Hematology Disorder

1. What is the main function of red blood cells?

a) To fight infection
b) To carry oxygen throughout the body
c) To help blood clot
d) To remove waste products from the body
Situation: Nurse Rizza is seeing a patient today who has come in for a follow-up
appointment. During the patient’s previous visit, he mentioned experiencing some
concerning symptoms, including fatigue, headaches, and dizziness. After reviewing the
patient's blood work, she suspects he may have polycythemia.

1. Which of the following symptoms is not typically associated with polycythemia?

a) Fatigue
b) Shortness of breath
c) Easy bruising or bleeding
d) Weight loss
2. What is the first-line treatment for most cases of polycythemia?
a) Chemotherapy
b) Bone marrow transplant
c) Phlebotomy
d) Radiation therapy
3. What are some potential risks of untreated polycythemia?
a) Heart attack
b) Stroke
c) High blood pressure
d) All of the above
4. What is a major complication of polycythemia?
a) Dehydration
b) Anemia (low red blood cell count)
c) Blood clots
d) All of the above
5. Polycythemia can be caused by smoking.
a.) True
b.) False
6. A 45-year-old female presents with pruritus (itching) after a warm shower, especially
on the extremities. Laboratory results show increased red blood cell mass. What is the
most likely cause of her symptoms?
a) Iron deficiency anemia
b) Secondary polycythemia
c) Sickle cell anemia
d) Polycythemia vera
7. A 35-year-old woman presents with fatigue, easy bruising, and recurrent infections.
Complete blood count (CBC) reveals leukocytosis, anemia, and thrombocytopenia.
Peripheral blood smear shows increased blasts. What is the most likely diagnosis?
a) Non-Hodgkin lymphoma
b) Multiple myeloma
c) Acute myeloid leukemia (AML)
d) Chronic lymphocytic leukemia (CLL)
8. A 50-year-old man presents with painless lymphadenopathy, night sweats, and weight
loss. Biopsy of a lymph node reveals abnormal lymphocytes with a nodular growth
pattern. What is the most likely diagnosis?
a) Leukemia
b) Hodgkin lymphoma
c) Multiple myeloma
d) Non-Hodgkin lymphoma (NHL)
9. A 50-year-old man presents with elevated red blood cell mass, headaches, and
dizziness. Physical examination reveals a ruddy complexion and engorged retinal veins.
Which diagnostic test is essential for confirming the diagnosis of polycythemia?
a) Serum erythropoietin level
b) Bone marrow biopsy
c) Complete blood count (CBC)
d) Chest X-ray
10. A patient with polycythemia is undergoing therapeutic phlebotomy. What is the
nurse's primary responsibility during and after the procedure?
a) Administer pain medication
b) Monitor for signs of bleeding
c) Encourage increased fluid intake
d) Assess for allergic reactions
11. A 55-year-old man with polycythemia presents with pruritus (itching) after a warm
shower. Which nursing intervention is appropriate to address this symptom?
a) Apply cold compresses to the skin
b) Administer antihistamines
c) Encourage oatmeal bath
d) Increase the room temperature
12. A patient with polycythemia vera is at an increased risk of thrombotic events. What
nursing intervention is essential to minimize this risk?
a) Encourage regular exercise
b) Administer iron supplements
c) Teach deep breathing exercises
d) Implement venous thromboembolism (VTE) prophylaxis
13. A 30-year-old female presents with fatigue, bruising, and frequent infections. CBC
reveals leukocytosis, anemia, and thrombocytopenia. Peripheral blood smear shows
blast cells. What diagnostic test is essential for confirming the diagnosis?
a) Serum protein electrophoresis
b) Bone marrow biopsy
c) CT scan of the chest
d) Lumbar puncture
14. A 25-year-old male is diagnosed with acute lymphoblastic leukemia (ALL). Which
medication is commonly used in the induction phase of ALL treatment to eliminate
leukemic cells?
a) Imatinib
b) Methotrexate
c) Rituximab
d) Prednisone
15. A 60-year-old woman presents with bone pain, fatigue, and recurrent infections.
Laboratory tests show monoclonal gammopathy and increased plasma cells in the bone
marrow. What diagnostic test is crucial for confirming the diagnosis of multiple
myeloma?
a) Serum protein electrophoresis
b) PET scan
c) Bone marrow biopsy
d) Flow cytometry
16. A 50-year-old man presents with mediastinal lymphadenopathy on imaging and a
lymph node biopsy showing Reed-Sternberg cells. What is the most likely diagnosis?
a) Multiple myeloma
b) Non-Hodgkin lymphoma
c) Hodgkin lymphoma
d) Acute lymphoblastic leukemia (ALL)
17. A patient with multiple myeloma presents with severe bone pain, hypercalcemia,
and renal insufficiency. Imaging shows lytic lesions in the bones. What complication is
the patient likely experiencing?
a) Pernicious Anemia
b) Thrombocytopenia
c) Osteoporosis
d) Multiple myeloma-related complications
18. A patient with thrombocytopenia is prescribed platelet transfusion. What nursing
intervention is crucial during platelet transfusion?
a) Administering the transfusion rapidly
b) Checking blood pressure every 15 minutes
c) Infusing the platelets with a normal saline solution
d) Monitoring for signs of transfusion reaction
19. A patient with polycythemia vera is prescribed aspirin. What education should the
nurse provide should be prioritized regarding aspirin therapy?
a) "Take aspirin on an empty stomach to enhance absorption."
b) "Avoid alcohol while taking aspirin to prevent interactions."
c) "Discontinue aspirin if you experience pruritus."
d) "Notify your healthcare provider if you notice blood in your urine."
20. A patient with polycythemia vera is experiencing pruritus. What nursing intervention
is appropriate to address this symptom?
a) Administer antihistamines
b) Apply warm compresses to the skin
c) Encourage hot showers
d) Increase fluid intake
21. A patient is undergoing chemotherapy for acute myeloid leukemia (AML). What
nursing intervention is essential to manage chemotherapy-related side effects?
a) Encourage frequent hot showers
b) Administer iron supplements
c) Provide a diet high in vitamin K
d) Monitor for signs of infection
22. A 45-year-old male undergoing chemotherapy presents with fever, chills, and signs
of infection. What nursing intervention should be administered as a priority in managing
neutropenia?
a) Administering platelet transfusion
b) Encouraging ambulation
c) Administering antibiotics promptly
d) Administering immunosuppressive drugs
23. A patient with pancytopenia is prescribed erythropoietin alfa. What nursing
consideration is important regarding erythropoietin alfa therapy?
a) Administer on an empty stomach
b) Monitor for signs of infection
c) Encourage a diet rich in vitamin K
d) Assess for signs of fluid overload
24. A patient is admitted with neutropenia. What nursing intervention is crucial in
implementing neutropenic precautions?
a) Encourage a high-fiber diet
b) Limit visitors with signs of infection
c) Administer antipyretics proactively
d) Promote frequent handwashing only
25. A 40-year-old female presents with fatigue, pallor, and frequent infections. CBC
reveals low counts of red blood cells, white blood cells, and platelets. What condition is
characterized by this simultaneous decrease in all blood cell types?

a) Aplastic anemia
b) Polycythemia vera
c) Thrombocytopenia
d) Leukemia