PCCN PCCN Hematology and Immunology 1

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

A platelet count below 20,000/mm³ carries a high risk of spontaneous bleeding, requiring immediate bleeding precautions.

Question 2

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

Accepted Answer

Low fibrinogen and elevated D-dimer

Answer

DIC is characterized by consumption of clotting factors and fibrinogen, along with elevated D-dimer from fibrinolysis.

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

Signs of a hemolytic transfusion reaction require immediate cessation of the transfusion to prevent life-threatening complications.

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

Acute chest syndrome is diagnosed by a new pulmonary infiltrate on imaging combined with respiratory symptoms such as hypoxia.

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

Febrile neutropenia is a medical emergency; blood cultures must be obtained and broad-spectrum antibiotics started promptly.

PCCN Exam Practice Test