Chapter 23: Hematology Test Questions

Question 1

What are the primary functions of red blood cells (RBCs)?

Answer 1

Transport oxygen and carry carbon dioxide back to the lungs.

Question 2

What are the primary functions of platelets?

Answer 2

Coagulation and capillary hemostasis.

Question 3

What are the five types of white blood cells (WBCs)?

Answer 3

Neutrophils, Eosinophils, Basophils, Monocytes (Macrophages), Lymphocytes.

Question 4

What does hemoglobin measure?

Answer 4

Oxygen-carrying protein in red blood cells.

Question 5

What does hematocrit represent?

Answer 5

Proportion of red blood cells to plasma in blood.

Question 6

What does MCV (Mean Corpuscular Volume) indicate?

Answer 6

Average size of red blood cells.

Question 7

What does MCH (Mean Corpuscular Hemoglobin) measure?

Answer 7

Average mass of hemoglobin per RBC.

Question 8

What does RDW (RBC Distribution Width) assess?

Answer 8

Variation in size of red blood cells.

Question 9

Definition of anemia?

Answer 9

Reduction in RBC count, hemoglobin quantity, and volume of packed red cells below normal levels.

Question 10

Causes of anemia?

Answer 10

Decreased production (marrow issues, poor nutrition), blood loss, destruction of RBCs.

Question 11

CBC patterns: Decreased production vs. destruction/loss?

Answer 11

All have low Hgb/Hct; reticulocyte count is low in production issues, high in blood loss or destruction.

Question 12

Reticulocyte count changes in anemia?

Answer 12

Increased in blood loss/hemolysis; decreased in marrow suppression or nutrient deficiency.

Question 13

Microcytic anemia characteristics?

Answer 13

Small, hypochromic RBCs; low MCV.

Question 14

Causes of macrocytic anemia?

Answer 14

Vitamin B12 and folate deficiency.

Question 15

Normocytic anemia features?

Answer 15

Normal MCV; often from RBC destruction or decreased production.

Question 16

Most common nutritional deficiency in kids?

Answer 16

Iron deficiency anemia.

Question 17

Typical lab findings in iron deficiency anemia?

Answer 17

Low ferritin, low serum iron, high TIBC.

Question 18

Diet pattern leading to iron deficiency?

Answer 18

Toddlers drinking >16–24 oz/day of milk.

Question 19

Why does cow’s milk contribute to iron deficiency?

Answer 19

Low in iron; calcium/casein inhibit iron absorption.

Question 20

Symptoms of iron deficiency anemia – early vs. late?

Answer 20

Early: pallor, fatigue, irritability. Late: pica, tachypnea, cardiomegaly.

Question 21

Iron dose for treatment of iron deficiency anemia?

Answer 21

2–5 mg/kg/day elemental iron.

Question 22

Best absorption tip for iron?

Answer 22

Take with vitamin C (ascorbic acid); avoid milk.

Question 23

Side effects of iron supplementation?

Answer 23

Nausea, constipation, dark stools.

Question 24

When should labs normalize with iron deficiency treatment?

Answer 24

In about 2 months with proper treatment.

Question 25

What is sickle cell disease?

Answer 25

Autosomal recessive disorder with abnormal hemoglobin S.

Question 26

Who is primarily affected by sickle cell disease?

Answer 26

Primarily African or Mediterranean descent.

Question 27

Main types of sickle cell disease?

Answer 27

Hemoglobin SS, Hemoglobin SC.

Question 28

What happens to RBCs in sickle cell disease?

Answer 28

They sickle—become stiff, sticky, and obstruct vessels.

Question 29

RBC lifespan in sickle cell disease vs. normal?

Answer 29

10–20 days vs. 120 days.

Question 30

Why is there chronic anemia in sickle cell disease?

Answer 30

Bone marrow can’t keep up with increased RBC destruction.

Question 31

Types of sickle cell crises?

Answer 31

Vaso-occlusive, splenic sequestration, aplastic, acute chest.

Question 32

What causes a vaso-occlusive crisis?

Answer 32

Sickled cells block vessels causing ischemia and pain.

Question 33

Symptoms of vaso-occlusive crisis?

Answer 33

Pain, swelling, fever, ischemia.

Question 34

Treatment for vaso-occlusive crisis?

Answer 34

IV fluids, monitor perfusion, pain management (Tylenol, NSAIDs, opioids).

Question 35

Nursing diagnoses for vaso-occlusive crisis?

Answer 35

Acute pain, risk for infection, impaired perfusion, fatigue.

Question 36

What is acute chest syndrome (ACS)?

Answer 36

Acute lower respiratory illness with infiltrates.

Question 37

Symptoms of acute chest syndrome?

Answer 37

Fever, chest pain, tachypnea, wheezing, low O2 sats.

Question 38

Why is acute chest syndrome serious?

Answer 38

Medical emergency and top cause of hospitalization in SCD.

Question 39

Why is there an infection risk in sickle cell disease?

Answer 39

Functional asplenia from 4–6 months of age.

Question 40

Why is fever an emergency in sickle cell disease?

Answer 40

Could signal sepsis due to impaired immune response.

Question 41

Workup for febrile sickle cell disease patient?

Answer 41

CBC, blood/urine cultures, CXR, possibly lumbar puncture.

Question 42

Common antibiotics for sickle cell disease?

Answer 42

Cefepime or other broad-spectrum agents.

Question 43

How is sickle cell disease diagnosed?

Answer 43

Newborn screen + hemoglobin electrophoresis.

Question 44

When do symptoms of sickle cell disease appear?

Answer 44

4–6 months old.

Question 45

Common treatments for sickle cell disease?

Answer 45

Folic acid, penicillin, hydroxyurea, stem cell transplant.

Question 46

What is the action of hydroxyurea?

Answer 46

Increases Hgb F, decreases Hgb S.

Question 47

Is sickle cell disease curable?

Answer 47

Yes, via stem cell transplant—but high risk.

Question 48

Who can use a PCA (Patient-Controlled Analgesia)?

Answer 48

Children ≥6 years who understand its use and can report pain.

Question 49

Nursing considerations for PCA?

Answer 49

Only the child should press the button. Monitor for respiratory depression.

Question 50

What to do if respiratory depression occurs during PCA?

Answer 50

Stop PCA, stimulate child, attempt deep breaths, give naloxone if needed.

Question 51

What is hemophilia?

Answer 51

X-linked recessive bleeding disorder—factor VIII or IX deficiency.

Question 52

Who is primarily affected by hemophilia?

Answer 52

Males (inherited from carrier mothers).

Question 53

Symptoms of hemophilia?

Answer 53

Excessive/prolonged bleeding, joint bleeds, bruising.

Question 54

Treatment for hemophilia?

Answer 54

Factor replacement therapy, sometimes prophylactic.