NCLEX Practice Exam – Blood Disorders

1. A client with iron deficiency anemia is scheduled for discharge. Which instruction about prescribed ferrous gluconate therapy should the nurse include in the teaching plan?

a. “Take the medication with an antacid.”
b. “Take the medication with a glass of milk.”
c. “Take the medication with cereal.”
d. “Take the medication on an empty stomach.”

2. Which of the following disorders results from a deficiency of factor VIII?

a. Sickle cell disease
b. Christmas disease
c. Hemophilia A
d. Hemophilia B

3. The nurse explains to the parents of a 1-year-old child admitted to the hospital in a sickle cell crisis that the local tissue damage the child has on admission is caused by which of the following?

a. Autoimmune reaction complicated by hypoxia
b. Lack of oxygen in the red blood cells
c. Obstruction to circulation
d. Elevated serum bilirubin concentration.

4. The mothers asks the nurse why her child’s hemoglobin was normal at birth but now the child has S hemoglobin. Which of the following responses by the nurse is most appropriate?

a. “The placenta bars passage of the hemoglobin S from the mother to the fetus.”
b. “The red bone marrow does not begin to produce hemoglobin S until several months after birth.”
c. “Antibodies transmitted from you to the fetus provide the newborn with temporary immunity.”
d. “The newborn has a high concentration of fetal hemoglobin in the blood for some time after birth.”

5. Which of the following would the nurse identify as the priority nursing diagnosis during a toddler’s vasoocclusive sickle cell crisis?

a. Ineffective coping related to the presence of a life-threatening disease
b. Decreased cardiac output related to abnormal hemoglobin formation
c. Pain related to tissue anoxia
d. Excess fluid volume related to infection

6. A mother asks the nurse if her child’s iron deficiency anemia is related to the child’s frequent infections. The nurse responds based on the understanding of which of the following?

a. Little is known about iron-deficiency anemia and its relationship to infection in children.
b. Children with iron deficiency anemia are more susceptible to infection than are other children.
c. Children with iron-deficiency anemia are less susceptible to infection than are other children.
d. Children with iron-deficient anemia are equally as susceptible to infection as are other children.

7. Which statements by the mother of a toddler would lead the nurse to suspect that the child has iron-deficiency anemia? Select all that apply.

a. “He drinks over 3 cups of milk per day.”
b. “I can’t keep enough apple juice in the house; he must drink over 10 ounces per day.”
c. “He refuses to eat more than 2 different kinds of vegetables.”
d. “He doesn’t like meat, but he will eat small amounts of it.”
e. “He sleeps 12 hours every night and take a 2-hour nap.”

8. Which of the following foods would the nurse encourage the mother to offer to her child with iron deficiency anemia?

a. Rice cereal, whole milk, and yellow vegetables
b. Potato, peas, and chicken
c. Macaroni, cheese, and ham
d. Pudding, green vegetables, and rice

9. The physician has ordered several laboratory tests to help diagnose an infant’s bleeding disorder. Which of the following tests, if abnormal, would the nurse interpret as most likely to indicate hemophilia?

a. Bleeding time
b. Tourniquet test
c. Clot retraction test
d. Partial thromboplastin time (PTT)

10. Which of the following assessments in a child with hemophilia would lead the nurse to suspect early hemarthrosis?

a. Child’s reluctance to move a body part
b. Cool, pale, clammy extremity
c. Eccymosis formation around a joint
d. Instability of a long bone in passive movement

11. Because of the risks associated with administration of factor VIII concentrate, the nurse would teach the client’s family to recognize and report which of the following?

a. Yellowing of the skin
b. Constipation
c. Abdominal distention
d. Puffiness around the eyes

12. A child suspected of having sickle cell disease is seen in a clinic, and laboratory studies are performed. A nurse checks the lab results, knowing that which of the following would be increased in this disease?

a. Platelet count
b. Hematocrit level
c. Reticulocyte count
d. Hemoglobin level

13. A clinic nurse instructs the mother of a child with sickle cell disease about the precipitating factors related to pain crisis. Which of the following, if identified by the mother as a precipitating factor, indicates the need for further instructions?

a. Infection
b. Trauma
c. Fluid overload
d. Stress

14. Laboratory studies are performed for a child suspected of having iron deficiency anemia. The nurse reviews the laboratory results, knowing that which of the following results would indicate this type of anemia?

a. An elevated hemoglobin level
b. A decreased reticulocyte count
c. An elevated RBC count
d. Red blood cells that are microcytic and hypochromic

15. A pediatric nurse health educator provides a teaching session to the nursing staff regarding hemophilia. Which of the following information regarding this disorder would the nurse plan to include in the discussion?

a. Hemophilia is a Y linked hereditary disorder
b. Males inherit hemophilia from their fathers
c. Females inherit hemophilia from their mothers
d. Hemophilia A results from a deficiency of factor VIII

16. Which of the following blood components is decreased in anemia?

a. Erythrocytes
b. Granulocytes
c. Leukocytes
d. Platelets

17. A client with anemia may be tired due to a tissue deficiency of which of the following substances?

a. Carbon dioxide
b. Factor VIII
c. Oxygen
d. T-cell antibodies

18. Which of the following cells is the precursor to the red blood cell (RBC)?

a. B cell
b. Macrophage
c. Stem cell
d. T cell

19. Which of the following symptoms is expected with hemoglobin of 10 g/dl?

a. None
b. Pallor
c. Palpitations
d. Shortness of breath

20. Which of the following diagnostic findings are most likely for a client with aplastic anemia?

a. Decreased production of T-helper cells
b. Decreased levels of white blood cells, red blood cells, and platelets
c. Increased levels of WBCs, RBCs, and platelets
d. Reed-Sternberg cells and lymph node enlargement