HEMATOLOGIC DISORDERS EXAM
WITH 100% CORRECT ANSWERS
2026/2027
The nurse is preparing to teach a client with iron deficiency anemia about the diet
to follow after discharge. Which of the following foods should be included in the
diet?
a. Eggs
b. Lettuce
c. Citrus Fruits
d. Cheese CORRECT ANSWER: A
A rich source of iron is needed in the diet, and eggs are high in iron. Other foods
high in iron include organ and muscle (dark) meats; shellfish, shrimp, and tuna;
enriched, whole-grain, and fortified cereals and breads; legumes, nuts, dried
fruits, and beans; oatmeal; and sweet potatoes. Dark green leafy vegetables and
citrus fruits are good sources of vitamin C. Cheese is a good source of calcium.
The nurse would instruct the client to eat which of the following foods to obtain
the best
supply of vitamin
B12?
A. Whole grains
B. Green leafy vegetables
C. Meats and dairy products
D. Broccoli and Brussels sprouts CORRECT ANSWER: C
,Good sources of vitamin B12 include meats and dairy products. Whole grains are
a good source of thiamine. Green leafy vegetables are good sources of niacin,
folate, and carotenoids (precursors of vitamin A). Broccoli and Brussels sprouts
are good sources of ascorbic acid (vitamin C).
The nurse has just admitted a 35-year-old female client who has a serum B12
concentration of 800 pg/ml. Which of the following laboratory findings would cue
the nurse to focus the client history on specific drug or alcohol abuse?
A. Total bilirubin, 0.3 mg/dL
B. Serum creatinine, 0.5 mg/dL
C. Hemoglobin, 16 g/dL
D. Folate, 1.5 ng/mL CORRECT ANSWER: D
The normal range of folic acid is 1.8 to 9 ng/mL, and the normal range of vitamin
B12 is 200 to 900 pg/mL. A low folic acid level in the presence of a normal vitamin
B12 level is indicative of a primary folic acid-deficiency anemia. Factors that
affect the absorption of folic acid are drugs such as methotrexate, oral
contraceptives, antiseizure drugs, and alcohol. The total bilirubin, serum
creatinine, and hemoglobin values are within normal limits.
The nurse understands that the client with pernicious anemia will have
which
distinguishing laboratory
findings?
A. Schilling's test, elevated
B. Intrinsic factor, absent
C. Sedimentation rate, 16 mm/hour
D. RBCs 5.0 million CORRECT ANSWER: B
The defining characteristic of pernicious anemia, a megaloblastic anemia, is lack
of the intrinsic factor, which results from atrophy of the stomach wall. Without the
intrinsic factor, vitamin B12 cannot be absorbed in the small intestines, and folic
acid needs vitamin B12 for DNA synthesis of RBCs. The gastric analysis was
done to determine the primary cause of the anemia. An elevated excretion of the
injected radioactive vitamin B12, which is protocol for the first and second stage
of the Schilling test, indicates that the client has the intrinsic factor and can
absorb vitamin B12 into the intestinal tract. A sedimentation rate of 16 mm/hour is
normal for both men and women and is a
nonspecific test to detect the presence of inflammation. It is not specific to
anemias. An RBC value of 5.0 million is a normal value for both men and women
and does not indicate anemia.
,The nurse devises a teaching plan for the patient with aplastic anemia. Which
of the
following is the most important concept to teach for health
maintenance?
A. Eat animal protein and dark leafy vegetables each day
B. Avoid exposure to others with acute infection
C. Practice yoga and meditation to decrease stress and anxiety
D. Get 8 hours of sleep at night and take naps during the day CORRECT
ANSWER: B Clients with aplastic anemia are severely immunocompromised
and at risk for infection and possible death related to bone marrow
suppression and pancytopenia. Strict aseptic technique and reverse isolation
are important measures to prevent infection. Although diet, reduced stress,
and rest are valued in supporting health, the potentially fatal consequence of
an acute infection places it as a priority for teaching the client about health
maintenance. Animal meat and dark green leafy vegetables, good sources of
vitamin B12 and folic acid, should be included in the daily diet. Yoga and
meditation are good complimentary therapies to reduce stress. Eight hours of
rest and naps are good for spacing and pacing activity and rest.
A client comes into the health clinic 3 years after undergoing a resection of the
terminal
ileum complaining of weakness, shortness of breath, and a sore tongue. Which
client
statement indicates a need for intervention and client
teaching?
A. "I have been drinking plenty of
fluids."
B. "I have been gargling with warm salt water for my sore
tongue."
C. "I have 3 to 4 loose stools per
day."
D. "I take a vitamin B12 tablet every day." CORRECT
ANSWER: D
Vitamin B12 combines with intrinsic factor in the stomach and is then carried
to the
ileum, where it is absorbed in the bloodstream. In this situation, vitamin B12
cannot be
absorbed regardless of the amount of oral intake of sources of vitamin B12 such
as animal protein or vitamin B12 tablets. Vitamin B12 needs to be injected every
month, because the ileum has been surgically removed. Replacement of fluids
, and electrolytes is important when the client has continuous multiple loose stools
on a daily basis. Warm salt water is used to soothe sore mucous membranes.
Crohn's disease and small bowel resection may cause several loose stools a day.
A vegetarian client was referred to a dietitian for nutritional counseling for
anemia.
Which client outcome indicates that the client does not understand
nutritional
counseling? The
client:
A. Adds dried fruit to cereal and baked goods
B. Cooks tomato-based foods in iron pots
C. Drinks coffee or tea with meals
D. Adds vitamin C to all meals CORRECT ANSWER: C
Coffee and tea increase gastrointestinal motility and inhibit the absorption of
nonheme iron. Clients are instructed to add dried fruits to dishes at every meal
because dried fruits are a nonheme or nonanimal iron source. Cooking in iron
cookware, especially acid-based foods such as tomatoes, adds iron to the diet.
Clients are instructed to add a rich supply of vitamin C to every meal because the
absorption of iron is increased when food with vitamin C or ascorbic acid is
consumed.
A client was admitted with iron deficiency anemia and blood-streaked emesis.
Which question is most appropriate for the nurse to ask in determining the extent
of the client's activity intolerance?
A. "What activities were you able to do 6 months ago compared with the
present?"
B. "How long have you had this problem?"
C. "Have you been able to keep up with all your usual activities?"
D. "Are you more tired now than you used to be?" CORRECT ANSWER: A
It is difficult to determine activity intolerance without objectively comparing
activities from one time frame to another. Because iron deficiency anemia can
occur gradually and individual endurance varies, the nurse can best assess the
client's activity tolerance by asking the client to compare activities 6 months ago
and at the present. Asking a client how long a problem has existed is a very open-
ended question that allows for too much subjectivity for any definition of the
client's activity tolerance. Also, the client may not even identify that a "problem"
exists. Asking the client whether he is staying abreast of usual activities
addresses whether the tasks were completed, not the tolerance of the client while
the tasks were being completed or the resulting condition of the client after the
tasks were completed. Asking the client if he is more tired now than usual does
WITH 100% CORRECT ANSWERS
2026/2027
The nurse is preparing to teach a client with iron deficiency anemia about the diet
to follow after discharge. Which of the following foods should be included in the
diet?
a. Eggs
b. Lettuce
c. Citrus Fruits
d. Cheese CORRECT ANSWER: A
A rich source of iron is needed in the diet, and eggs are high in iron. Other foods
high in iron include organ and muscle (dark) meats; shellfish, shrimp, and tuna;
enriched, whole-grain, and fortified cereals and breads; legumes, nuts, dried
fruits, and beans; oatmeal; and sweet potatoes. Dark green leafy vegetables and
citrus fruits are good sources of vitamin C. Cheese is a good source of calcium.
The nurse would instruct the client to eat which of the following foods to obtain
the best
supply of vitamin
B12?
A. Whole grains
B. Green leafy vegetables
C. Meats and dairy products
D. Broccoli and Brussels sprouts CORRECT ANSWER: C
,Good sources of vitamin B12 include meats and dairy products. Whole grains are
a good source of thiamine. Green leafy vegetables are good sources of niacin,
folate, and carotenoids (precursors of vitamin A). Broccoli and Brussels sprouts
are good sources of ascorbic acid (vitamin C).
The nurse has just admitted a 35-year-old female client who has a serum B12
concentration of 800 pg/ml. Which of the following laboratory findings would cue
the nurse to focus the client history on specific drug or alcohol abuse?
A. Total bilirubin, 0.3 mg/dL
B. Serum creatinine, 0.5 mg/dL
C. Hemoglobin, 16 g/dL
D. Folate, 1.5 ng/mL CORRECT ANSWER: D
The normal range of folic acid is 1.8 to 9 ng/mL, and the normal range of vitamin
B12 is 200 to 900 pg/mL. A low folic acid level in the presence of a normal vitamin
B12 level is indicative of a primary folic acid-deficiency anemia. Factors that
affect the absorption of folic acid are drugs such as methotrexate, oral
contraceptives, antiseizure drugs, and alcohol. The total bilirubin, serum
creatinine, and hemoglobin values are within normal limits.
The nurse understands that the client with pernicious anemia will have
which
distinguishing laboratory
findings?
A. Schilling's test, elevated
B. Intrinsic factor, absent
C. Sedimentation rate, 16 mm/hour
D. RBCs 5.0 million CORRECT ANSWER: B
The defining characteristic of pernicious anemia, a megaloblastic anemia, is lack
of the intrinsic factor, which results from atrophy of the stomach wall. Without the
intrinsic factor, vitamin B12 cannot be absorbed in the small intestines, and folic
acid needs vitamin B12 for DNA synthesis of RBCs. The gastric analysis was
done to determine the primary cause of the anemia. An elevated excretion of the
injected radioactive vitamin B12, which is protocol for the first and second stage
of the Schilling test, indicates that the client has the intrinsic factor and can
absorb vitamin B12 into the intestinal tract. A sedimentation rate of 16 mm/hour is
normal for both men and women and is a
nonspecific test to detect the presence of inflammation. It is not specific to
anemias. An RBC value of 5.0 million is a normal value for both men and women
and does not indicate anemia.
,The nurse devises a teaching plan for the patient with aplastic anemia. Which
of the
following is the most important concept to teach for health
maintenance?
A. Eat animal protein and dark leafy vegetables each day
B. Avoid exposure to others with acute infection
C. Practice yoga and meditation to decrease stress and anxiety
D. Get 8 hours of sleep at night and take naps during the day CORRECT
ANSWER: B Clients with aplastic anemia are severely immunocompromised
and at risk for infection and possible death related to bone marrow
suppression and pancytopenia. Strict aseptic technique and reverse isolation
are important measures to prevent infection. Although diet, reduced stress,
and rest are valued in supporting health, the potentially fatal consequence of
an acute infection places it as a priority for teaching the client about health
maintenance. Animal meat and dark green leafy vegetables, good sources of
vitamin B12 and folic acid, should be included in the daily diet. Yoga and
meditation are good complimentary therapies to reduce stress. Eight hours of
rest and naps are good for spacing and pacing activity and rest.
A client comes into the health clinic 3 years after undergoing a resection of the
terminal
ileum complaining of weakness, shortness of breath, and a sore tongue. Which
client
statement indicates a need for intervention and client
teaching?
A. "I have been drinking plenty of
fluids."
B. "I have been gargling with warm salt water for my sore
tongue."
C. "I have 3 to 4 loose stools per
day."
D. "I take a vitamin B12 tablet every day." CORRECT
ANSWER: D
Vitamin B12 combines with intrinsic factor in the stomach and is then carried
to the
ileum, where it is absorbed in the bloodstream. In this situation, vitamin B12
cannot be
absorbed regardless of the amount of oral intake of sources of vitamin B12 such
as animal protein or vitamin B12 tablets. Vitamin B12 needs to be injected every
month, because the ileum has been surgically removed. Replacement of fluids
, and electrolytes is important when the client has continuous multiple loose stools
on a daily basis. Warm salt water is used to soothe sore mucous membranes.
Crohn's disease and small bowel resection may cause several loose stools a day.
A vegetarian client was referred to a dietitian for nutritional counseling for
anemia.
Which client outcome indicates that the client does not understand
nutritional
counseling? The
client:
A. Adds dried fruit to cereal and baked goods
B. Cooks tomato-based foods in iron pots
C. Drinks coffee or tea with meals
D. Adds vitamin C to all meals CORRECT ANSWER: C
Coffee and tea increase gastrointestinal motility and inhibit the absorption of
nonheme iron. Clients are instructed to add dried fruits to dishes at every meal
because dried fruits are a nonheme or nonanimal iron source. Cooking in iron
cookware, especially acid-based foods such as tomatoes, adds iron to the diet.
Clients are instructed to add a rich supply of vitamin C to every meal because the
absorption of iron is increased when food with vitamin C or ascorbic acid is
consumed.
A client was admitted with iron deficiency anemia and blood-streaked emesis.
Which question is most appropriate for the nurse to ask in determining the extent
of the client's activity intolerance?
A. "What activities were you able to do 6 months ago compared with the
present?"
B. "How long have you had this problem?"
C. "Have you been able to keep up with all your usual activities?"
D. "Are you more tired now than you used to be?" CORRECT ANSWER: A
It is difficult to determine activity intolerance without objectively comparing
activities from one time frame to another. Because iron deficiency anemia can
occur gradually and individual endurance varies, the nurse can best assess the
client's activity tolerance by asking the client to compare activities 6 months ago
and at the present. Asking a client how long a problem has existed is a very open-
ended question that allows for too much subjectivity for any definition of the
client's activity tolerance. Also, the client may not even identify that a "problem"
exists. Asking the client whether he is staying abreast of usual activities
addresses whether the tasks were completed, not the tolerance of the client while
the tasks were being completed or the resulting condition of the client after the
tasks were completed. Asking the client if he is more tired now than usual does
