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NR 661 Hematology 1 to 60 An African American male complains of pain in his back and trunk. He is diagnosed with multiple myeloma. He is probably: Correct Answer: About 65 years old (correct answer in bracket).

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NR 661 Hematology 1 to 60

  1. An African American male complains of pain in his back and trunk. He is diagnosed with multiple myeloma. He is probably:
    • Correct Answer: About 65 years old (correct answer in bracket).
    • Explanation: Multiple myeloma is most common in older adults, typically around the age of 65.
  2. Which statement is true about vitamin B12?
    • Correct Answer: Inadequate amounts can produce cognitive changes (correct answer in bracket).
    • Explanation: Vitamin B12 deficiency can lead to neurological issues, including cognitive impairments.
  3. A patient has had an allergic reaction to seafood with anaphylaxis 48 hours ago. Which white cell will probably be abnormal?
    • Correct Answer: Eosinophils (correct answer in bracket).
    • Explanation: Eosinophils are often elevated in allergic reactions, especially those involving anaphylaxis.
  4. What statement is true about anemia in older adults?
    • Correct Answer: Anemia may have more than one origin and co-exist in older adults (correct answer in bracket).
    • Explanation: Anemia in older adults often has multiple causes, such as chronic disease and nutritional deficiencies.
  5. Thalassemia minor can be recognized by:
    • Correct Answer: Microcytic, hypochromic red cells (correct answer in bracket).
    • Explanation: Thalassemia minor typically presents with small (microcytic) and pale (hypochromic) red blood cells.
  6. Lead toxicity can be associated with:
    • Correct Answer: Sideroblastic anemia (correct answer in bracket).
    • Explanation: Lead toxicity can interfere with hemoglobin production, leading to sideroblastic anemia.
  7. A 28-year-old female patient reports fatigue for the past 4-6 weeks. Based on her most likely diagnosis, she will receive an oral supplement as treatment for her anemia. For best absorption, it should be taken:
    • Correct Answer: On an empty stomach (correct answer in bracket).
    • Explanation: Iron supplements are best absorbed when taken on an empty stomach, as food can inhibit absorption.
  8. An older adult has suspected vitamin B12 deficiency. Which of the following lab indices is more indicative of a vitamin B12 deficiency?
    • Correct Answer: Macrocytosis (correct answer in bracket).
    • Explanation: Macrocytosis (enlarged red blood cells) is a common sign of vitamin B12 deficiency.
  9. A patient with pernicious anemia may be observed to have:
    • Correct Answer: Glossitis (correct answer in bracket).
    • Explanation: Pernicious anemia often presents with glossitis, an inflammation of the tongue.
  10. What diagnosis is likely based on this patient’s laboratory values?
    • Correct Answer: Pernicious anemia (correct answer in bracket).
    • Explanation: Pernicious anemia is characterized by specific lab findings, including low vitamin B12 levels and macrocytosis
  11. A patient is found to have anemia. What term is used to describe the patient’s MCH in this CBC?
    • Correct Answer: Normochromic (correct answer in bracket).
    • Explanation: Normochromic refers to red blood cells that have a normal concentration of hemoglobin, which is typical in certain types of anemia.
  12. A 20-year-old student has an MMR titer that demonstrates an unprotective titer for rubella. She is HIV positive. Her CD4 cell count is unknown. Which statement is true?
    • Correct Answer: She is at risk for MMR but should not be immunized (correct answer in bracket).
    • Explanation: Immunization with live vaccines like MMR is contraindicated in individuals with compromised immune systems, such as those with low CD4 counts.
  13. The following lab values most likely indicate what type of anemia?
    • Correct Answer: Iron deficiency anemia (correct answer in bracket).
    • Explanation: Iron deficiency anemia typically presents with low hemoglobin, hematocrit, and ferritin levels, along with microcytosis and hypochromia.
  14. A 26-year-old female has thalassemia minor. What should be limited in her diet to avoid hepatotoxicity?
    • Correct Answer: Multivitamin with iron (correct answer in bracket).
    • Explanation: Iron overload can be harmful in individuals with thalassemia minor, leading to liver damage, so iron supplementation should be avoided.
  15. A measure of the degree of variation in red cell size is indicated by:
    • Correct Answer: RDW (correct answer in bracket).
    • Explanation: Red cell distribution width (RDW) is a measurement of the variability in the size of red blood cells.
  16. A serum ferritin level:
    • Correct Answer: Demonstrates the amount of iron in storage (correct answer in bracket).
    • Explanation: Ferritin is a protein that stores iron, and its levels in the blood indicate the amount of iron stored in the body.
  17. A patient is being treated for iron deficiency anemia. Iron is better absorbed:
    • Correct Answer: On an empty stomach (correct answer in bracket).
    • Explanation: Taking iron supplements on an empty stomach enhances absorption, though it may cause gastrointestinal discomfort in some patients.
  18. A patient had a splenectomy after an automobile accident 3 months ago. Patients who are asplenic are:
    • Correct Answer: More susceptible to bacterial infection (correct answer in bracket).
    • Explanation: The spleen plays a crucial role in fighting bacterial infections, and its absence increases the risk of infection.
  19. A patient is found to have an anemia. What term is used to describe this patient’s MCV?
    • Correct Answer: Normocytic (correct answer in bracket).
    • Explanation: Normocytic anemia refers to anemia with normal-sized red blood cells, which can occur in chronic diseases.
  20. A 75-year-old adult asks for the pneumonia vaccine. His immunization record indicates that he had one at age 65 and another a year later. What is the recommendation of the CDC about how the NP should handle his request?
    • Correct Answer: Do not revaccinate this patient at this time (correct answer in bracket).
    • Explanation: The CDC recommends not revaccinating older adults if they have already received the appropriate pneumonia vaccines unless specific conditions warrant it.
  21. A 75-year-old male patient has been in poor health for a decade. Which type of anemia is LEAST likely in this patient?
    • Correct Answer: Sideroblastic anemia (correct answer in bracket).
    • Explanation: Sideroblastic anemia is less common in older adults and usually arises from congenital or acquired causes, often unrelated to general poor health.
  22. A 50-year-old female presents to your clinic with symptoms of fatigue over the past 1-2 months. Preliminary labs have been performed. What should the NP do next?
    • Correct Answer: Prescribe an iron supplement (correct answer in bracket).