Brunner: Medical-Surgical Nursing, 11th Edition
Test Bank
Chapter 33: Assessment and Management of Patients With Hematologic Disorders
Multiple Choice
1. The nurse informs a patient who asks where the body forms blood cells responds that blood
cells are formed in the:
A) Spleen
B) Kidneys
C) Bone marrow
D) Liver
Ans: C
Chapter: 33
Cognitive Level: Comprehension
Difficulty: Easy
Integrated Process: Nursing Process
Objective: 1
Patient Needs: D-1
Feedback: Bone marrow is the primary site for hematopoiesis. The spleen and liver may be
involved during embryonic development or when marrow is destroyed. The kidneys release
erythropoietin, which stimulates the marrow to increase production of RBCs.
2. A patient complains of a heavy menstrual flow. Because red blood cell production increases
during menstruation, the nurse is aware that the patient may need to increase her daily intake of:
A) Vitamin C
B) Vitamin D
C) Iron
D) Magnesium
Ans: C
Chapter: 33
Cognitive Level: Application
Difficulty: Moderate
,Integrated Process: Nursing Process
Objective: 2
Patient Needs: D-4
Feedback: To replace blood loss, the rate of red blood cell production increases. Iron is
incorporated into hemoglobin.
3. A patient receives an injury to the skin that causes minor blood loss. Primary hemostasis is
activated, during which:
A) Severed blood vessels constrict.
B) Thromboplastin is released.
C) Prothrombin is converted to thrombin.
D) Fibrin is lysed.
Ans: A
Chapter: 33
Cognitive Level: Comprehension
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 2
Patient Needs: D-4
Feedback: Primary hemostasis involves the severed vessel constricting and platelets collecting at
the injury site. Secondary hemostasis occurs when thromboplastin is released, prothrombin
converts to thrombin, and fibrin is lysed.
4. A patient is diagnosed with a hypoproliferative anemia. The nurse is aware that this type of
anemia is due to:
A) Lack of production of RBCs
B) Loss of RBCs
C) Injury to the RBCs in circulation
D) Abnormality of RBCs
Ans: A
Chapter: 33
Cognitive Level: Comprehension
Difficulty: Easy
Integrated Process: Nursing Process
Objective: 3
Patient Needs: D-4
Feedback: Hypoproliferative anemia is usually a result of inadequate numbers of RBCs being
produced by the bone marrow. A deficit of RBCs is usually a result of blood loss. Hemolytic
, anemia can be a result of injury to the RBCs in circulation, possibly due to heart valve
hemolysis. Abnormality of RBCs can occur in sickle cell anemia.
5. A patient reports symptoms of fatigue and pica. Laboratory findings reveal a low serum iron
level and a low ferritin level. Upon evaluation of this assessment and laboratory data, the nurse
suspects that the patient will be diagnosed with:
A) Iron deficient anemia
B) Pernicious anemia
C) Sickle cell anemia
D) Hemolytic anemia
Ans: A
Chapter: 33
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 3
Patient Needs: D-4
Feedback: A low serum iron level, a low ferritin level, and symptoms of pica are associated with
iron deficiency anemia. TIBC level may also be elevated.
6. A patient is admitted with sickle cell anemia. The nurse is aware that the care of this patient
often requires:
A) Chronic transfusions with RBCs
B) Platelet transfusions
C) Vitamin B12 replacement
D) Phlebotomy
Ans: A
Chapter: 33
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 3
Patient Needs: D-1
Feedback: Medical management of sickle cell anemia includes chronic transfusions with RBCs,
use of hydroxyurea, and bone marrow transplantations.
Test Bank
Chapter 33: Assessment and Management of Patients With Hematologic Disorders
Multiple Choice
1. The nurse informs a patient who asks where the body forms blood cells responds that blood
cells are formed in the:
A) Spleen
B) Kidneys
C) Bone marrow
D) Liver
Ans: C
Chapter: 33
Cognitive Level: Comprehension
Difficulty: Easy
Integrated Process: Nursing Process
Objective: 1
Patient Needs: D-1
Feedback: Bone marrow is the primary site for hematopoiesis. The spleen and liver may be
involved during embryonic development or when marrow is destroyed. The kidneys release
erythropoietin, which stimulates the marrow to increase production of RBCs.
2. A patient complains of a heavy menstrual flow. Because red blood cell production increases
during menstruation, the nurse is aware that the patient may need to increase her daily intake of:
A) Vitamin C
B) Vitamin D
C) Iron
D) Magnesium
Ans: C
Chapter: 33
Cognitive Level: Application
Difficulty: Moderate
,Integrated Process: Nursing Process
Objective: 2
Patient Needs: D-4
Feedback: To replace blood loss, the rate of red blood cell production increases. Iron is
incorporated into hemoglobin.
3. A patient receives an injury to the skin that causes minor blood loss. Primary hemostasis is
activated, during which:
A) Severed blood vessels constrict.
B) Thromboplastin is released.
C) Prothrombin is converted to thrombin.
D) Fibrin is lysed.
Ans: A
Chapter: 33
Cognitive Level: Comprehension
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 2
Patient Needs: D-4
Feedback: Primary hemostasis involves the severed vessel constricting and platelets collecting at
the injury site. Secondary hemostasis occurs when thromboplastin is released, prothrombin
converts to thrombin, and fibrin is lysed.
4. A patient is diagnosed with a hypoproliferative anemia. The nurse is aware that this type of
anemia is due to:
A) Lack of production of RBCs
B) Loss of RBCs
C) Injury to the RBCs in circulation
D) Abnormality of RBCs
Ans: A
Chapter: 33
Cognitive Level: Comprehension
Difficulty: Easy
Integrated Process: Nursing Process
Objective: 3
Patient Needs: D-4
Feedback: Hypoproliferative anemia is usually a result of inadequate numbers of RBCs being
produced by the bone marrow. A deficit of RBCs is usually a result of blood loss. Hemolytic
, anemia can be a result of injury to the RBCs in circulation, possibly due to heart valve
hemolysis. Abnormality of RBCs can occur in sickle cell anemia.
5. A patient reports symptoms of fatigue and pica. Laboratory findings reveal a low serum iron
level and a low ferritin level. Upon evaluation of this assessment and laboratory data, the nurse
suspects that the patient will be diagnosed with:
A) Iron deficient anemia
B) Pernicious anemia
C) Sickle cell anemia
D) Hemolytic anemia
Ans: A
Chapter: 33
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 3
Patient Needs: D-4
Feedback: A low serum iron level, a low ferritin level, and symptoms of pica are associated with
iron deficiency anemia. TIBC level may also be elevated.
6. A patient is admitted with sickle cell anemia. The nurse is aware that the care of this patient
often requires:
A) Chronic transfusions with RBCs
B) Platelet transfusions
C) Vitamin B12 replacement
D) Phlebotomy
Ans: A
Chapter: 33
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 3
Patient Needs: D-1
Feedback: Medical management of sickle cell anemia includes chronic transfusions with RBCs,
use of hydroxyurea, and bone marrow transplantations.
