Chapter 15: Hematological and Immune System Disorders

Question 1

Iron Deficiency Anemia (IDA) is classified as a microcytic, hypochromic anemia. This classification refers to which of the following laboratory data?

Answer 1

Mean Corpuscular Volume (MCV) and Mean Corpuscular Hemoglobin (MCH)

Question 2

Initial therapy for patients with IDA is:

Answer 2

Increasing dietary intake of green leafy vegetables

Question 3

Mrs. G, a 70-year-old patient, presents to you with a hemoglobin of 9.4 and a decreased MCV/MCV. You diagnose her with IDA and start her on ferrous sulfate 325 mg PO tid. The next step in your work-up would be:

Answer 3

Obtain stool for occult blood

Question 4

Despite adherence to oral iron therapy of 2 weeks, your elderly patient with IDA demonstrates a drop in his hemoglobin from 8.4 to 7.4. He is complaining of fatigue, dyspnea, and heart racing. You would change his therapy by which of the following:

Answer 4

Schedule patient for outpatient blood transfusion

Question 5

You are prescribing oral iron therapy for a patient with IDA. In teaching your patient about iron therapy, all of the following instructions should be reviewed except:

Answer 5

Adding vitamin D daily enhances absorption of iron

Question 6

When interpreting laboratory data, you would expect to see the following in a patient with Anemia of Chronic Disease (ACD):

Answer 6

Hemoglobin <12 g/dl, Mean Corpuscular Volume (MCV) normal, Mean

Question 7

The pathophysiological hallmark of ACD is

Answer 7

Impaired ability to use iron stores

Question 8

The main focus of treatment of patients with ACD is:

Answer 8

Management of the underlying disorder

Question 9

In addition to the CBC with differential, which of the following laboratory tests is considered to be most useful in diagnosing ACD and IDA?

Answer 9

Serum ferritin

Question 10

Education of patient and family regarding ACD includes discussion of all of the following except:

Answer 10

Explaining the ACD is mainly attributed to the aging process

Question 11

Symptoms in the initial HIV infection include all of the following except:

Answer 11

Weight loss

Question 12

The primary mode of HIV transmission in the U.S. is:

Answer 12

Men having sex with men

Question 13

In the older adult, which group comprises the highest rate of HIV/AIDS?

Answer 13

African American women

Question 14

Contributing factors in HIV development in the older adult include all of the following except:

Answer 14

Older adults are less likely to use condoms

Question 15

Immune system changes that render older adults more susceptible to contracting HIV include all of the following except:

Answer 15

Hyper-responsive T cells