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Hematology Test Bank
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Hematology Test BankA patient with a hematologic disorder asks the nurse how the body forms blood cells. The nurse should
describe a process that takes place where?
A) In the spleen
B) In the kidneys
C) In the bone marrow
D) In the liver - Correct Ans: C
Feedback:
Bone marrow is the primary site for hematopoiesis. The liver and spleen may be involved during
embryonic development or when marrow is destroyed. The kidneys release erythropoietin, which
stimulates the marrow to increase production of red blood cells (RBCs). However, blood cells are not
primarily formed in the spleen, kidneys, or liver.
A patient has come to the OB/GYN clinic due to recent heavy menstrual flow. Because of the patient's
consequent increase in RBC production, the nurse knows that the patient may need to increase her daily
intake of what substance?
A) Vitamin E
B) Vitamin D
,C) Iron
D) Magnesium - Correct Ans: C
Feedback:
To replace blood loss, the rate of red cell production increases. Iron is incorporated into hemoglobin.
Vitamins E and D and magnesium do not need to be increased when RBC production is increased.
A nurse is caring for a patient who undergoing preliminary testing for a hematologic disorder. What sign
or symptom most likely suggests a potential hematologic disorder?
A) Sudden change in level of consciousness (LOC)
B) Recurrent infections
C) Anaphylaxis
D) Severe fatigue - Correct Ans: D
Feedback:
The most common indicator of hematologic disease is extreme fatigue. This is more common than
changes in LOC, infections, or analphylaxis.
,The nurse caring for a patient receiving a transfusion notes that 15 minutes after the infusion of packed
red blood cells (PRBCs) has begun, the patient is having difficulty breathing and complains of severe
chest tightness. What is the most appropriate initial action for the nurse to take?
A) Notify the patient's physician.
B) Stop the transfusion immediately.
C) Remove the patient's IV access.
D) Assess the patient's chest sounds and vital signs. - Correct Ans: B
Feedback:
Vascular collapse, bronchospasm, laryngeal edema, shock, fever, chills, and jugular vein distension are
severe reactions. The nurse should discontinue the transfusion immediately, monitor the patient's vital
signs, and notify the physician. The blood container and tubing should be sent to the blood bank. A
blood and urine specimen may be needed if a transfusion reaction or a bacterial infection is suspected.
The patient's IV access should not be removed.
The nurse is caring for a patient who has developed scar tissue in many of the areas that normally
produce blood cells. What organs can become active in blood cell production by the process of
extramedullary hematopoiesis?
A) Spleen and kidneys
B) Kidneys and pancreas
C) Pancreas and liver
, D) Liver and spleen - Correct Ans: D
Feedback:
In adults with disease that causes marrow destruction, fibrosis, or scarring, the liver and spleen can also
resume production of blood cells by a process known as extramedullary hematopoiesis. The kidneys and
pancreas do not produce blood cells for the body.
A patient undergoing a hip replacement has autologous blood on standby if a transfusion is needed.
What is the primary advantage of autologous transfusions?
A) Safe transfusion for patients with a history of transfusion reactions
B) Prevention of viral infections from another person's blood
C) Avoidance of complications in patients with alloantibodies
D) Prevention of alloimmunization - Correct Ans: B
Feedback:
The primary advantage of autologous transfusions is the prevention of viral infections from another
person's blood. Other secondary advantages include safe transfusion for patients with a history of
transfusion reactions, prevention of alloimmunization, and avoidance of complications in patients with
alloantibodies.
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