NCLEX Questions Hematology
NCLEX Questions Hematology
1. Ms. X is diagnosed with acquired immunodeficiency syndrome (AIDS). The nurse
caring for this patient is aware that for a patient to be diagnosed with HIV she should
have which condition?
a. Infection of HIV, have a CD4+ T-cell count of 500 cells/microliter, history of acute HIV
infection
b. Infection with Tuberculosis, HIV and cytomegalovirus
c. Infection of HIV, have a CD4+ T-cell count of >200 cells/microliter, history of acute HIV
infection
d. Infection with HIV, history of HIV infection and T-cell count below 200 cells/microliter
2. The nurse observes precaution in caring for Mr. X as HIV is most easily transmitted in:
a. Vaginal secretions and urine
b. Breast milk and tears
c. Feces and saliva
d. Blood and semen
3. Nurse Jaja is giving an injection to Ms. X. After giving an injection, the nurse
accidentally stuck her finger with the needle when the client became very agitated. To
determine if the nurse became infected with HIV when is the best time to test her for
HIV antibodies?
a. Immediately and repeat the test after 12 weeks
b. Immediately and repeat the test after 4 weeks
c. After a week and repeat the test in 4 months
d. After a weeks and repeat the test in 6 months
4. The blood test first used to identify a response to HIV infection is:
a. Western blot
b. ELISA test
c. CD4+ T-cell count
d. CBC
5. What is the main reason why it is difficult to develop a vaccine against HIV?
a. HIV is still unknown to human
b. HIV mutates easily
c. HIV spreads rapidly throughout the body
d. HIV matures easily
6. Human Immunodeficiency virus belongs to which classifications?
a. Rhabdovirus
b. Rhinovirus
c. Retrovirus
d. Rotavirus
7. Which organ is responsible for stimulating the production of red blood cells?
a. Yellow marrow
b. Red marrow
c. Spleen
d. Kidney
8. In anemia, which of the following blood components is decreased?
a. Erythrocytes
b. Granulocytes
c. Leukocytes
d. Platelets
9. The precursor of red blood cells is called:
a. T cells
b. B cells
c. Stem cells
d. Macrophage
10. In erythropoiesis, the sequence of erythrocyte formation is chronologically described
in which option?
a. Stem cells, erythroblast, reticulocyte, erythrocytes
b. Stem cells, reticulocyte, erythroblast, erythrocytes
c. Erythroblast, stem cells, reticulocyte, erythrocytes
d. Erythroblast, reticulocyte, stem cells, erythrocytes
11. Which of the following is true of red blood cell?
a. It is nucleated.
b. It has a lifespan of 100 days
c. It’s production and formation depends on the action of the kidney
d. It is produced in the yellow marrow
12. Which type of immunoglobulin passes or crosses the placenta starting at the first
trimester of pregnancy?
a. IgG
b. IgA
c. IgM
d. All of these
13. The first immunoglobulin produced by the body when the neonate is distressed, has
acquired an infection or is challenged is:
a. IgG
b. IgA
c. IgM
d. All of these
14. Which of the following is essential for the hemoglobin synthesis during RBC
production?
a. Folic Acid
b. Iron
c. Vitamin B12
d. All of these
15. The age group most at risk for developing anemia is:
a. 20-25 years old
b. 26-32 years old
c. 40-50 years old
d. >65 years old
16. Decreased number of platelets is called:
a. Thrombectomy
b. Thrombocytopenia
c. Thrombocytopathy
d. Thrombocytosis
17. To improve the platelet count of a patient with an idiopathic thrombocytopenic
purpura, this medication should be given:
a. Vitamin K
b. Methotrexate
c. Corticosteroid
d. Acetylsalicylic Acid
18. B-cells are involved in which of the following types of immunity?
a. Humoral immunity
b. Cell-mediated immunity
c. Antigen-mediated immunity
d. All of these
19. What is the life span of normal platelets?
a. 3-4 months
b. 1-2 months
c. 1-3 days
d. 7-10 days
20. A patient is diagnosed with a systematic lupus erythematous (SLE). SLE primarily
attacks which tissues?
a. Heart
b. Lung
c. Nerve
d. Connective
21. A sign of neurologic involvement in SLE is manifested by:
a. CVA
b. Infection
c. Psychosis
d. Facial tic
22. A classic sign of SLE is:
a. Rashes over the cheeks and nose
b. Weight loss
c. Vomiting
d. Difficulty urinating
23. A laboratory test result that supports the diagnosis of SLE is:
a. Leukocytosis, elevated BUN and CREA
b. Pancytopenia, elevated antinuclear antibody (ANA) titer
c. Thrombocytosis, elevated ESR
d. None of these
24. Which food should a client with leukemia avoid?
a. Wheat bread
b. Steak
c. Orange
d. All of these
25. The average length of time from HIV infection to the development of AIDS is?
a. Less than 3 years
b. 5-7 years
c. 10 years
d. More than 10 years
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NCLEX Questions Hematology Answers and Rationale
NCLEX Questions Hematology Answers and
Rationale
1. Answer C. The three criteria for a client to be diagnosed with AIDS are the following:
• HIV positive
• CD4+ T-cell count below 200 cells/microliter
• Have one or more specific conditions that include acute infection of HIV
2. Answer D. Keyword: MOST EASILY. Rationale: HIV is MOST EASILY transmitted in
blood, semen and vaginal secretions. However, it has been noted to be found in fecal
materials, urine, saliva, tears and breast milk.
3. Answer A. Keyword: BEST TIME. Rationale: To determine if a preexisting infection is
present a test should be done immediately and is repeated again in 3 months time (12
weeks) to detect seroconversion as a result of the needle stick.
4. Answer B. Keyword: FIRST. Rationale: The ELISA test is the first screening test for HIV.
A Western blot test confirms a positive ELISA test. Other blood tests that support the
diagnosis of HIV include CD4+ and CD8 + counts, CBC, immunoglobulin levels, p24
antigen assay, and quantitative ribonucleic acid assays.
5. Answer B. Keyword: MAIN REASON. Rationale: HIV was identified in 1983, thus, A is
incorrect. By 1988 two strains of HIV existed, HIV-1 and HIV-2. Viruses spread rapidly
and mature easily but these factors don’t affect the potential for development against
HIV. Mutating too easily makes it hard to create a vaccine against it.
6. Answer C. Rationale: HIV is a retrovirus that has a ribonucleic acid dependent reverse
transcriptase.
7. Answer D. Keyword: STIMULATING THE PRODUCTION OF RBC. Rationale: Kidneys
produce and release the hormone erythropoietin that is responsible for initiating the
production of RBCs in the red marrow, thus, the correct answer is D. The Red Marrow is
the site of RBC production. The spleen is responsible for removing the damage RBC.
8. Answer A. Rationale: Anemia is characterized by a decreased in the number of RBCs.
9. Answer C. Keyword: PRECURSOR. Rationale: the precursor of RBC is the stem cells in
the red marrow.
10. Answer A. Rationale: Stem cells – erythroblast- reticulocyte – erythrocytes.
Erythropoietin is the hormone that stimulates red blood cell production in the red
marrow. Mature red blood cells are formed from stem cells in the bone marrow. With
the presence of erythropoietin, red cell pathway starts to form proerythroblast from
stem cells. At this point the cell still contains nucleus. However, as the development
progresses the nucleus becomes smaller and the cytoplasm becomes basophilic due to
the presence of ribosome, thus the cell is now called basophilic erythroblast. As the cell
becomes older it also becomes smaller and eventually when it begins to produce
hemoglobin it is now termed as polychromatic erythroblast. Later on the cytoplasm will
become more eosinophilic and the cell is now called orthochromatic erythroblast, which
will then extrude its nucleus as the cells slowly fill with hemoglobin before entering the
circulation as reticulocytes. Reticulocytes will mature to form the anucleated red blood
cells.
11. Answer C. Keyword: TRUE. Rationale: Kidneys produce and release the hormone
erythropoietin that is responsible for initiating the production of RBCs in the red
marrow. Red blood cells are anucleated cells (without nucleus) and have a life span of
120 days or 4 months.
12. Answer A. Keyword: PASSES/CROSSES THE PLACENTA. Rationale: There is only one
immunoglobulin that passes or crosses that placenta, the IgG. IgG starts to cross the
placenta at the first trimester of pregnancy. However, the largest amount of IgG transfer
is noted during the third trimester of pregnancy. This type of immunoglobulin provides
the fetus a passive immunity to possible bacterial and viral infections. However, the
passive immunity it provides is only temporary. The immunity gradually disappears at
about 6 to 8 months of life. The gradual disappearance of passive immunity, leads to the
gradual production of larger quantities of immunoglobulin to replace the IgG from the
mother.
13. Answer C. Keyword: FIRST IMMUNOGLOBULIN PRODUCED BY THE BODY. Rationale:
IgM is the first immunoglobulin produced by the body when the neonate is distressed,
has acquired an infection or is challenged. When a newborn is exposed to
environmental antigens, production of IgM rapidly increases. This type of
immunoglobulin provides protection from gram-negative bacteria. IgM cannot cross the
placental barrier. In cases where large amount of IgM is found in the placenta, possible
exposure to infection in the utero is probable
14. Answer B. Keyword: HEMOGLOBIN SYNTHESIS. Rationale: Dietary elements are
essential for RBC production. The following are needed by the red marrow to produce
erythrocytes:
• Iron – for hemoglobin synthesis
• Folic Acid – for DNA synthesis
• Vitamin B12 – for DNA synthesis
15. Answer D. Keyword: MOST AT RISK. Rationale: The elderly are most at risk for
anemia often due to financial concerns affecting protein intake or poor dentition that
interferes with chewing meat.
16. Answer B. Keyword: DECREASED NUMBER OF PLATELETS. Rationale:
thrombocytopenia is a decreased number of platelets. Thrombocytosis is an excess in
the number of platelets. Thrombocytopathy is a platelet dysfunction. Thrombectomy is
the surgical removal of a thrombus.
17. Answer C. Rationale: TO IMPROVE PLATELET COUNT. Rationale: Corticosteroid
therapy can decrease antibody production and phagocytosis of the antibody-coated
platelets, retaining more functioning platelets. Methotrexate can cause
thrombocytopenia. Vitamin K is used to treat an excessive anticoagulable state from
warfarin overload, and ASA decreases platelet aggregation.
18. Answer A. Keyword: B-CELLS. Rationale: B-Cells are responsible for humoral or
immunoglobulin mediated immunity. T-cells are responsible for cell-mediated immunity.
There is such thing as antigen-mediated immunity.
19. Answer D. Rationale: The life span of a normal platelet is 7-10 days. However, in
idiopathic thrombocytopenia the life span is reduced to 1-3 days.
20. Answer D. Keyword: PRIMARILY. Rationale: SLE is a chronic, inflammatory,
autoimmune disorder affecting primarily the connective tissues. It also affects the skin
and kidneys and may affect the pulmonary, cardiac, neural and renal systems.
21. Answer C. Keyword: NEUROLOGICAL INVOLVEMENT. Rationale: neurologic
involvement may be shown by:
• Psychosis
• Seizures
• Headaches
22. Answer A. Keyword: CLASSIC SIGN. Rationale: Although all these symptoms can be
signs of SLE, the classic sign is the butterfly rash over the cheeks and nose.
23. Answer B. Keyword: SUPPORTS THE DIAGNOSIS. Rationale: lab findings for clients
with SLE usually show:
• Pancytopenia
• Elevated ANA titer
• Decreased serum complement levels
24. Answer C. Keyword: AVOID. Rationale: a low-bacteria diet would be indicated. Raw
fruits and vegetables are excluded in the client’s diet.
25. Answer C. Keyword: AVERAGE LENGTH OF TIME. Rationale: epidemiologic studies
show the average time from initial contact with HIV to the development of AIDS is 10
years.
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