Hematology

 Sickle Cell Anemia Quiz

 Blood Transfusion Quiz
 Blood Types Quiz
 Pernicious Anemia Quiz
 Iron-deficiency Anemia Quiz

Sickle Cell Anemia NCLEX Questions

1. Which statement about how sickle cell anemia is passed to offspring is

CORRECT?

 A. This disease is an x-linked recessive disease.

 B. Sickle cell anemia is an autosomal dominant disease.

 C. This condition is an autosomal recessive disease.

  D. Sickle cell anemia is rarely passed to offspring and is an autosomal x-
linked dominant disease.

The answer is C. SCA is an autosomal recessive disease in that the offspring must
receive TWO hemoglobin S genes (one for each parent). The parents usually don’t
have the disease but are carriers. For the disease to occur in the offspring they must
receive both of those genes (Hbg SS). On the contrary, with autosomal dominant the
offspring has to only receive an abnormal gene from one parent, who probably has
signs and symptoms of the disease too.

2. Which type of hemoglobin is present in a patient who has sickle cell anemia?

 A. Hemoglobin AA

 B. Hemoglobin AS

 C. Hemoglobin SS

 D. Hemoglobin AC

The answer is C. SCA is homozygous and the patient must have two abnormal
alleles present to have sickle cell anemia. The patient receives each abnormal allele
for each parent (hence one from each parent which is Hemoglobin SS). If a patient
has Hemoglobin AS (normal allele (A) and abnormal allele (S)) this is known as
sickle cell trait, which most patients with this don’t present with signs and symptoms
of the disease…it’s rare because they usually have just enough hemoglobin A to
prevent the RBCs from sickling.

3. Which type of hemoglobin is present in a patient who has sickle cell TRAIT?

 A. Hemoglobin AA

 B. Hemoglobin AS

 C. Hemoglobin SS

 D. Hemoglobin AC

The answer is B. Sickle cell TRAIT is heterozygous, which means the patient has
one NORMAL allele (which is Hemoglobin A…this is NORMAL hemoglobin) and one
ABNORMAL allele (which is Hemoglobin S)…..this is the abnormal hemoglobin that
leads to the abnormal construction of the RBC). However, most patients with sickle
cell trait don’t show signs and symptoms related to sickle cell anemia because they
have just enough of the normal hemoglobin A to prevent sickling of the RBC.

4. A 25 year-old pregnant female and her partner both have sickle cell trait. What is
the percentage that their offspring will develop sickle cell anemia?
  A. 50%

 B. 25%

 C. 75%

 D. 100%

The answer is B. If both parents have the sickle cell trait it means they each have
normal hemoglobin A and abnormal hemoglobin S on their RBCs….so both present
with hbg AS. Remember they don’t have sickle cell disease just the abnormal gene
that can be passed to their child. Sickle cell anemia is autosomal recessive,
therefore there is a 25% chance their child will obtain both abnormal genes (the Hbg
S) from EACH parent and develop sickle cell anemia.

5. You’re assisting a physician with sickle cell anemia screening. As the nurse you
know that which patient population listed below is at risk for sickle cell disease?

 A. Native Americans

 B. African-Americans

 C. Pacific Islanders

 D. Latino

The answer is B. Sickle cell anemia is most common in African-Americans along

with Middle Eastern, Asian, Caribbean, and Eastern Mediterranean. WHY?
According to the CDC, 1 in 12 African-Americans have the sickle cell trait, so it can
easily be passed to their offspring. Remember if both parents have sickle cell trait
there is a 25% chance they will pass it to their child.

6. A 14 year-old female has sickle cell anemia. Which factors below can increase the
patient’s risk for developing sickle cell crisis?

Select all that apply:

 A. Shellfish

 B. Infection

 C. Dehydration

 D. Hypoxia

 E. Low altitudes
  F. Hemorrhage

 G. Strenuous exercise

The answers are B, C, D, F and G. Sickle cell crisis can occur when the body
experiences low amounts of oxygen in the body (so think about something that
increases the body’s need for oxygen or affects how oxygen is being transported).
Therefore, infection (especially respiratory infections), dehydration, hypoxia, HIGH
(not low) altitudes, hemorrhage (blood loss), or strenuous exercise can lead to a
sickle cell crisis.

7. A 6 year-old is admitted with sickle cell crisis. The patient has a FACE scale rating
of 10 and the following vital signs: HR 115, BP 120/82, RR 18, oxygen saturation
91%, temperature 101.4’F. Select all the appropriate nursing interventions for this
patient at this time?

 A. Administer IV Morphine per MD order

 B. Administer oxygen per MD order

 C. Keep NPO

 D. Apply cold compresses

 E. Start intravenous fluids per MD order

 F. Administer iron supplement per MD order

 G. Keep patient on bed rest

 H. Remove restrictive clothing or objects from the patient

The answers are A, B, E, G, and H. When a patient is in sickle cell crisis, the
abnormal RBCs are sickling and sticking together, which blocks blood flow. To help
alleviate the RBCs from clumping together and sickling, oxygen and hydration are
priority. This will help dilute the blood (hence decrease the sticking of RBCs) and
help supply oxygen to the RBCs (remember abnormal RBCs with hemoglobin S are
very sensitive to low oxygen levels and will sickle when there is low oxygen). In
addition, pain needs to be addressed. Opioid medication is the best on a scheduled
basis rather than PRN (as needed). Avoid keeping patient NPO unless needed
(remember patient needs hydration). Avoid cold compresses (can lead to more
sickling) but instead use warm compresses. The patient will need FOLIC ACID
supplements to help with RBC creation rather than iron (iron can actually build up in
the body and collect in the organs in patients with sickle cell disease). Patients
definitely need to be on bedrest, and restrictive clothing or objects (blood pressure
cuff etc.) should be removed to help blood flow.
8. A patient is being tested for sickle cell disease. As the nurse, you know
the ________ will assess for abnormal hemoglobin on the red blood cell, but will not
differentiate between sickle cell disease and sickle cell trait. Therefore, the patient
will need to have what other test to determine this?

 A. dithionite test; hemoglobin electrophoresis

 B. hemoglobin electrophoresis; sickledex

 C. edrophonium test, dithionite test

 D. sickledex; edrophonium test

The answer is A.

9. During an outpatient well visit with a patient who has sickle cell anemia, you make
it PRIORITY to assess the patient’s?

 A. hemoglobin A1C level

 B. heart rate

 C. reflexes

 D. vaccination history

The answer is D. Patients will sickle cell anemia are at risk for infection because of
spleen compromise. Many patients with SCA experience splenomegaly because
blood flow is compromised to the spleen due to sickling of RBCs and the spleen is
overworked from recycling the old RBCs (remember a patient with sickle cell anemia
does NOT have long-living RBCs…the RBCs tend to die in 20 days rather than 120
days). Therefore, vaccination history is very important. The patient should be up-to-
date with the flu, pneumococcal, and meningococcal vaccines.

10. An 18 year-old male is taking Hydroxyurea for treatment of sickle cell anemia.
Which option below indicates this medication is working successfully?

 A. The patient needs fewer blood transfusions.

 B. The patient experiences diuresis.

 C. The patient experiences an increase in fetal hemoglobin (Hbg F).

 D. The patient experiences a decrease in hemoglobin S.

The answers are A and C. This medications actually treats cancer, but it will help
with SCA in that it will help create fetal hemoglobin hgb F (this helps decrease
sickling episodes) and helps with anemia (decreasing the need for so many blood
transfusions).

11. You’re providing education to a patient with sickle cell anemia who is taking
Hydroxyurea. You will make it priority to tell the patient to?

 Consume foods high in calcium and potassium

 B. Avoid sick people and maintain strict hand hygiene

 C. Take this medication with at least 8 oz of water

 D. Monitor your blood glucose level daily

The answer is B. This medication can lower the white blood cell count. Therefore,
the nurse should make it priority to tell the patient to avoid infection by avoiding sick
people and performing hand hygiene regularly.

12. A mother brings in her 8 month-old child to the ER. The mother reports the baby
has recently started being extremely fussy, has a fever, and swelling in the hands
and feet. The child is diagnosed with sickle cell disease. As the nurse you know that
the swelling in the hands and feet in the infant is termed?

 A. Dactylitis

 B. Erythromelaglia

 C. Dyshidrotia

 D. Phalitis

The answer is A. Dactylitis (also called hand-foot syndrome) occurs mainly in infants
who are newly diagnosed with sickle cell anemia.

13. You’re providing seminar teaching to a group of nurses about sickle cell anemia.
Which of the following is NOT a treatment for this condition?

 A. Blood transfusion

 B. Stem cell transplant

 C. Intravenous fluids

 D. Iron supplements

 E. Antibiotics
  F. Morphine

The answer is D. Iron supplements are not prescribed (rather Folic Acid) because
this type of anemia is not caused by low iron levels, and patients who take iron
supplements with sickle cell disease are at risk for building up too much iron in the
body, which will damage the organs.

14. You’re educating the parents of a 12 year-old, who was recently treated for
sickle cell crisis, on ways to prevent further sickle cell crises in the further. Which
statement by the parents demonstrates they understood your instructions?

 A. “We will limit fluid intake during the day to 1-2 L a day.”

 B. “Cold showers are best to help with pain associated with sickling.”

 C. “We will avoid traveling to high altitude locations.”

 D. “It is important we refuse all future vaccinations unless absolutely

necessary.”

The answer is C. Remember sickle cell crisis can be caused by blood loss, illness
(it’s important the patient is up-to-date with all vaccinations), high altitudes, stress,
dehydration, elevated temperature, or extreme cold temperatures. All options are
wrong except C.
Blood Transfusion NCLEX Questions
Blood transfusions nclex questions for nursing: As a nurse you will be
transfusing blood and you will want to know how to properly perform this procedure.

During a blood transfusion, the patient is at risk for various transfusion reactions like
hemolytic, allergic, febrile (non-hemolytic), graft versus host disease etc. Therefore,
the nurse must be familiar with how to monitor for these types of reactions, the
various blood types, and how to transfuse blood.

Don’t forget to watch the lecture on blood transfusions before taking the quiz.

1. Red blood cells are very for vital survival. Which statement below is NOT correct
about red blood cells?

 A. “Red blood cells help carry oxygen throughout the body with the help of the
protein hemoglobin.”

 B. “Extreme loss of red blood cells can lead to a suppressed immune system
and clotting problems.”

 C. “Red blood cells help remove carbon dioxide from the body.”

 D. “Red blood cells are suspended in the blood’s plasma.”

The answer B. Extreme loss of red blood cells leads to anemia which can cause a
patient to experience shortness of breath (there is a decreased ability to carry
oxygen throughout the body), tachycardia, fatigue, pale skin color etc. Suppressed
immune system can be from LOW white blood cells, and clotting problems can be
from LOW platelets.

2. You’re providing care to a 36 year old male. The patient experienced abdominal
trauma and recently received 2 units of packed red blood cells. You’re assessing the
patient’s morning lab results. Which lab result below demonstrates that the blood
transfusion was successful?

 A. Hemoglobin level 7 g/dL

 B. Platelets 300,000 µl

 C. Hemoglobin level 15 g/dL

 D. Prothrombin Time 12.5 seconds

The answer is C. Hemoglobin levels are used to assess the effectiveness of a blood
transfusion. A normal Hgb level for a MALE is 14 to 18 g/dL. For a FEMALE, the
level is 12 to 16 g/dL.
3. According to the American Association of Blood Banks, what is the recommended
hemoglobin level for a blood transfusion?

 A. 5-7 g/dL

 B. 7-8 g/dL

 C. 4-7 g/dL

 D. 9-10 g/dL

The answer is B. This is the recent recommendation for by the AABB (7-8 g/dL).

4. What blood type is known as the “universal donor”?

 A. Type A

 B. Type B

 C.Type AB

 D. Type O

The answer is D. Type O is known as the universal donor.

5. What blood type is known as the “universal recipient”?

 A. Type A

 B. Type B

 C. Type AB

 D. Type O

The answer is C. Type AB is known as the universal recipient.

6. A patient needs 2 units of packed red blood cells. The patient is typed and
crossmatched. The patient has B+ blood. As the nurse you know the patient can
receive what type of blood? Select all that apply:

 A. B-

 B. A+

 C. O-
  D. B+

 E. O+

 F. A-

 G. AB+

 H. AB-

The answers are A, C, D and E. The patient must receive blood from either a donor
that has O or B blood. Since the patient is B+ (Rh factor is positive), they can receive
both negative or positive blood. So, the patient can receive B-, B+, O-, and O+
blood.

7. A donor has AB- blood. Which patient or patients below can receive this type of
blood safely?

 A. A patient with O- blood.

 B. A patient with A- blood.

 C. A patient with B- blood.

 D. A patient with AB- blood.

The answer is D. Donors with AB type blood can only donate to others who have the
AB type blood, in this case AB- blood. However, they are the universal recipients in
that they can receive blood for every blood type but can only donate to their same
exact blood type.

8. As the nurse you know that there is a risk of a transfusion reaction during the
administration of red blood cells. Which patient below it is at most RISK for a febrile
(non-hemolytic) transfusion reaction?

 A. A 38 year old male who has received multiple blood transfusions in the
past year.

 B. A 42 year old female who is immunocompromised.

 C. A 78 year old male who is B+ that just received AB+ blood during a
transfusion.

 D. A 25 year old female who is AB+ and just received B+ blood.

The answer is A. A febrile transfusion reaction is where the recipient’s WBCs are
reacting with the donor’s WBCs. This causes the body to build antibodies. It is most
COMMON in patients who have received blood transfusion in the past. Option B is at
risk for GvHD (graft versus host disease). Option C is wrong because this places the
patient at risk for a hemolytic transfusion reaction (not febrile). The patient is
receiving incompatible blood. However, option D is not the patient at MOST risk
compared to option A. Note the patient is receiving compatible blood. Note the
patient is receiving compatible blood in this option.

9. Before a blood transfusion you educate the patient to immediately report which of
the following signs and symptoms during the blood transfusion that could represent
a transfusion reaction:

 A. Sweating

 B. Chills

 C. Hives

 D. Poikilothermia

 E. Tinnitus

 F. Headache

 G. Back pain

 H. Pruritus

 Paresthesia

 J. Shortness of Breath

 K. Nausea

The answers are A, B, C, F, G, H, J, and K. As the nurse you want to educate the
patient to report signs and symptoms associated with blood transfusion reactions,
which would include: sweating, chills, hives, headache, back pain, pruritus (itching),
shortness of breath, and nausea.

10. Your patient needs 1 unit of packed red blood cells. You’ve completed all the
prep and the blood bank notifies you the patient’s unit of blood is ready. You send
for the blood and the transporter arrives with the unit at 1200. You know that you
must start transfusing the blood within _________.

 A. 5 minutes

 B. 15 minutes
  C. 30 minutes

 D. 1 hour

The answer is C. The blood must be started within 30 minutes.

11. A patient who needs a unit of packed red blood cells is ordered by the physician
to be premeditated with oral diphenhydramine and acetaminophen. You will
administer these medications?

 A. 15 minutes before starting the transfusion

 B. Immediately after starting the transfusion

 C. Right before starting the transfusion

 D. 30 minutes before starting the transfusion

The answer is D. For ORAL medications you will administer the medications 30
minutes before starting the transfusion.

12. A patient is receiving 1 unit of packed red blood cells. The unit of blood will be
done at 1200. The patient is scheduled to have IV antibiotics at 1000. As the nurse
you will:

A. Stop the blood transfusion and administer the IV antibiotic, and when the
antibiotic is done resume the blood transfusion.

B. Administer the IV antibiotic via secondary tubing into the blood transfusion’s y-
tubing.

C. Hold the antibiotic until the blood transfusion is done.

D. Administer the IV antibiotic as scheduled in a second IV access site.

The answer is D. If any IV medications will be needed while the blood is transfusing,
the nurse will need to start another IV access site. The nurse would NEVER
administer the IV antibiotic in the same tubing as the blood product or stop the
transfusion. Remember blood is time sensitive and must be transfused within 4
hours. Also, holding the antibiotic is not correct because antibiotics are time
sensitive as well and must be administered at the scheduled time to maintain blood
levels.

13. You’re gathering supplies to start a blood transfusion. You will gather?

 A. PVC free tubing and dextrose

  B. Polyethylene-line tubing and 0.9% Normal Saline

 C. Y-tubing with in-line filter and dextrose

 D. Y-tubing with in-line and 0.9% Normal Saline

The answer is D. This is the type of tubing and solution you will use to transfuse
blood. Normal Saline is the ONLY solution used to transfuse blood!!

14. A patient is ordered to receive 2 units of packed red blood cells. The first unit
was started at 1400 and ended at 1800. You send for the other bag of red blood
cells. As the nurse you know it is priority to:

 A. obtain signed informed consent for the second unit of blood from the
patient

 B. obtain a new y-tubing set for this unit of blood

 C. type and crossmatch the patient

 D. hang a new bag of dextrose to transfuse with the blood

The answer is B. The patient has already received 1 unit of blood and another unit is
needed. It took 4 hours for the first unit to transfuse and the nurse needs to obtain
new y-tubing for the next unit of blood. Y-tubing sets are only good for 4 hours.
Some hospitals require new tubing sets with each unit transfusion or after 4
hours….always check your hospital’s protocol.

15. Before starting a blood transfusion the nurse will perform a verification process
with __________. This will include?

 A. any available personnel; physician’s order, patient’s identification, blood

bank’s information, expiration date of blood

 B. licensed personnel only (another RN); physician’s order, patient’s

identification, blood bank’s information, patient’s blood type and donor’s type
along with Rh factor, expiration date, assess the bag of blood for damage or
abnormal substances

 C. blood bank; patient’s identification, blood bank’s information, patient’s

blood type and donor’s type along with Rh factor, expiration date, bag of
blood for damage or abnormal substances

 D. licensed personnel only (another RN); blood compatibility, physician order,

expiration date
The answer is B. The nurse will verify with another licensed personnel (another RN)
the physician’s order, patient’s identification and blood bank’s information, patient’s
blood type and donor’s type along with the Rh factor, expiration date, assess the bag
for damage or abnormal substances BEFORE starting the transfusion.

16. Before initiating the blood transfusion, you obtain the patient’s baseline vital
signs, which are: heart rate 100, blood pressure 115/72, respiratory rate 18, and
temperature 100.8’F. Your next action is to:

 A. Administer the blood transfusion as ordered.

 B. Hold the blood transfusion and reassess vital signs in 1 hour.

 C. Notify the physician before starting the transfusion.

 D. Administer 200 mL of the blood and then reassess the patient’s vital signs.

The answer is C. The patient has an elevated temperature. Any temperature greater
than 100’F (before the administration of the blood) the physician should be notified.

17. You’ve started the first unit of packed red blood cells on a patient. You stay with
the patient during the first 15 minutes and:

 A. run the blood at 100 mL/hr and then increase the rate after 15 minutes, if
tolerated by the patient.

 B. run the blood at 20 mL/hr and then increase the rate after 15 minutes, if
tolerated by the patient.

 C. run the blood at 200 mL/hr and then decrease the rate after 15 minutes, if
tolerated by the patient.

 D. run the blood at 2 mL/hr and then increase the rate after 15 minutes, if
tolerated by the patient.

The answer is D. The blood will be started on an infusion pump at 2 mL/hr, and if the
blood is tolerated by the patient, it will be increased AFTER 15 minutes. Remember
the blood must be transfused within 2-4 hours….most bags are 250 to 300 mL.
During the first 15 minutes is when the patient is most likely to have a transfusion
reaction. Running the blood slowly during the first 15 minutes allows the patient to
receive the LEAST amount of blood possible if a reaction does occur.

18. A patient started receiving their first unit of blood at 1000. It is now 1010 and the
patient is reporting itching, chills, and a headache. In addition, the patient’s
temperature is now 99.8’F from 98’F. Your next nursing action is:

 A. Stop the transfusion

  B. Notify the physician

 C. Decrease the rate of the transfusion

 D. Reassure the patient that this is normal and will resolve in 30 minutes.

The answer is A. The patient is possibly having a transfusion reaction. FIRST, the
nurse should STOP the transfusion and then disconnect the IV tubing at the access
site and replace it with NEW tubing. In addition, have normal saline infusing to keep
the vein open. THEN the nurse will notify the physician and blood bank.

19. What solution or solutions below are compatible with red blood cells?

 A. Normal Saline

 B. Dextrose Solutions

 C. Any medications with normal saline

 D. No solutions are compatible with blood

The answer is A. Only NORMAL SALINE is compatible with blood.

20. A patient with O+ blood received A+ blood. The patient is at risk for?

 A. Febrile transfusion reaction

 B. None: O+ and A+ are compatible blood types

 C. Hemolytic transfusion reaction

 D. Allergic transfusion reaction

The answer is C. O+ and A+ are NOT compatible blood types. Patients with O+ can
only receive blood from others with O blood. This patient is at risk for a hemolytic
reaction. This is where the immune system is killing the donors RBCs. The
antibodies in the recipient’s blood match the antigens on the donor’s blood
cells….the patient has been mistyped!!

21. Your patient is having a transfusion reaction. You immediately stop the
transfusion. Next you will:

 A. Notify the physician.

 B. Disconnect the blood tubing from the IV site and replace it with a new IV
tubing set-up and keep the vein open with normal saline 0.9%.
  C. Collect urine sample.

 D. Send the blood tubing and bag to the blood bank.

The answer is B. This question wants to know your NEXT nursing action. AFTER
stopping the transfusion, the nurse will DISCONNECT the blood tubing from the IV
site and replace it with a new IV tubing set-up and keep the vein open with normal
saline 0.9%. This will limit any more blood from entering the patient’s system. THEN
the nurse will notify the MD and blood bank.

Blood Types NCLEX Quiz

Blood types NCLEX quiz for nursing students on the ABO blood typing system.
As a nurse you will be transfusing blood products, especially packed red blood cells.
Therefore, you must be familiar with the various blood types and if they are
compatible with one another.

Don’t forget to watch the lecture on blood types before taking the quiz.

Blood Types NCLEX quiz

This quiz will test your knowledge on the ABO blood types in preparation for the
NCLEX exam.
1. What blood type is known as the “universal donor”?

A. Type A

B. Type B

C. Type AB

D. Type O

The answer is D. Type O is known as the universal donor.

2. What blood type is known as the “universal recipient”?

A. Type A

B. Type B

C. Type AB

D. Type O

The answer is C. Type AB is known as the universal recipient.

3. A patient needs 2 units of packed red blood cells. The patient is typed and
crossmatched. The patient has A+ blood. As the nurse you know the patient can
receive what type of blood? Select all that apply:

A. A-

B. O-

C. O+

D. A+

E. AB-
F. AB+

G. B+

The answers are A, B, C, and D. The patient must receive blood from either a donor
that has O or A blood. Since the patient is A+ (RH factor is positive), they can
receive both negative or positive blood.

4. A donor has AB- blood. Which patient or patients below can receive this type
of blood safely?

A. A patient with O- blood.

B. A patient with A- blood

C. A patient with B- blood

D. A patient with AB- blood.

The answer is D. Donors with AB type blood can only donate to others who have AB
type blood, in this case AB- blood. However, they are the universal recipients in that
they can receive blood for every blood type but can only donate to the same exact
blood type.

5. You’re educating a group of outpatients about ABO blood typing and

compatibility. Which statement is INCORRECT?

A. A person with B- blood can donate to people with either B- or AB- blood.

B. A person with B- blood can receive blood from donors with O- and B- blood.

C. A person with O- blood can donate to every blood type regardless of the RH
factor.

D. A person with AB+ blood can only donate to other people with either AB+ or AB-
blood.

The answer is D. This answer is incorrect. A person with AB+ can only donate to
another person with AB+ blood. Patients who are AB- can NOT receive AB+ blood
because of the Rh factor.

6. A person is O+. Select all the donor blood types this person could receive
blood from:

A. AB+

B. AB-
C. O+

D. O-

E. A-

F. A+

G. B-

H. B+

The answer is C and D. The patient is Rh factor positive so they can receive both Rh
negative or positive blood. However, O blood types can only receive blood from
other O types.

7. True or False: Agglutination can occur when Type A blood is given to a person
with Type O blood.

The answer is TRUE. A person with Type A blood can NOT donate to a person with
Type O blood. This would cause a blood transfusion reaction….hence agglutination.
Agglutination occurs when the same antigens found on the RBCs from the donor
come into contact with its corresponding antibody (found in the recipient’s plasma
surrounding the RBCs). In this scenario, the donor has Type A blood which has A
antigens on the RBC surface while the recipient has Type O blood type that contains
both A and B antibodies in the plasma. If the A antigens from the donor come into
contact with the A antibodies in the recipient’s blood it will cause an IMMUNE
RESPONSE….agglutination.

8. A 26 year old female is 27 weeks pregnant with her second child. The woman is
A-. As the nurse you know that:

A. If the patient was A+ she would need to receive RhoGAM.

B. The patient will need to receive RhoGAM during this visit to prevent hemolytic
disease of the newborn.

C. The baby will need to receive RhoGAM after it’s born.

D. Since the mother is A- the baby can be Rh positive, which could lead to an
immune attack on the mother’s body.

The answer is B. This is the only correct answer. Since the woman A- she will need
to receive the RhoGAM shot during 26 to 28 weeks.
9. True or False: Patients who are Rh positive can only receive Rh positive blood,
while patients who are Rh negative can only receive blood from donors who are Rh
negative.

 A. True

 B. False

The answer is FALSE. Rh positive patients can receive BOTH negative and positive
blood….while Rh negative patients can receive ONLY negative blood.

10. Your patient is scheduled for surgery and is ordered to be typed and
crossmatched. The lab result shows your patient has B- blood. What type of blood
can the patient receive during surgery, if needed?

 A. B-

 B. B+

 C. A-

 D. A+

 E. O+

 F. O-

 G. AB+

 H. AB-

The answers are A and F. The patient can only receive blood from donors who are
B- or O-. Remember since the patient is Rh negative they can only receive negative
factor blood.
Pernicious Anemia NCLEX Questions Quiz
This is a quiz that contains NCLEX review questions about pernicious
anemia. Patients who have pernicious anemia have low levels of red blood cells
caused by low vitamin B12 levels. This is due to an autoimmune condition causing
the patient to lack intrinsic factor.

In the previous NCLEX review series, I explained about other disorders you may be
asked about on the NCLEX exam, so be sure to check out those reviews and
quizzes as well.

As the nurse, it is important to know how to care for a patient with

pernicious anemia. In addition, the nurse needs to be aware of the causes, risk
factors, and management of pernicious anemia.

The NCLEX exam loves to ask questions about patient education and major signs
and symptoms about pernicious anemia.

This quiz will test you on:

 Pathophysiology of pernicious anemia

 Signs and Symptoms of pernicious anemia
 Nursing Interventions for pernicious anemia
 Patient Education

Pernicious Anemia NCLEX Quiz

This quiz will test you on pernicious anemia in preparation for the NCLEX exam.
1. You’re providing discharge teaching to a patient about pernicious anemia. Which
statement by the patient indicates they did NOT understand the discharge teaching?

 A. “Pernicious anemia is caused by not consuming enough Vitamin B12.”

 B. “Pernicious anemia causes the red blood cells to appear very large and
oval.”

 C. “Treatment for pernicious anemia includes a series of intramuscular

injections of Vitamin B12.”

 D. “A red, smooth tongue can be a sign of pernicious anemia.”

2. In pernicious anemia, intrinsic factor is not being secreted by the _______ cells
which are found in the gastric mucosa.

 A. Visceral
  B. Langerhan

 C. Parietal

 D. Chief

3. Select the patient below who is at MOST risk for pernicious anemia:

 A. A 75 year old male who recently had surgery on the ileum.

 B. A 25 year old female who reports craving ice and clay.

 C. A 66 year old male whose peripheral blood smear showed hypochromic

red blood cells.

 D. All the patients above are at risk for pernicious anemia.

4. A doctor suspects pernicious anemia in a patient presenting with a beefy red

tongue. The patient reports feeling extremely fatigued and numbness and tingling in
the hands. The doctor orders a peripheral blood smear. From your nursing
knowledge, how will the red blood cells appear in the peripheral blood smear if
pernicious anemia is present?

 A. Round-shaped and hypochromic

 B. Oval-shaped and hyperchromic

 C. Large and oval-shaped

 D. Small and hyperchromic

5. Select ALL the signs and symptoms that can present in pernicious anemia:

 Erythema

 B. Paresthesia of hands and feet

 C. Racing thoughts

 D. Extreme hunger

 E. Depression

 F. Unsteady gait

 G. Shortness of breath with activity

6. A patient with pernicious anemia is ordered to receive supplementary Vitamin
B12. What is the best route to administer this medication for patients with this
disorder?

 A. Intravenous

 B. Orally

 C. Through a central line

 D. Intramuscular

7. True or False: Intrinsic factor is a protein that plays a role in how the body absorbs
Vitamin B12.

 A. True

 B. False

8. A patient with severe pernicious anemia is being discharged home and requires
routine injections of Vitamin B12. Which statement by the patient demonstrates they
understood your instructions about their treatment regime?

 A. “I will require one injection every 6 months until my Vitamin B12 levels are
therapeutic and then I’m done.”

 B. “Initially, I will need weekly injections of Vitamin B12 and then monthly
injections for maintenance, which will be a lifelong regime.”

 C. “I will only need vitamin B12 injections for a month and then I can take a
low dose of oral vitamin B12.”

 D. “When I start to feel weak and short of breath I need to call the doctor so I
can schedule an appointment for a Vitamin B12 injection.”

Answer Key:

1. A
2. C
3. A
4. C
5. B, E, F, G
6. D
7. True
8. B