PCCN PCCN Hematology and Immunology

Question 1

A progressive care patient has a platelet count of 18,000/mm³. Which intervention is the highest priority?

Accepted Answer

Initiate bleeding precautions

Answer

Administer aspirin for pain

Answer

Encourage ambulation

Answer

Apply compression stockings

Question 2

Which laboratory finding is most consistent with disseminated intravascular coagulation (DIC)?

Accepted Answer

Low fibrinogen and elevated D-dimer

Answer

Elevated fibrinogen and low D-dimer

Answer

Elevated platelets and normal PT

Answer

Normal PTT and low INR

Question 3

A patient receiving a blood transfusion develops fever, chills, and flank pain 15 minutes after initiation. What is the nurse's first action?

Accepted Answer

Stop the transfusion immediately

Answer

Slow the transfusion rate

Answer

Administer acetaminophen

Answer

Obtain a repeat type and crossmatch

Question 4

Which finding indicates a patient with sickle cell crisis is developing acute chest syndrome?

Accepted Answer

New infiltrate on chest X-ray with hypoxia

Answer

Hemoglobin of 10 g/dL

Answer

WBC of 12,000/mm³

Answer

Pain localized to the lower back

Question 5

A patient with neutropenia (ANC < 500) develops a temperature of 38.5°C. The nurse should anticipate which intervention first?

Accepted Answer

Blood cultures and broad-spectrum antibiotics

Answer

Oral antipyretics only

Answer

Isolation and observation for 24 hours

Answer

Antifungal prophylaxis

Question 6

Which blood product is most appropriate for a patient with hemophilia A experiencing an acute bleed?

Accepted Answer

Cryoprecipitate or Factor VIII concentrate

Answer

Packed red blood cells

Answer

Platelets

Answer

Fresh frozen plasma