acute infectious process is going on, there will be left shift which means there are more
bands than normal
Eosinophils: altered with an allergic reaction or a parasitic infection
Basophils: altered with an allergic reaction
Monocytes: responsible for finding and destroying germs
Lymphocytes: responsible for finding and destroying germs
RBCs - (ANSWER)Total RBC: 3.5-5
Hbg/Hct ratio is 1:3 so if your Hgb is 10, your Hct should be 30. If your Hct is running higher, you should
consider dehydration
Hgb: < 13 males, < 12 females, < 11 pregnant females
MCV: how big is the RBC? (volume)
MCH: what color is the RBC?
MCHC: how big and what color?
Retic count: is it hemolytic or not? Looks at how many juvenile RBCs are in the blood
RDW: red cell distribution width
PLT - (ANSWER)Total PLT: 150-400
,NURP-532-Exam 3 Questions With Complete Solutions
Drug Induced Thrombocytopenia:
- PLT < 20,000
- Quinine causes low PLT counts
- Onset is 5-10 days after starting the medication
- Tx: possible infusion, stop causative agent (should resolve one week after stopping medication)
Immune Thrombocytopenia:
- PLT < 100,000
- Diagnosis of exclusion
- Tx: refer to hematology, steroids, IVIG
Classifications of Anemia - (ANSWER)Hypoproliferative: not enough RBC production
Non-hypoproliferative: there is not an issue with production but an issue with RBCs dying or being lost
Microcytic: MCV < 80;
Macrocytic: MCV > 100
Generally will transfuse between a Hgb of 7-9
Hemolytic Anemia - (ANSWER)Anemia caused by the destruction of red blood cells
S&S: jaundice, scleral icterus, dark urine, hepatoslplenomegaly, fever, pallor, tachycardia, signs of HF,
hemoglobinuria
Microcytic Anemia - (ANSWER)Low Hgb and MCV
Iron deficiency anemia: normal retic count
,NURP-532-Exam 3 Questions With Complete Solutions
Thalassemia: high retic count
Macrocytic Anemia - (ANSWER)Folic acid vs. B12 deficiency
Aplastic Anemia - (ANSWER)Failure of blood cell production in the bone marrow
S&S: pancytopenia, low Hgb, low RBC
Tx in adults: immunosuppressants
Tx in children: bone marrow transplant
Sickle Cell Disease - (ANSWER)Genetic disorder in which red blood cells have abnormal hemoglobin
molecules and take on an abnormal shape.
Universal screening at birth
S&S (emerge around 6 months of age): fatigue, pain, bacterial infections
Labs: low HCT, Hgl, and high reticulocyte count
Tx: hydration, pain management, abx prophylaxis for infants and young children, referral to
hematologist, monitor growth and development
A complete blood count on a 12-month-old infant reveals microcytic, hypochromic anemia with a
hemoglobin of 9.5 g/dL. The infant has mild pallor with no hepatosplenomegaly. The primary care
pediatric nurse practitioner suspects what disorder? - (ANSWER)Iron-deficiency anemia
The primary care pediatric nurse practitioner sees a 12-month-old infant who is being fed goat's milk
and a vegetarian diet. The child is pale and has a beefy-red, with sore tongue and oral mucous
, NURP-532-Exam 3 Questions With Complete Solutions
membranes. Which tests will the nurse practitioner order to evaluate this child's condition? -
(ANSWER)RBC folate, iron, and B12 levels
The primary care pediatric nurse practitioner evaluates a 5-year-old child who presents with pallor and
obtains labs revealing a hemoglobin of 8.5 g/dL and a hematocrit of 31%. How will the nurse practitioner
manage this patient? - (ANSWER)The child has mild to moderate iron-deficiency anemia and will need
iron supplementation. The hemoglobin, hematocrit, and reticulocytes should be reevaluated in 4 weeks
after initiation of treatment.
A patient reports recent mild fatigue and palpitations. A complete blood count reveals a decreased
hemoglobin level and a normal ferritin level. What other findings are likely to be present? -
(ANSWER)Decreased hematocrit
Lead Poisoning in Adults - (ANSWER)S&S: asymptomatic, GI manifestations, GI manifestations, anemia,
HTN, nephropathy, peripheral neuropathy, spontaneous abortion, male infertility
Lead Poisoning in Children - (ANSWER)Lead level > 5
S&S: asymptomatic, learning disabilities, behavioral disorders, decreased hearing, decreased growth,
hypochromic microcytic anemia, HA, abdominal pain, seizure, coma
Childhood Leukemia - (ANSWER)S&S: pallor, fatigue, prolonged fever, petechiae, lymphadenopathy,
bone pain
Childhood Central Nervous System Tumors - (ANSWER)S&S: HA in the AM, N/V, ataxia, diplopia,
seizures, behavioral changes, increased ICP symptoms
Childhood Lymphoma - (ANSWER)S&S: lymphadenopathy, night sweats, fever, weight loss, epitrochlear
nodes on elbows, subclavicular nodes
Red Flags for Childhood Cancer - (ANSWER)Constitutional:
- Prolonged fever of unknown origin
