©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
Lewis Ch 29 Assessment of Hematologic
System Exam Practice Questions and
Answers
The nurse is caring for a patient who is being discharged after an emergency splenectomy following a
motor vehicle crash. Which instructions should the nurse include in the discharge teaching?
a. Check often for swollen lymph nodes.
b. Watch for excess bleeding or bruising.
c. Take iron supplements to prevent anemia.
d. Wash hands and avoid persons who are ill. - Ans:✔✔-ANS: D. Wash hands and avoid persons who are
ill.
Splenectomy increases the risk for infection, especially with gram-positive bacteria. The risks for
lymphedema, bleeding, and anemia are not increased after a person has a splenectomy.
Page 1/37
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
The nurse assesses a patient who has numerous petechiae on both arms. Which question should the
nurse ask the patient?
a. "Are you taking any oral contraceptives?"
b. "Have you been prescribed antiseizure drugs?"
c. "Do you take medication containing salicylates?"
d. "How long have you taken antihypertensive drugs?" - Ans:✔✔-ANS: C. "Do you take medication
containing salicylates?"
Salicylates interfere with platelet function and can lead to petechiae and ecchymoses. Antiseizure drugs
may cause anemia but not clotting disorders or bleeding. Oral contraceptives increase a person's clotting
risk. Antihypertensives do not usually cause problems with decreased clotting.
A nurse reviews the laboratory data for an older patient. The nurse would be most concerned about
which finding?
a. Hematocrit of 35%
Page 2/37
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FIRST PUBLISH OCTOBER 2024
b. Hemoglobin of 11.8 g/dL
c. Platelet count of 400,000/µL
d. White blood cell (WBC) count of 2800/µL - Ans:✔✔-ANS: D. White blood cell (WBC) count of 2800/µL
Because the total WBC count is not usually affected by aging, the low WBC count in this patient would
indicate that the patient's immune function may be compromised and the underlying cause of the
problem needs to be investigated. The platelet count is normal. The slight decrease in hemoglobin and
hematocrit are not unusual for an older patient.
A patient with pancytopenia has a bone marrow aspiration from the left posterior iliac crest. Which
action would be important for the nurse to take after the procedure?
a. Elevate the head of the bed to 45 degrees.
b. Have the patient lie on the left side for 1 hour.
c. Apply a sterile 2-inch gauze dressing to the site.
d. Use a half-inch sterile gauze to pack the wound. - Ans:✔✔-ANS: B. Have the patient lie on the left side
for 1 hour.
Page 3/37
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
To decrease the risk for bleeding, the patient should lie on the left side for 30 to 60 minutes. After a bone
marrow biopsy, the wound is small and will not be packed with gauze. A pressure dressing is used to
cover the aspiration site. There is no indication to elevate the patient's head.
The nurse assesses a patient with pernicious anemia. Which assessment finding would the nurse expect?
a. Yellow-tinged sclerae
b. Shiny, smooth tongue
c. Numbness of the extremities
d. Gum bleeding and tenderness - Ans:✔✔-ANS: C. Numbness of the extremities
Extremity numbness is associated with cobalamin (vitamin B12) deficiency or pernicious anemia. Loss of
the papillae of the tongue occurs with chronic iron deficiency. Yellow-tinged sclera is associated with
hemolytic anemia and the resulting jaundice. Gum bleeding and tenderness occur with
thrombocytopenia or neutropenia.
A patient's complete blood count (CBC) shows a hemoglobin of 19 g/dL and a hematocrit of 54%. Which
question should the nurse ask to determine possible causes of this finding?
Page 4/37
FIRST PUBLISH OCTOBER 2024
Lewis Ch 29 Assessment of Hematologic
System Exam Practice Questions and
Answers
The nurse is caring for a patient who is being discharged after an emergency splenectomy following a
motor vehicle crash. Which instructions should the nurse include in the discharge teaching?
a. Check often for swollen lymph nodes.
b. Watch for excess bleeding or bruising.
c. Take iron supplements to prevent anemia.
d. Wash hands and avoid persons who are ill. - Ans:✔✔-ANS: D. Wash hands and avoid persons who are
ill.
Splenectomy increases the risk for infection, especially with gram-positive bacteria. The risks for
lymphedema, bleeding, and anemia are not increased after a person has a splenectomy.
Page 1/37
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
The nurse assesses a patient who has numerous petechiae on both arms. Which question should the
nurse ask the patient?
a. "Are you taking any oral contraceptives?"
b. "Have you been prescribed antiseizure drugs?"
c. "Do you take medication containing salicylates?"
d. "How long have you taken antihypertensive drugs?" - Ans:✔✔-ANS: C. "Do you take medication
containing salicylates?"
Salicylates interfere with platelet function and can lead to petechiae and ecchymoses. Antiseizure drugs
may cause anemia but not clotting disorders or bleeding. Oral contraceptives increase a person's clotting
risk. Antihypertensives do not usually cause problems with decreased clotting.
A nurse reviews the laboratory data for an older patient. The nurse would be most concerned about
which finding?
a. Hematocrit of 35%
Page 2/37
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
b. Hemoglobin of 11.8 g/dL
c. Platelet count of 400,000/µL
d. White blood cell (WBC) count of 2800/µL - Ans:✔✔-ANS: D. White blood cell (WBC) count of 2800/µL
Because the total WBC count is not usually affected by aging, the low WBC count in this patient would
indicate that the patient's immune function may be compromised and the underlying cause of the
problem needs to be investigated. The platelet count is normal. The slight decrease in hemoglobin and
hematocrit are not unusual for an older patient.
A patient with pancytopenia has a bone marrow aspiration from the left posterior iliac crest. Which
action would be important for the nurse to take after the procedure?
a. Elevate the head of the bed to 45 degrees.
b. Have the patient lie on the left side for 1 hour.
c. Apply a sterile 2-inch gauze dressing to the site.
d. Use a half-inch sterile gauze to pack the wound. - Ans:✔✔-ANS: B. Have the patient lie on the left side
for 1 hour.
Page 3/37
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
To decrease the risk for bleeding, the patient should lie on the left side for 30 to 60 minutes. After a bone
marrow biopsy, the wound is small and will not be packed with gauze. A pressure dressing is used to
cover the aspiration site. There is no indication to elevate the patient's head.
The nurse assesses a patient with pernicious anemia. Which assessment finding would the nurse expect?
a. Yellow-tinged sclerae
b. Shiny, smooth tongue
c. Numbness of the extremities
d. Gum bleeding and tenderness - Ans:✔✔-ANS: C. Numbness of the extremities
Extremity numbness is associated with cobalamin (vitamin B12) deficiency or pernicious anemia. Loss of
the papillae of the tongue occurs with chronic iron deficiency. Yellow-tinged sclera is associated with
hemolytic anemia and the resulting jaundice. Gum bleeding and tenderness occur with
thrombocytopenia or neutropenia.
A patient's complete blood count (CBC) shows a hemoglobin of 19 g/dL and a hematocrit of 54%. Which
question should the nurse ask to determine possible causes of this finding?
Page 4/37
