HEMATOLOGY

1. The nurse is preparing to teach a client with microcytic hypochromic anemia about the diet to
follow after discharge. Which of the following food should be included in the diet?
a. eggs c. citrus fruits
b. lettuce d. cheese

2. The nurse should instruct the client to eat which of the following foods to obtain the best
supply of vitamin B12?
a. whole grains c. meat and dairy products
b. green leafy vegetables d. broccoli and Brussels sprout

3. 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 green leafy vegetables everyday
b. avoid exposure to others with acute infections
c. practice yoga and meditation to decrease stress and anxiety
d. get 8 hours of sleep at night and take naps during the day

4. A client with Crohn’s disease comes to the Women’s Health Clinic 3 years after a resection of
the terminal ileum. She is complaining of weakness, shortness of breath, weight loss and a sore
tongue. The nurse recognizes a knowledge deficit when the client states which of the following?
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 everyday

5. A 26 year old executive who was admitted to the hospital with iron deficiency anemia stated
that he had been experiencing gastrointestinal upset and blood streaked vomiting. When taking
his nursing history, which question is most appropriate for the nurse to ask in determining the
extent of the client’s activity intolerance?
a. What daily activities were you able to do 6 months age 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?

6. Which position would be most helpful to decrease a client’s discomfort when the client’s
spouse injects vitamin B12 using the dorsogluteal site?
a. lying on the side with legs extended
b. lying on the abdomen with toes pointed inward
c. leaning over edge of a low table with the hips flexed
d. standing upright with the feet one shoulder’s width apart

7. The primary purpose of the Schilling test is to measure the client’s ability to:
a. store vitamin B12 c. absorb vitamin B12
b. digest vitamin B12 d. produce vitamin B12
8. The nurse implements which of the following for the client who is starting a Schilling test:
a. administering Methylcellulose (Citrucel)
b. starting a 24-48 hour urine specimen collection
c. maintaining NPO status
d. starting a 72 hour stool specimen collection

9. A client with pernicious anemia asks why she must take vitamin B12 injections for the rest of
her life. What is the nurse’s best response?
a. The reason for your vitamin deficiency is an inability to absorb the vitamin because the
stomach is not producing sufficient acid
b. The reason for your vitamin deficiency is an inability to absorb the vitamin because the
stomach is not producing sufficient intrinsic factor
c. The reason for your vitamin deficiency is an excessive excretion of the vitamin
because of kidney dysfunction
d. The reason for your vitamin deficiency is an increased requirement for the vitamin
because of rapid red blood cell production

10. A client is to receive epoetin (Epogen)injections. What laboratory value should the nurse
assess before giving the injection?
a. hematocrit
b. partial thromboplastin time
c. hemoglobin concentration
d. prothrombin time

11. An elderly client states that she is afraid of receiving vitamin B12 injections every month
because of potential toxic reactions. What is the nurse’s best response to relieve these fears?
a. Vitamin B12 will cause ringing in the ears before a toxic level is reached.
b. Vitamin B12 may cause a very mild skin rash initially.
c. Vitamin B12 may cause mild nausea but nothing toxic.
d. Vitamin B12 is generally free of toxicity because it is water soluble.

12. A vegetarian with microcytic anemia is having trouble selecting food from the hospital menu.
Which food is best for the nurse to suggest for satisfying the client’s nutritional needs and
personal preferences?
a. egg yolks c. vegetables
b. brown rice d. tea

13. Which of the following nursing assessments is a late symptom of polycythemia vera?
a. headache c. pruritus
b. dizziness d. shortness of breath

14. When a client is diagnosed with aplastic anemia, the nurse monitors for changes in which of
the following physiologic functions?
a. bleeding tendencies c. peripheral sensation
b. intake and output d. bowel function
15. Which assessment finding is not a characteristic clinical manifestation of polycythemia vera?
a. spleenomegaly c. pruritus
b. plethora d. elevated temperature

SITUATION (MS-HEMA): Mrs. Geronimo is 25 years old, pale looking cafeteria owner who
often retires very late at night. She went to the clinic complaining of dizziness, fatigue, exertional
dyspnea and body malaise.

16. Mrs. Geronimo’s doctor suspects that she might be suffering anemia. The blood
examination that would help diagnose her condition is:
a. Hematocrit count c. WBC count
b. RBC count d. Hemoglobin

17. The blood examination revealed that she is suffering from anemia. All of these are
hematonic drugs, except:
a. Jectofer c. Clusivol
b. Imferon d. Iberet 500

18. Your health teaching to improve Mrs. Geronimo’s condition include foods that are
rich in iron. Which of the following is the best source of iron?
a. Ampalaya c. Eggyolk
b. Kangkong d. Lean meat

19. The intrinsic factor necessary for the manufacture of red blood cells is found in the:
a. Bone marrow c. Liver
b. Blood d. Stomach

20. The cause of pernicious anemia is:

a. poor diet
b. overproduction of RBC
c. absence of the intrinsic factor
d. absence of extrinsic factor