Sherpath - Hematological Conditions

Question 1

Which blood product would the nurse administer to a patient with hypovolemic shock?

a. Albumin
b. Platelets
c. Fresh-frozen plasma
d. Packed red blood cells

Answer 1

a. Albumin

Albumin = volume expander
• It’s a colloid, meaning it stays in the blood vessels (unlike crystalloids like saline that wander off into tissues).
• It increases oncotic pressure, pulling fluid from tissues into circulation.
• This helps restore intravascular volume fast, which is exactly what you want in hypovolemic shock—when you’ve lost fluid and perfusion is tanking.

Question 2

Which statement by the patient indicates a need for further instruction about safety measures and thrombocytopenia?

a. “I will avoid blowing my nose.”
b. “At the gym, I will not lift weights.”
c. “I will use an electric razor to shave.”
d. “I will take aspirin if I have a headache.”

Answer 2

d. “I will take aspirin if I have a headache.”

The correct answer here is d. “I will take aspirin if I have a headache.” Because clearly, this patient missed the entire memo about aspirin being a platelet function saboteur. When you’re already low on platelets, popping an aspirin is like throwing gasoline on a bleeding wound and yelling “YOLO.”

Meanwhile, the other statements are fine-ish:
• Avoiding blowing your nose? Weird but actually smart—nosebleeds are a no-go.
• Not lifting weights? Wise. One wrong move and boom—spontaneous bruises like a second grader’s shin.
• Using an electric razor? Chef’s kiss—because nicking your face with a blade when you bleed like a soap opera character is not ideal.

Question 3

What is the most important preventative measure in minimizing the risk of infection in a patient with neutropenia?

a. Avoiding public spaces
b. Frequent hand washing
c. Using alcohol-based mouthwashes
d. Limiting dietary intake of fresh fruits and vegetables.

Answer 3

b. Frequent hand washing

Neutropenia = Abnormally low levels of neutrophils in the blood.
• Neutrophils are your body’s frontline infantry—your first responders against infections. They patrol your bloodstream like mall cops with real purpose, hunting down bacteria and other invaders.
• So when neutrophils take a nosedive? Welcome to neutropenia, a.k.a. “immune system on vacation” syndrome.

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Why does it happen?
• Chemotherapy: Nukes fast-dividing cells, including your poor neutrophils.
• Bone marrow disorders: Like leukemia, where the bone marrow is too busy being evil to make normal cells.
• Autoimmune conditions: Your immune system pulls a traitor move and attacks itself.
• Severe infections: Sometimes the body uses up neutrophils faster than it can make them.
• Certain meds: Like antipsychotics or antibiotics, because medicine is just a roulette wheel with side effects.

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Why is it dangerous?

Because even a basic paper cut or a sniffle from someone across the room could spiral into a full-blown life-threatening infection. That’s why things like frequent hand washing, no sick visitors, and sometimes even reverse isolation are needed.

Basically, in neutropenia, your body’s like:

“We’d love to fight that infection for you, but unfortunately, no one showed up to work today.”

Question 4

What is the clinical manifestation of mild anemia?

a. Glossitis
b. Weight loss
c. Dyspnea upon exertion
d. Icteric conjunctiva and sclera

Answer 4

c. Dyspnea upon exertion

Question 5

Which amount of time would the nurse monitor their patient for when beginning a transfusion of packed red blood cells?

a. 10 minutes
b. 15 minutes
c. 20 minutes
d. 25 minutes

Answer 5

b. 15 minutes

Question 6

What integumentary finding is indicative of anemia?

a. Pallor
b. Pruritus
c. Jaundice
d. Hyperpigmentation

Answer 6

a. Pallor

Question 7

Which intervention is included in the collaborative management of iron-deficiency anemia?

a. Administration of enteric-coated iron supplement capsules
b. Subcutaneous injection of iron in the case of malabsorption
c. Taking an oral iron supplement with a dietary source of vitamin C
d. Inclusion of iron-rich foods in the diet like dairy products and seafood.

Answer 7

c. Taking an oral iron supplement with a dietary source of vitamin C

Question 8

What term describes an abnormal condition characterized by increased red blood cells?

a. Leukemia
b. Thalassemia
c. Polycythemia
d. Hemochromatosis

Answer 8

c. Polycythemia

Polycythemia is a condition where there is an abnormally high number of red blood cells in the bloodstream. This increases blood viscosity (thickness), which can lead to complications like blood clots, high blood pressure, and increased risk of stroke or heart attack.

It differs from:
• Leukemia – a cancer of white blood cells.
• Thalassemia – an inherited disorder that results in abnormal hemoglobin and fewer red blood cells.
• Hemochromatosis – a condition where the body absorbs too much iron, not necessarily related to red blood cell count

Question 9

Which breakfast choice is most appropriate for a patient with iron-deficiency anemia?

a. Cantaloup and kiwi fruit
b. Peanut butter and banana
c. Scrambled eggs and spinach
d. Blueberry muffin and a glass of milk

Answer 9

c. Scrambled eggs and spinach

Question 10

What is the primary symptom associated with sickle cell crisis?

a. Pain
b. Fever
c. Swelling
d. Tachypnea

Answer 10

a. Pain

Question 11

To prepare for a transfusion of packed red blood cells, the nurse selects which intravenous solution to use for the procedure?

a. 3% Normal saline
b. Lactated Ringer’s
c. 5% Dextrose in water
d. 0.9% Normal saline

Answer 11

d. 0.9% Normal saline

Question 12

Which time is the latest a nurse can hang a unit of packed red blood cells if they are picked up from the blood bank at 1015?

a. 1030
b. 1045
c. 1100
d. 1115

Answer 12

b. 1045

Question 13

What patient teaching would the nurse include for a patient whose platelet count is below 10 x 10^9/L

a. Avoid people who have infections
b. Include iron-rich food in the diet
c. Anticipate further testing to determine the cause of the abnormally high number.
d. Look for signs of hemorrhage such as visual abnormalities

Answer 13

d. Look for signs of hemorrhage such as visual abnormalities

Question 14

Which extrinsic factors can cause hemolytic anemia?

a. Trauma or splenic sequestration crisis
b. Abnormal hemoglobin or enzyme deficiency
c. Macroangiopathic or microangiopathic factors
d. Chronic diseases or medications and chemicals

Answer 14

c. Macroangiopathic or microangiopathic factors

Question 15

Which action would the nurse take when required to safely infuse one unit of fresh-frozen plasma before the patient’s arrival to the operating room?

a. Infuse the fresh-frozen plasma over 4 hours and then bring the patient to the OR.
b. Infuse the fresh-frozen plasma as rapidly as the patient will tolerate
c. Hang the fresh-frozen plasma as a piggyback to the primary IV solution
d. Hang the fresh-frozen plasma as a piggyback to lactated Ringer’s solution

Answer 15

b. Infuse the fresh-frozen plasma as rapidly as the patient will tolerate

Question 16

Which erythrocyte characteristic would the nurse expect to see in the laboratory findings for a patient with acute blood loss after an accident?

a. Microcytic
b. Hypochromic
c. Normocytic
d. Megaloblastic

Answer 16

c. Normocytic

Question 17

Which assessment finding does the nurse recall to be a classic sign of pernicious anemia?

a. Diarrhea
b. Indigestion
c. Flushed skin
d. Red, beefy tongue

Answer 17

d. Red, beefy tongue

Question 18

Which priority intervention would the nurse perform when caring for a patient who is neutropenic and having a febrile episode?

a. Obtain blood cultures from two sites
b. Administer a broad-spectrum intravenous antibiotic
c. Administer an oral antibiotic
d. Obtain cultures of the throat

Answer 18

b. Administer a broad-spectrum intravenous antibiotic

Question 19

The primary purpose of protective (reverse) isolation is to help prevent the spread of organisms by doing what?

a. Using special techniques to destroy discharge from the patient’s body
b. Using special techniques to handle the patient’s linen and personal items
c. Preventing spread to the patient from sources outside the patient’s environment
d. Preventing spread from the patient to health care personnel, visitors, and other patients.

Answer 19

c. Preventing spread to the patient from sources outside the patient’s environment

Question 20

Before beginning a transfusion of red blood cells, which action by the nurse would be of highest priority to avoid an error during the procedure?

a. Check the identifying information on the unit of blood against the patient’s identification bracelet.
b. Select new primary IV tubing primec with lactated Ringers solution to use for the transfusion
c. Remain with the patient for 60 minutes after beginning the transfusion to watch for signs of a transfusion reaction.
d. Add the blood transfusion as a secondary line to the existing IV and use the IV controller to maintain correct flow.

Answer 20

a. Check the identifying information on the unit of blood against the patient’s identification bracelet.

Question 21

Which patient teaching would be the priority for the treatment for non-Hodgkin’s lymphoma?

a. Skin care that will be needed
b. Method of obtaining the treatment
c. Gastrointestinal tract effects of treatment
d. Treatment type and expected side effects

Answer 21

d. Treatment type and expected side effects

Question 22

Which management intervention would the nurse teach the patient who has been experiencing fatigue when executing activities of daily living?

a. Assist the patient in walking immediately after meals.
b. Ensure that all activities are completed in the morning.
c. Encourage visitors to visit the patient often.
d. Assist in assigning priority to activities

Answer 22

d. Assist in assigning priority to activities

Question 23

Which would the nurse place highest priority on reducing for a patient with metastatic cancer and a hemoglobin level of 87 mmol/L and hematocrit of 26%?

a. Thirst
b. Fatigue
c. Headache
d. Abdominal pain

Answer 23

b. Fatigue

Question 24

Which description would the nurse give when a patient with acute lymphocytic leukemia asks for clarification about the disease?

a. Infectious in nature and characterized by increased white blood cells.
b. Malignant in nature and characterized by increased circulating red blood cells.
c. Malignant in nature and characterized by a proliferation of immature white blood cells.
d. Inflammatory in nature and characterized by a solid tumour formation in the lymph nodes.

Answer 24

c. Malignant in nature and characterized by a proliferation of immature white blood cells.

Question 25

After the diagnosis of disseminated intravascular coagulation, what is the first priority of collaborative care? a. Administer heparin b. Administer whole blood c. Treat the causative problem d. Administer fresh-frozen plasma

Answer 25

c. Treat the causative problem

Question 26

The nurse would take which action to prevent an adverse effect during the transfusion of two units of blood? a. Immediately pick up both units of blood from the blood bank. b. Infuse the blood slowly for the first 15 minutes of the transfusion c. Regulate the flow rate so that each unit takes at least 4 hours to transfuse. d. Set up the Y-tubing of the blood set with dextrose in water as the flush solution.

Answer 26

b. Infuse the blood slowly for the first 15 minutes of the transfusion

Question 27

Which assessment finding may be indicative of the development of disseminated intravascular coagulation ? a. Scattered wheezes b. Increasing dyspnea c. Bradycardia and hypertension d. Blood oozing from venipuncture sites

Answer 27

d. Blood oozing from venipuncture sites

Question 28

Which interventions will the nurse likely perform when caring for a patient with a diagnosis of polycythemia vera? a. Encourage deep breathing and coughing b. Assist with or perform phlebotomy at the bedside. c. Teach the patient how to maintain a low-activity lifestyle d. Perform thorough and regularly scheduled neurological assessments.

Answer 28

b. Assist with or perform phlebotomy at the bedside.

Question 29

What is the nurse's priority for the patient who has sickle cell disease and has developed cellulitis above the left ankle? a. Start IV fluids b. Maintain oxygenation c. Maintain distal warmth d. Check peripheral pulses.

Answer 29

b. Maintain oxygenation

Question 30

Which clinical stage of hodgkin's lymphoma do fever, night sweats, weight loss, and lymph nodes above and below the diaphragm represent? a. Stage IIIA b. Stage IIIB c. Stage IVA d. Stagfe IVB

Answer 30

b. Stage IIIB

Question 31

Which health team member would the nurse ask to assist in checking a unit of packed RBCs before administration? a. Unit secretary b. A physician's assistant c. Another registered nurse d. An unlicensed assistive personnel

Answer 31

c. Another registered nurse

Question 32

Which discharge instruction would the nurse include for a patient with chronic anemia? a. Take vitamin C b. Avoid large crowds c. Participate in a nutrition education session d. Anticipate the need for supplemental iron injections.

Answer 32

c. Participate in a nutrition education session

Question 33

Which patient is most likely to experience anemia related to an increased destruction of RBCs? a. An adult whose alcoholism has precipitated folic acid deficiency b. A young adult of African descent who has a diagnosis of sickle cell disease c. A young adult with a history of "heavy periods" accompanied by anemia d. A child whose impaired growth and development is attributable to thalassemia

Answer 33

b. A young adult of African descent who has a diagnosis of sickle cell disease

Question 34

Which chemotherapy regimen is most likely to be prescribed for a young adult who has been diagnosed with stage 1A Hodgkin's lymphoma? a. Brentuximab vedotin b. Two to four cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine. c. Four to six cycles of ABVD d. Bleomycin, etoposide, Doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone BEACOPP)

Answer 34

b. Two to four cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine. c. Four to six cycles of ABVD