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HEMATOPOIETIC SYSTEM NCLEX EXAM QUESTIONS AND ANSWERS
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HEMATOPOIETIC SYSTEM NCLEX EXAM QUESTIONSAND ANSWERS
A nursing student wants to know why clients with COPD tend to be polycythemic.
What response by the nurse instructor is best?
a. It is due to side effects of medications for bronchodilation.
b. It is from overactive bone marrow in response to chronic disease.
c. It combats the anaemia caused by an increased metabolic rate.
d. It compensates for tissue hypoxia caused by lung disease. - ANSWER D ~ In
response to hypoxia, more red blood cells are made so more oxygen can be carried
and delivered to tissues. This is a physiologic process in response to the disease; it
is not a medication side effect, the result of overactive bone marrow, or a response
to anaemia.
What is the normal lab value for Platelet Count? - ANSWER A normal platelet
count ranges from 150,000 to 450,000 platelets per microliter of blood. Having
more than 450,000 platelets is a condition called thrombocytosis; having less than
150,000 is known as thrombocytopenia.
A client is receiving rivaroxaban (Xarelto) and asks the nurse to explain how it
works. What response by the nurse is best?
a. It inhibits thrombin.
b. It inhibits fibrinogen.
c. It thins your blood.
d. It works against vitamin K. - ANSWER A ~ Rivaroxaban is a direct thrombin
inhibitor. It does not work on fibrinogen or vitamin K. It is not a blood thinner,
although many clients call anticoagulants by this name.
,What is the normal lab value for Red Blood Cells (RBC)? - ANSWER Men = 4.7
to 6.1 million cells per microliter (mcL). Women = 4.2 to 5.4 million mcL.
Children is 4.0 to 5.5 million mcL.
The health care provider tells the nurse that a client is to be started on a platelet
inhibitor. About what drug does the nurse plan to teach the client?
a. Clopidogrel (Plavix)
b. Enoxaparin (Lovenox)
c. Reteplase (Retavase)
d. Warfarin (Coumadin) - ANSWER A ~ Clopidogrel is a platelet inhibitor.
Enoxaparin is an indirect thrombin inhibitor. Reteplase is a fibrinolytic agent.
Warfarin is a vitamin K antagonist.
What is the normal lab value for White Blood Cells (WBC)? - ANSWER 4,000 -
11,000 per microliter of blood
A nurse is assessing a dark-skinned client for pallor. What action is best?
a. Assess the conjunctiva of the eye.
b. Have the client open the hand widely.
c. Look at the roof of the client's mouth.
d. Palpate for areas of mild swelling. - ANSWER A ~ To assess pallor in
dark-skinned people, assess the conjunctiva of the eye or the mucous membranes.
Looking at the roof of the mouth can reveal jaundice. Opening the hand widely is
not related to pallor, nor is palpating for mild swelling.
What is the normal lab value for Hemoglobin (Hgb)? - ANSWER Men = 13.5 -
17.5 g/dL
Women 12.0 - 15.5 g/dL
A hospitalized client has a platelet count of 58,000/mm3. What action by the nurse
is best?
a. Encourage high-protein foods.
, b. Institute neutropenic precautions.
c. Limit visitors to healthy adults.
d. Place the client on safety precautions. - ANSWER D ~ With a platelet count
between 40,000 and 80,000/mm3, clients are at risk of prolonged bleeding even
after minor trauma. The nurse should place the client on safety precautions.
High-protein foods, while healthy, are not the priority. Neutropenic precautions are
not needed as the client's white blood cell count is not low. Limiting visitors would
also be more likely related to a low white blood cell count.
What is the normal lab value for Hematocrit (Hct)? - ANSWER Men = 38.8% -
50%
Women = 34.9% - 44.5%
A client is having a bone marrow biopsy today. What action by the nurse takes
priority?
a. Administer pain medication first.
b. Ensure valid consent is on the chart.
c. Have the client shower in the morning.
d. Premedicate the client with sedatives. - ANSWER B ~ A bone marrow biopsy is
an invasive procedure that requires informed consent. Pain medication and sedation
are important components of care for this client but do not take priority. The client
may or may not need or be able to shower.
What is the normal lab value for Reticulocyte Count? - ANSWER 0.5-1.5%
A nurse is caring for four clients. After reviewing today's laboratory results, which
client should the nurse see first?
a. Client with an international normalized ratio of 2.8
b. Client with a platelet count of 128,000/mm3
c. Client with a prothrombin time (PT) of 28 seconds
d. Client with a red blood cell count of 5.1 million/L - ANSWER C ~ A normal PT
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