NUR 258
NUR 258 Exam 4 |Questions with Correct
Answers |2026 Update
Anemia: three types
Hypo-proliferative: Defective RBC production, bone marrow sup. Or chemo
Hemolytic: RBC destruction, sickle cell disease
Bleeding/blood loss: GI, hemorrhage, heavy menstruation
Anemia: manifestations
- fatigue
- dizzy
- syncope with standing/exertion
- pallor
- sensitivity to cold
- brittle/ridged/concave nails
- angular cheilosis of lips
- pica
- tongue changes
- vitals: ↑ HR, ↑ RR, ↓ spo2, dyspnea, hypotension (bleeding)
- jaundice if from hemolysis(sickle cell anemia)
Complete Blood Count (CBC) Labs
Hemoglobin (Hgb): Transports O₂ to all tissues
Hematocrit (HCT): % of RBC in relation to blood volume
Diagnostics for hematologic disorders
Ferritin: iron stores
Sickle-cell test: sickling RBC
Bone marrow aspiration/biopsy: aplastic anemia and leukemia, performed on iliac
crest, post-op precautions for bleeding and infection
NUR 258
,NUR 258
Iron deficiency anemia Risks, Causes, Diagnostics:
Risks: inadequate intake of iron, vegan, vegetarian
Check ferritin level
Causes: blood loss, menorrhagia, pregnancy, alcohol abuse, IBD, NSAID & aspirin
Diagnostics: colonoscopies, history of heavy periods, dietary intake
Iron deficiency anemia: management
Replace what is missing
Iron supplements:
- Vit C helps absorption
- food decreases absorption
- take between meals
- liquid supplement: stains teeth, brush teeth after, drink through straw
Diet: meat, seafood, legume, leafy vegetables, raisins
Aplastic anemia & ssx
Damage to the bone marrow stem cells
Pancytopenia: anemia, leukopenia, thrombocytopenia
S/S: infections, purpura, petechiae, retinal hemorrhage, splenomegaly
Aplastic anemia Tx
Tx:
- Hematopoietic stem cell transplantation (HSCT)
- Immunosuppressive therapy
- transfusions (prevent infection & bleeding)
Megaloblastic/pernicious anemia & ssx/Labs
Large RBC
Deficient in: Vit B12 (no intrinsic factor) and folic acid
S/S: think neuro
- sore red tongue
NUR 258
, NUR 258
- pallor
- paresthesia in legs and feet
- loss of balance
- loss of proprioception
- confusion (late sign)
Labs: folic acid, Vit B12, MCV
Megaloblastic anemia: management
Lifelong
Vitamin B9: broccoli, eggs, legumes, avocados, oral supplement
- educate: large doses will turn urine dark yellow and can mask B12 deficiency
Vitamin B12: milk, almonds, fish, cheese, eggs, red meats
- IM or Sub Q for life
Sickle cell anemia & ssx/Causes/Findings
Blood is thick and sickling
Hypoxemia: occlusive/ischemia of organs
- Acute chest syndrome: ischemia of lungs and heart, emergency
S/S: Pain, Pallor, Fatigue
- sickled cells hemolyze (destruction of RBC)
- arrhythmias
- jaundice
- tissue hypoxia, damage, necrosis (slow healing wounds, poor perfusion to heal wound)
Causes: dehydration, infection, stressors
Expected findings: gallstones, splenomegaly
Sickle cell vaso-occlusive crisis & Tx
Periodic episodes of extreme pain, called pain crises
- hypoxia causes pain
- bone pain
NUR 258
NUR 258 Exam 4 |Questions with Correct
Answers |2026 Update
Anemia: three types
Hypo-proliferative: Defective RBC production, bone marrow sup. Or chemo
Hemolytic: RBC destruction, sickle cell disease
Bleeding/blood loss: GI, hemorrhage, heavy menstruation
Anemia: manifestations
- fatigue
- dizzy
- syncope with standing/exertion
- pallor
- sensitivity to cold
- brittle/ridged/concave nails
- angular cheilosis of lips
- pica
- tongue changes
- vitals: ↑ HR, ↑ RR, ↓ spo2, dyspnea, hypotension (bleeding)
- jaundice if from hemolysis(sickle cell anemia)
Complete Blood Count (CBC) Labs
Hemoglobin (Hgb): Transports O₂ to all tissues
Hematocrit (HCT): % of RBC in relation to blood volume
Diagnostics for hematologic disorders
Ferritin: iron stores
Sickle-cell test: sickling RBC
Bone marrow aspiration/biopsy: aplastic anemia and leukemia, performed on iliac
crest, post-op precautions for bleeding and infection
NUR 258
,NUR 258
Iron deficiency anemia Risks, Causes, Diagnostics:
Risks: inadequate intake of iron, vegan, vegetarian
Check ferritin level
Causes: blood loss, menorrhagia, pregnancy, alcohol abuse, IBD, NSAID & aspirin
Diagnostics: colonoscopies, history of heavy periods, dietary intake
Iron deficiency anemia: management
Replace what is missing
Iron supplements:
- Vit C helps absorption
- food decreases absorption
- take between meals
- liquid supplement: stains teeth, brush teeth after, drink through straw
Diet: meat, seafood, legume, leafy vegetables, raisins
Aplastic anemia & ssx
Damage to the bone marrow stem cells
Pancytopenia: anemia, leukopenia, thrombocytopenia
S/S: infections, purpura, petechiae, retinal hemorrhage, splenomegaly
Aplastic anemia Tx
Tx:
- Hematopoietic stem cell transplantation (HSCT)
- Immunosuppressive therapy
- transfusions (prevent infection & bleeding)
Megaloblastic/pernicious anemia & ssx/Labs
Large RBC
Deficient in: Vit B12 (no intrinsic factor) and folic acid
S/S: think neuro
- sore red tongue
NUR 258
, NUR 258
- pallor
- paresthesia in legs and feet
- loss of balance
- loss of proprioception
- confusion (late sign)
Labs: folic acid, Vit B12, MCV
Megaloblastic anemia: management
Lifelong
Vitamin B9: broccoli, eggs, legumes, avocados, oral supplement
- educate: large doses will turn urine dark yellow and can mask B12 deficiency
Vitamin B12: milk, almonds, fish, cheese, eggs, red meats
- IM or Sub Q for life
Sickle cell anemia & ssx/Causes/Findings
Blood is thick and sickling
Hypoxemia: occlusive/ischemia of organs
- Acute chest syndrome: ischemia of lungs and heart, emergency
S/S: Pain, Pallor, Fatigue
- sickled cells hemolyze (destruction of RBC)
- arrhythmias
- jaundice
- tissue hypoxia, damage, necrosis (slow healing wounds, poor perfusion to heal wound)
Causes: dehydration, infection, stressors
Expected findings: gallstones, splenomegaly
Sickle cell vaso-occlusive crisis & Tx
Periodic episodes of extreme pain, called pain crises
- hypoxia causes pain
- bone pain
NUR 258
