NURP-532-Exam 3 With complete solu on| RATED A+ |
UPDATED | NEW 2026
WBC
Total: 5,000-10,000
Neutrophils: first WBC to respond when there is an inflammatory or infec!ous response
Bands: if an acute infec!ous process is going on, there will be le$ shi$ which means there are
more bands than normal
Eosinophils: altered with an allergic reac!on or a parasi!c infec!on
Basophils: altered with an allergic reac!on
Monocytes: responsible for finding and destroying germs
Lymphocytes: responsible for finding and destroying germs
RBCs
Total RBC: 3.5-5
Hbg/Hct ra!o is 1:3 so if your Hgb is 10, your Hct should be 30. If your Hct is running higher, you
should consider dehydra!on
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?
Re!c count: is it hemoly!c or not? Looks at how many juvenile RBCs are in the blood
RDW: red cell distribu!on width
PLT
Total PLT: 150-400
Drug Induced Thrombocytopenia:
,- PLT < 20,000
- Quinine causes low PLT counts
- Onset is 5-10 days a$er star!ng the medica!on
- Tx: possible infusion, stop causa!ve agent (should resolve one week a$er stopping medica!on)
Immune Thrombocytopenia:
- PLT < 100,000
- Diagnosis of exclusion
- Tx: refer to hematology, steroids, IVIG
Classifica!ons of Anemia
Hypoprolifera!ve: not enough RBC produc!on
Non-hypoprolifera!ve: there is not an issue with produc!on but an issue with RBCs dying or
being lost
Microcy!c: MCV < 80;
Macrocy!c: MCV > 100
Generally will transfuse between a Hgb of 7-9
Hemoly!c Anemia
Anemia caused by the destruc!on of red blood cells
S&S: jaundice, scleral icterus, dark urine, hepatoslplenomegaly, fever, pallor, tachycardia, signs
of HF, hemoglobinuria
Microcy!c Anemia
Low Hgb and MCV
Iron deficiency anemia: normal re!c count
Thalassemia: high re!c count
Macrocy!c Anemia
Folic acid vs. B12 deficiency
Aplas!c Anemia
,Failure of blood cell produc!on in the bone marrow
S&S: pancytopenia, low Hgb, low RBC
Tx in adults: immunosuppressants
Tx in children: bone marrow transplant
Sickle Cell Disease
Gene!c 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): fa!gue, pain, bacterial infec!ons
Labs: low HCT, Hgl, and high re!culocyte count
Tx: hydra!on, 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 microcy!c, hypochromic anemia with
a hemoglobin of 9.5 g/dL. The infant has mild pallor with no hepatosplenomegaly. The primary
care pediatric nurse prac!!oner suspects what disorder?
Iron-deficiency anemia
The primary care pediatric nurse prac!!oner 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 membranes. Which tests will the nurse prac!!oner order to evaluate this child's
condi!on?
RBC folate, iron, and B12 levels
The primary care pediatric nurse prac!!oner 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 prac!!oner manage this pa!ent?
The child has mild to moderate iron-deficiency anemia and will need iron supplementa!on. The
hemoglobin, hematocrit, and re!culocytes should be reevaluated in 4 weeks a$er ini!a!on of
treatment.
, A pa!ent reports recent mild fa!gue and palpita!ons. A complete blood count reveals a
decreased hemoglobin level and a normal ferri!n level. What other findings are likely to be
present?
Decreased hematocrit
Lead Poisoning in Adults
S&S: asymptoma!c, GI manifesta!ons, GI manifesta!ons, anemia, HTN, nephropathy, peripheral
neuropathy, spontaneous abor!on, male infer!lity
Lead Poisoning in Children
Lead level > 5
S&S: asymptoma!c, learning disabili!es, behavioral disorders, decreased hearing, decreased
growth, hypochromic microcy!c anemia, HA, abdominal pain, seizure, coma
Childhood Leukemia
S&S: pallor, fa!gue, prolonged fever, petechiae, lymphadenopathy, bone pain
Childhood Central Nervous System Tumors
S&S: HA in the AM, N/V, ataxia, diplopia, seizures, behavioral changes, increased ICP symptoms
Childhood Lymphoma
S&S: lymphadenopathy, night sweats, fever, weight loss, epitrochlear nodes on elbows,
subclavicular nodes
Red Flags for Childhood Cancer
Cons!tu!onal:
- Prolonged fever of unknown origin
- Pallor, fa!gue, malaise
- Anorexia that cannot be explained
- "B symptoms"
- Hemorrhagic diathesis
Lymphadenopathy in Children
Node > 1.5 cm for > 4 weeks = possible malignancy
Common in children, watching-and-wai!ng is okay to do
UPDATED | NEW 2026
WBC
Total: 5,000-10,000
Neutrophils: first WBC to respond when there is an inflammatory or infec!ous response
Bands: if an acute infec!ous process is going on, there will be le$ shi$ which means there are
more bands than normal
Eosinophils: altered with an allergic reac!on or a parasi!c infec!on
Basophils: altered with an allergic reac!on
Monocytes: responsible for finding and destroying germs
Lymphocytes: responsible for finding and destroying germs
RBCs
Total RBC: 3.5-5
Hbg/Hct ra!o is 1:3 so if your Hgb is 10, your Hct should be 30. If your Hct is running higher, you
should consider dehydra!on
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?
Re!c count: is it hemoly!c or not? Looks at how many juvenile RBCs are in the blood
RDW: red cell distribu!on width
PLT
Total PLT: 150-400
Drug Induced Thrombocytopenia:
,- PLT < 20,000
- Quinine causes low PLT counts
- Onset is 5-10 days a$er star!ng the medica!on
- Tx: possible infusion, stop causa!ve agent (should resolve one week a$er stopping medica!on)
Immune Thrombocytopenia:
- PLT < 100,000
- Diagnosis of exclusion
- Tx: refer to hematology, steroids, IVIG
Classifica!ons of Anemia
Hypoprolifera!ve: not enough RBC produc!on
Non-hypoprolifera!ve: there is not an issue with produc!on but an issue with RBCs dying or
being lost
Microcy!c: MCV < 80;
Macrocy!c: MCV > 100
Generally will transfuse between a Hgb of 7-9
Hemoly!c Anemia
Anemia caused by the destruc!on of red blood cells
S&S: jaundice, scleral icterus, dark urine, hepatoslplenomegaly, fever, pallor, tachycardia, signs
of HF, hemoglobinuria
Microcy!c Anemia
Low Hgb and MCV
Iron deficiency anemia: normal re!c count
Thalassemia: high re!c count
Macrocy!c Anemia
Folic acid vs. B12 deficiency
Aplas!c Anemia
,Failure of blood cell produc!on in the bone marrow
S&S: pancytopenia, low Hgb, low RBC
Tx in adults: immunosuppressants
Tx in children: bone marrow transplant
Sickle Cell Disease
Gene!c 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): fa!gue, pain, bacterial infec!ons
Labs: low HCT, Hgl, and high re!culocyte count
Tx: hydra!on, 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 microcy!c, hypochromic anemia with
a hemoglobin of 9.5 g/dL. The infant has mild pallor with no hepatosplenomegaly. The primary
care pediatric nurse prac!!oner suspects what disorder?
Iron-deficiency anemia
The primary care pediatric nurse prac!!oner 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 membranes. Which tests will the nurse prac!!oner order to evaluate this child's
condi!on?
RBC folate, iron, and B12 levels
The primary care pediatric nurse prac!!oner 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 prac!!oner manage this pa!ent?
The child has mild to moderate iron-deficiency anemia and will need iron supplementa!on. The
hemoglobin, hematocrit, and re!culocytes should be reevaluated in 4 weeks a$er ini!a!on of
treatment.
, A pa!ent reports recent mild fa!gue and palpita!ons. A complete blood count reveals a
decreased hemoglobin level and a normal ferri!n level. What other findings are likely to be
present?
Decreased hematocrit
Lead Poisoning in Adults
S&S: asymptoma!c, GI manifesta!ons, GI manifesta!ons, anemia, HTN, nephropathy, peripheral
neuropathy, spontaneous abor!on, male infer!lity
Lead Poisoning in Children
Lead level > 5
S&S: asymptoma!c, learning disabili!es, behavioral disorders, decreased hearing, decreased
growth, hypochromic microcy!c anemia, HA, abdominal pain, seizure, coma
Childhood Leukemia
S&S: pallor, fa!gue, prolonged fever, petechiae, lymphadenopathy, bone pain
Childhood Central Nervous System Tumors
S&S: HA in the AM, N/V, ataxia, diplopia, seizures, behavioral changes, increased ICP symptoms
Childhood Lymphoma
S&S: lymphadenopathy, night sweats, fever, weight loss, epitrochlear nodes on elbows,
subclavicular nodes
Red Flags for Childhood Cancer
Cons!tu!onal:
- Prolonged fever of unknown origin
- Pallor, fa!gue, malaise
- Anorexia that cannot be explained
- "B symptoms"
- Hemorrhagic diathesis
Lymphadenopathy in Children
Node > 1.5 cm for > 4 weeks = possible malignancy
Common in children, watching-and-wai!ng is okay to do
