Ch. 34: Hematologic Problems Lewis: Medical-Surgical
Nursing Exam Questions And Correct Answers (Verified
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A 52-yr-old patient has a new diagnosis of pernicious anemia. The nurse determines
that the
patient understands the teaching about the disorder when the patient states,
a. "I need to start eating more red meat and liver."
b. "I will stop having a glass of wine with dinner."
c. "I could choose nasal spray rather than injections of vitamin B12."
d. "I will need to take a proton pump inhibitor such as omeprazole (Prilosec)."
ANS: C
Because pernicious anemia prevents the absorption of vitamin B12, this patient
requires
injections or intranasal administration of cobalamin. Alcohol use does not cause
cobalamin
deficiency. Proton pump inhibitors decrease the absorption of vitamin B12. Eating
more foods
rich in vitamin B12 is not helpful because the lack of intrinsic factor prevents
absorption of the
vitamin.
DIF: Cognitive Level: Apply (application) REF: 612
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
,An appropriate nursing intervention for a hospitalized patient with severe hemolytic
anemia is
to
a. provide a diet high in vitamin K.
b. alternate periods of rest and activity.
c. teach the patient how to avoid injury.
d. place the patient on protective isolation.
ANS: B
Nursing care for patients with anemia should alternate periods of rest and activity to
encourage activity without causing undue fatigue. There is no indication that the
patient has a
bleeding disorder, so a diet high in vitamin K or teaching about how to avoid injury is
not
needed. Protective isolation might be used for a patient with aplastic anemia, but it is
not
indicated for hemolytic anemia.
DIF: Cognitive Level: Apply (application) REF: 608
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
,Which patient statement to the nurse indicates a need for additional instruction
about taking
oral ferrous sulfate?
a. "I will call my health care provider if my stools turn black."
b. "I will take a stool softener if I feel constipated occasionally."
c. "I should take the iron with orange juice about an hour before eating."
d. "I should increase my fluid and fiber intake while I am taking iron tablets."
ANS: A
It is normal for the stools to appear black when a patient is taking iron, and the
patient should
not call the health care provider about this. The other patient statements are correct.
DIF: Cognitive Level: Apply (application) REF: 609
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
Which collaborative problem will the nurse include in a care plan for a patient
admitted to the
hospital with idiopathic aplastic anemia?
a. Potential complication: seizures
b. Potential complication: infection
c. Potential complication: neurogenic shock
d. Potential complication: pulmonary edema
ANS: B
Because the patient with aplastic anemia has pancytopenia, the patient is at risk for
infection
and bleeding. There is no increased risk for seizures, neurogenic shock, or
pulmonary edema.
DIF: Cognitive Level: Apply (application) REF: 614
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
, 4/14/26, 11:40 AM Ch. 34: Hematologic Problems Lewis: Medical-Surgical Nursing
A 62-year old man with chronic anemia is experiencing increased fatigue and
occasional
palpitations at rest. The nurse would expect the patient's laboratory test findings to
include
a. an RBC count of 4,500,000/L.
b. a hematocrit (Hct) value of 38%.
c. normal red blood cell (RBC) indices.
d. a hemoglobin (Hgb) of 8.6 g/dL (86 g/L).
ANS: D
The patient's clinical manifestations indicate moderate anemia, which is consistent
with a Hgb
of 6 to 10 g/dL. The other values are all within the range of normal.
DIF: Cognitive Level: Understand (comprehension) REF: 607
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
Which menu choice indicates that the patient understands the nurse's teaching about
recommended dietary choices for iron-deficiency anemia?
a. Omelet and whole wheat toast
b. Cantaloupe and cottage cheese
c. Strawberry and banana fruit plate
d. Cornmeal muffin and orange juice
ANS: A
Eggs and whole grain breads are high in iron. The other choices are appropriate for
other
nutritional deficiencies but are not the best choice for a patient with iron-deficiency
anemia.
DIF: Cognitive Level: Apply (application) REF: 610
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
/ 2/44
Nursing Exam Questions And Correct Answers (Verified
Answers) Already Graded A+ |Guaranteed Success!!
Newest Exam | Just Released!!
A 52-yr-old patient has a new diagnosis of pernicious anemia. The nurse determines
that the
patient understands the teaching about the disorder when the patient states,
a. "I need to start eating more red meat and liver."
b. "I will stop having a glass of wine with dinner."
c. "I could choose nasal spray rather than injections of vitamin B12."
d. "I will need to take a proton pump inhibitor such as omeprazole (Prilosec)."
ANS: C
Because pernicious anemia prevents the absorption of vitamin B12, this patient
requires
injections or intranasal administration of cobalamin. Alcohol use does not cause
cobalamin
deficiency. Proton pump inhibitors decrease the absorption of vitamin B12. Eating
more foods
rich in vitamin B12 is not helpful because the lack of intrinsic factor prevents
absorption of the
vitamin.
DIF: Cognitive Level: Apply (application) REF: 612
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
,An appropriate nursing intervention for a hospitalized patient with severe hemolytic
anemia is
to
a. provide a diet high in vitamin K.
b. alternate periods of rest and activity.
c. teach the patient how to avoid injury.
d. place the patient on protective isolation.
ANS: B
Nursing care for patients with anemia should alternate periods of rest and activity to
encourage activity without causing undue fatigue. There is no indication that the
patient has a
bleeding disorder, so a diet high in vitamin K or teaching about how to avoid injury is
not
needed. Protective isolation might be used for a patient with aplastic anemia, but it is
not
indicated for hemolytic anemia.
DIF: Cognitive Level: Apply (application) REF: 608
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
,Which patient statement to the nurse indicates a need for additional instruction
about taking
oral ferrous sulfate?
a. "I will call my health care provider if my stools turn black."
b. "I will take a stool softener if I feel constipated occasionally."
c. "I should take the iron with orange juice about an hour before eating."
d. "I should increase my fluid and fiber intake while I am taking iron tablets."
ANS: A
It is normal for the stools to appear black when a patient is taking iron, and the
patient should
not call the health care provider about this. The other patient statements are correct.
DIF: Cognitive Level: Apply (application) REF: 609
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
Which collaborative problem will the nurse include in a care plan for a patient
admitted to the
hospital with idiopathic aplastic anemia?
a. Potential complication: seizures
b. Potential complication: infection
c. Potential complication: neurogenic shock
d. Potential complication: pulmonary edema
ANS: B
Because the patient with aplastic anemia has pancytopenia, the patient is at risk for
infection
and bleeding. There is no increased risk for seizures, neurogenic shock, or
pulmonary edema.
DIF: Cognitive Level: Apply (application) REF: 614
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
, 4/14/26, 11:40 AM Ch. 34: Hematologic Problems Lewis: Medical-Surgical Nursing
A 62-year old man with chronic anemia is experiencing increased fatigue and
occasional
palpitations at rest. The nurse would expect the patient's laboratory test findings to
include
a. an RBC count of 4,500,000/L.
b. a hematocrit (Hct) value of 38%.
c. normal red blood cell (RBC) indices.
d. a hemoglobin (Hgb) of 8.6 g/dL (86 g/L).
ANS: D
The patient's clinical manifestations indicate moderate anemia, which is consistent
with a Hgb
of 6 to 10 g/dL. The other values are all within the range of normal.
DIF: Cognitive Level: Understand (comprehension) REF: 607
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
Which menu choice indicates that the patient understands the nurse's teaching about
recommended dietary choices for iron-deficiency anemia?
a. Omelet and whole wheat toast
b. Cantaloupe and cottage cheese
c. Strawberry and banana fruit plate
d. Cornmeal muffin and orange juice
ANS: A
Eggs and whole grain breads are high in iron. The other choices are appropriate for
other
nutritional deficiencies but are not the best choice for a patient with iron-deficiency
anemia.
DIF: Cognitive Level: Apply (application) REF: 610
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
/ 2/44
