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NURSING*RADTECH*DENTISTRY*CRIMINOLOGY*MIDWIFERY*MEDTEC

H LET*PSYCHOMET*RESPIRATORY THERAPY*CIVIL SERVICE*NAPOLCOM


NCLEX*DHA*HAAD* PROMETRIC* UK-CBT

FINAL COACHING EXAMINATION HEMATOLOGY Prepared by: Prof; Rene Jesus


Dinglasan, RMT,MSMT, 5th Placer Philippine Medical Technologist Licensure
Examination

NAME:

1. Of the following tests listed below, which one must be drawn first? a. ASAP b. STAT c.
Timed d. Fasting

2. Which of the findings below will be helpful in differentiating folate deficiency from
vitamin B 12 deficiency? 1. Hypersegmented neutrophils 2. Anisocytosis 3. Hemoglobin
level 4. Mean cell volume (MCV) 5. holoTC assay a. 1, 2, 3, 4, and 5 c. 3 and 5 b. 1, 2, 3,
and 4 d. 5 only

holoTC assay = vit b12 – transcobalamin complex = is the metabolic active form of
vitamin b 12 Transcobalamin = Prev. known as Transcobalamin II

3. A blood smear is viewed through the microscope. In there, the erythrocytes appear
redder than normal, the neutrophils are barely visible, and the eosinophils are bright
orange. What is the most probable cause? a. The slide was not stained. b. The stain was
too alkaline. c. The slide was not rinsed sufficiently. d. The buffer was too acidic.

4. The morphology of red cells that one would typically find in the blood smear of Sickle
Cell Disease patients is: a. Microcytic, hypochromic c. Macrocytic, normochromic b.
Normocytic, normochromic d. Any of these

5. All deficiencies of coagulation factors are transmitted as autosomal recessive with the
exceptions of: a. Factor VIII deficiency b. Factor IX deficiency

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c. Both A and B d. Neither A nor B


6. While you are preparing the materials for blood extraction, the patient asked you
what information will the requested blood tests give his physician. What must you do?

a. Tell the patient something about the weather or the celebrity you have a crush on. b.
Enlighten the patient about the purpose of the tests using simple terms so that he can
understand. c. Tell the patient to shut up. d. Tell the patient that he can ask his physician
about this question and politely explain that this is the protocol.

7. Which of the following RBC anomalies is detectable ONLY by examination of a blood


smear? a. Hypochromia = MCHC, PBS, etc b. Microcytosis = MCV, Hct , PBS, etc c.
Anisocytosis = PBS, MCV , RDW , RBC histogram d. Poikilocytosis 8. If you are to obtain
blood from an arm on the same side as a mastectomy, physician permission is required
because: 1. The possibility of infection is higher 2. Lymphostasis may adversely affect lab
test results 3. Tourniquet application may cause injury a. 1,2, and 3 b. 2 only c. 2 and 3 d.
1 and 2

9. An erythrocyte containing eosinophilic stippling(A.K.A Schuffner’s dots) may be


encountered in: a. Plumbism b. Thalassemia c. Malarial infection d. All of these

10. Identify the inner nuclear membrane protein that plays a major role in leukocyte
nuclear shape changes that occur during normal maturation.

a. Lamin β-receptor c. NETs b. Transcobalamin I d. MBP

11. Hypersegmented neutrophils are expected in all of the following cases, except: a.
Myelokathexis c. Mycoplasma pneumoniae infections b. Vitamin B12 deficiency d. Folate
deficiency

12. All of the choices below may be demonstrated with the use of Wright’s stain, except:
a. Cabot rings b. Basophilic stippling c. Pappenheimer bodies d. Hb H inclusion bodies

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13. In the microhematocrit procedure, one should seal the tubes at the:a. End of the
tube without the colored ring c. Either a or bb. End of the tube with the colored ring d.
Middle part of the tube
14. It is almost 1:00 in the morning when you arrived at the patient’s room and he is
already deeplyasleep. You need to draw a timed blood specimen from him. How must
you proceed? a. Do notwake him up and proceed with the blood collection quietly.b.
Softly wake the patient up before proceeding with the blood collection.c. Make a loud
noise while calling out the patient’s name.d. Inform the physician or the nurse that you
will come back later when the patient is already awake.

15. Reticulum cell sarcoma is the solid tumor counterpart of the:a. Monocytic leukemia
c. CLLb. ALL d. Plasma cell leukemia

16. Identify the drug that is most frequently implicated in acquired aplastic anemia.a.
Amidopyrine c. Cephalosporinb. Phenacetin d. Chloramphenicol

17. If a person’s genotype is β+ / β+, the kind of beta thalassemia that he has is:a. β-
thalassemia trait c. Hb Bart hydrops fetalis syndromeb. Cooley’s anemia d. Hb H disease

18. Burr cells are found in large numbers in which of the following conditions? a. Liver
disease c. Erythroblastosis fetalis b. Uremia d. Leukemia

19. The most common glycolytic enzyme deficiency associated with the aerobic pathway
of RBC metabolism is:a. Pyruvate kinaseb. Methemoglobin reductase deficiencyc.
Hexokinase deficiencyd. Glucose-6-phosphate dehydrogenase (G6PD)

20. In which stage of erythrocytic maturation does hemoglobin formation begin? a.


Reticulocyteb. Pronormoblastc. Basophilic normoblastd. Polychromatic normoblast

21. Which of the following test results is expectedly abnormal in Christmas disease?a.
Platelet count c. Prothrombin time (PT)3 TOPRANK REVIEW ACADEMY
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b. Tourniquet test d. Activated partial thromboplastin time (APTT)

22. You are asked to draw venous blood samples from a patient using ETS (evacuated
tube system). Afterapplying the tourniquet onto the arm and cleansing the site, you
inserted the needle into the antecubital fossa.When should you remove the tourniquet?
a. Once the first tube has been filled completely.b. Immediately after the first tube starts
to fill.c. Once the last tube has been filled completely.d. Once the needle has been
completely removed from the antecubital fossa.
23. The medical technologist stained a blood smear. He then held it up to the light and
noticed that thesmear is bluer than normal. What abnormality may be expected on this
smear?

a. Leptocytes c. Rouleauxb. Lymphocytosis d. Sickle cells

24. The most common clinical application of flow cytometry is:a. Diagnosis of Sickle Cell
Diseaseb. Detection of fetomaternal hemorrhagec. Diagnosis of leukemias and
lymphomasd. Differentiation of anemias

25. The coagulation factors that require vitamin K for their production include all of
these, except:a. Stuart factor c. Fibrinogenb. Factor IX d. Proconvertin

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26. All of the following findings suggest thalassemia, except:a. Florid complexion c.
Skeletal deformitiesb. Jaundice d. Splenomegaly

27. If Hb S is present in the patient’s sample, his specimen will demonstrate this result in
the sodium dithionitetube test: ( AKA SOLUBILITY TEST )a. Sickle cells or “holly leaf” cells
under the microscopeb. Black lines on the reader scale: visible through the solution =c.
Black lines on the reader scale: not visible through the solutiond. Slightly crenated or
RBCs with normal shape under the microscope

28. In the granulocytic series of maturation, what is the last stage to undergo mitosis?a.
Myeloblast b. Promyelocyte c. Myelocyte d. Metamyelocyte

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29. Statement 1: EDTA causes swelling of platelets (causes approximately 10%[20%]


increase in MPVduring the first hour) Statement 2: MPV should be based on EDTA
specimens that are between 1 to 4 hours old

a. Statement 1 is true; statement 2 is false c. Statement 1 and 2 are both true.b.


Statement 1 is false; statement 2 is true d. Statement 1 and 2 are both false.
30. The first factor to be affected by warfarin is:a. Factor V c. Factor VIIIb. Factor VII d.
Factor IX

31. Which of the tests below will be most helpful in distinguishing IDA from ACI?1. TIBC
3. Serum ferritin2. FEP 4. Serum irona. 1, 2, 3, and 4 b. 1 and 3 c. 2 and 4 d. 1, 2 and 3

32. The reversal of UFH (unfractionated heparin) overdose is done using protamine
sulfate. It is described as acationic protein extracted from:a. Porcine mucosa c. Moldy
sweet cloverb. Salmon sperm d. Green tea

33. The critical value for reticulocyte counts (adults):a. 0.8% b. 5.80% c. 7.8% d. Greater
than 20%

34. Which of the following is considered as the storage site for vWF in the blood vessel
cells?a. Platelet alpha granules c. Both A and Bb. Weibel-Palade bodies d. Neither A nor
B

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35. RBC basophilic stippling may be found in which of the following conditions? 1.
Pyrimidine-5’-Nucleotidase (PN) Deficiency 2. Thalassemia 3. Lead poisoninga. 1 and 3
b. 1, 2, and 3 c. 2 and 3 d. 3 only

36. These are specialized types of capillaries found in locations such as the bone
marrow, spleen andliver:a. Sinusoids c. Arteriolesb. Venules d. None of these

37. Prostacyclin, also known as Prostaglandin I2, inhibits thrombocyte activation and is
generated by the: a. Eicosanoid pathway in plateletsb. Eicosanoid pathway in endothelial
cellsc. Both A and Bd. Inositol Triphosphate-Diacylglycerol (IP3-DAG) pathway

38. A normal (wedge) blood film must reveal approximately:a. 7 to 21 platelets per 10x
field c. 2 to 6 platelets per 100x fieldb. 2 to 6 platelets per 40x field d. 7 to 21 platelets
per 100x field

39. The ultrastructure of the platelets is being studied using:1. Electron microscopy 2.
Flow cytometry 3. Molecular sequencinga. 1 only b. 1 and 2 c. 2 and 3 d. 1, 2 and 3
40. For this number, refer to the following case:The following data were obtained from a
23-year-old Filipino female who is currently admittedin a public hospital. ●WBC count =
13,900/mm3 ●Differential count:Neutro: 71%Lympho: 25%Eosinophils: 2%Monocytes:
2%

In the case given above, there is:1. Absolute lymphocytosis 3. Absolute neutrophilia 5.
Absolute eosinophilia2. Relative eosinophilia 4. Absolute monocytopenia 6. Relative
neutrophiliaa. 1,3,5 b. 1,2,3 c. 3 and 5 d. 3 and 6

41. The most common cause of clinically important bleeding is:a. Platelet count of less
than 100,000/µL c. Scurvyb. Platelet count of less than 50,000/µL d. Chronic
myelogenous leukemia

42. The surface-connected canalicular system (SCCS) is the route for:1. secretion of
dense granule contents 3. endocytosis7 TOPRANK REVIEW ACADEMY
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2. secretion of α-granule contents 4. secretion of lysosome contentsa. 1 and 2 b. 1, 2,


and 4 c. 2, 3, and 4 d. 1, 2, 3 and 4

43. All of these statements are true for the eosinophils, except:a. It stores and transports
plasminogen.b. Moderate to severe eosinophilia is observed in helminthic infections.c. It
is classified as a phagocyte.d. None of the above.

44. Which of the following is considered as the earliest marker of erythroid


differentiation?a. CD 8 b. CD 34 c. CD 71 d. CD 41

45. Faggot cells are most commonly encountered in:a. Acute promyelocytic leukemia c.
Chronic myelogenous leukemiab. Acute myelomonocytic leukemia d. Acute
erythroleukemia

46. A blood smear that shows holes all over the film may mean that the patient’s
specimen has:a. Increased protein levels c. Increased lipid levelsb. Markedly increased
WBC counts and platelet counts d. All of these

47. Identify from the choices below which one serves as the platelet receptor
forepinephrine(AKA ADRENALINE).

a. PAR 1 c. IPb. PAR 4 d. α2-adrenergic


48. Which of the following may be used as a buffer in the staining of peripheral blood
films?1. Methanol 4. Tap water placed in a glass bottle for at least 24 hours2. Sodium
phosphate 5. Distilled water placed in a glass bottle for 26 hours already3. Methylene
blue 6. Distilled water placed in a glass bottle for at least 12 hoursa. 1 and 3 b. 2 and 4 c.
2 and 5 d. 1, 3, 5

49. Which of the following appear as the first markers of megakaryocytic differentiation?
1. CD71 2. CD41 3. CD45 4. CD61a. 1 and 2 b. 2 and 4 c. 2 and 3 d. 2, 3, and 4

50. The largest molecule in the human plasma is:a. HMWK b. Factor V c. Fibrinogen d.
VWF

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51. Which of the following enzymes regulates the size of circulating VWF by cleaving
ultra-long VWFmultimers (ULVWF) into shorter segments?

a. Fibrinolysin b. TAFI c. ADAMTS-13 d. Plasmin

52. To properly mix the blood and the anticoagulant in the light blue top tube, the
medtech must invertthe tube:a. Five to eight times c. Eight timesb. Three to four times d.
Twice

53. The cyclooxygenase of the eosinophils is found in the:a. Lipid bodies c. Secondary
granulesb. Small lysosomal granules d. Primary granules

54. All of the following abnormalities are expected in a Fanconi anemia patient, except:a.
Skeletal abnormalities like thumb malformationsb. Tall staturec. Cancer susceptibilityd.
Skin pigmentation

55. Which of the following machines is used for ESR determination?a. VES-MATIC 20
Instrument c. Abbott CELL-DYN Sapphireb. Sysmex R-3500 d. HemoCue

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56. Which of the tests below will be helpful in distinguishing IDA from Thalassemias? 3.
1. TIBC Serum ferritin 4. 2. FEP Serum iron a. 1, 2, 3, and 4 b. 1 and 3 c. 2 and 4 d. 1, 2
and 3

57. A patient’s sample showed the following test results: abnormal PT, abnormal APTT
and normal TT. These results may be found in: 1. Afibrinogenemia 3. Administration of
Coumadin

2. Deficiency of Factor II 4. Deficiency of Factor V a. 1,2,3 b. 2,3,4 c. 1 and 2 d. 1 and

58. Which of the following descriptions is/are true for the fibrinogen group of
coagulation factors? 1. Present in serum 3. Adsorbed by barium sulfate 2. NOT vitamin K
dependent 4. Acute phase reactants a. 1 and 3 b. 1 ,2, and 3 c. 2 and 4 d. 2 only

59. Which of the following components of the platelet dense granules supports
neighboring platelet aggregation by binding to P2Y1 and P2Y12? a. ADP b. Histamine c.
Epinephrine d. ATP

60. The four globin chains present in Hemoglobin A1 are: a. 2 pairs of alpha, 2 pairs of
beta c. 1 pair of alpha, 1 pair of beta b. Two pairs of beta d. 1 pair of alpha

61. Which of the following conditions will produce a falsely increased WBC count? a.
Presence of lysis-resistant RBCs containing abnormal hemoglobins b. Increased numbers
of nucleated RBCs c. Both A and B d. Lipemia

62. What is the correct order of draw for the skin puncture procedure? a. EDTA
microcollection tube→Serum microcollection tube→ Other microcollection tubes with
anticoagulants→ Slides →Tube for blood gas analysis b. Tube for blood gas analysis→
Slides→ EDTA microcollection tube→ Other microcollection tubes with anticoagulants→
Serum microcollection tube c. EDTA microcollection tube →Other microcollection tubes
with anticoagulants→Serum microcollection tube→ Slides→Tube for blood gas analysis
d. Tube for blood gas analysis → EDTA microcollection tube→ Other

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microcollection tubes with anticoagulants→Serum microcollection tube→Slides


63. All of these globin chains are composed of 141 amino acids, except:1. Alpha 2. Beta
3. Delta 4. Gamma 5. Zetaa. 1 and 5 b. 2, 3 and 4 c. 1 and 2 d. 1,2, and 3 e. 5 only

64. All of the following situations will produce an increased ESR result, except:a. Placing
the ESR tubes on a table where, currently, a medical technologist is busy writing down
laboratory results.b. Placing the ESR tubes inside a bacteriology incubator which is
currently in use.c. A specimen coming from a pregnant patient.d. An EDTA blood
specimen that was not properly inverted immediately after blood collection.

65. It is the enzyme involved in the breakdown of ribosomal ribonucleic acid (RNA) in
reticulocytes:a. Pyrimidine 5’-nucleotidase c. Ferrochelataseb. Uroporphyrinogen
synthase d. Heme synthetase

●For nos. 66 to 70, shade or type A if the scenario may cause a SHORTENED coagulation
test result; shade or type B ifthe scenario may cause a PROLONGED coagulation test
result.66. After collecting the specimen, the technologist immediately inverted the tube
four times. He placed the blood collection tube in the phlebotomy transport box.
However, he did not use the tray and allowed the tube to lie down inside the box. He
then carried the transport box containing the specimen to the laboratory. A

67. After inserting the needle into the arm of the patient, the phlebotomist found out
that he did not hit the vein. He then tried to search the vein while the needle was still
inside the arm. A

68. After collecting the specimen, the technologist immediately inverted the tube twice.
B

69. The patient’s skin was still wet with 70% alcohol when the phlebotomist inserted the
needle into the arm and collected the needed blood specimen. A

70. The phlebotomist was not able to collect the right volume of blood for the
coagulation test. The required volume to be placed in the light blue top is 5 mL but he
was only able to get 2 mL of blood. B

71. The process of replacing the active marrow by adipose tissue during development is
called:

a. Retrogression c. Extramedullary hematopoiesisb. Progression d. None of these

72. The most common forms of BSS (Bernard-Soulier syndrome) involve defects in:
a. GP Ibα synthesis or expressionb. GP V synthesis or expressionc. GP Ibβ synthesis or
expressiond. GP IX synthesis or expression

73. Which of the following statements regarding the yellow marrow are correct?1. It is
mostly adipose tissue.2. It is hematopoietically active.3. During abnormal demand, it
may be changed to red marrow.4. It is found primarily in the bones of the newborn.

a. 1 and 3 c. 1, 2, and 3

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b. 1 and 4 d. 4 only74. These cells are the most abundant type of cell in the body:a. Red
blood cells b. Macrophages c. Skin cells d. Lymphocytes75. A blood test is requested for
a patient and so you went to the patient’s room right away. Upon arrival, you found
outthat he and his physician are currently having a discussion. In what situation would it
be proper to interrupt theirconversation?a. If the blood to be collected is a timed
sample.b. If the blood to be collected is a STAT sample.c. Both A and Bd. None of the
choices. In any given situation, the phlebotomist must never interrupt the conversation
between the physician and the patient.

76. The appropriate name for inorganic iron granules within RBCs on a Wright-stained
blood smear is:a. Siderotic granules c. Howell-Jolly bodiesb. Pappenheimer bodies d.
Heinz bodies

77. What component of the coagulation cascade is a strong stimulus to the activation of
the platelets?a. Factor Va b. Thrombin c. Factor XIIIa d. Prostacyclin

78. Which of the following is described as an autosomal recessive disorder with


oculocutaneous albinism andnormal platelet count?a. Hermansky-Pudlak c. Wiskott-
Aldrichb. Chediak-Higashi d. Thrombocytopenia with absent radius

79. Which of the patients below will most likely demonstrate an increased ESR result?1.
A male patient with a hematocrit of 20%2. A patient with megaloblastic anemia3. A
patient with hereditary spherocytosis4. A patient with PRV (polycythemia rubra vera)a. 1,
2, 3 and 4 b. 3 and 4 c. 1 and 2 d. 1 and 3
80. In the first trimester of gestation, the hemoglobins that are normally present are
the:1. Hb A1 4. Gower 22. Gower 1 5. Hb A2 3. Hb F 6. Portlanda. 2, 3, 4, and 6 b. 2, 4
and 6 c. 1, 2, 3 and 4 d. 1, 2, 3, 4, 5, and 6

81. Which of the following is described as an autosomal recessive disorder with no


albinism and normalplatelet count?a. Hermansky-Pudlak c. Wiskott-Aldrichb. Chediak-
Higashi d. Thrombocytopenia with absent radius

82. Hemolytic Uremic Syndrome (HUS) is characterized by all of the following, except:1.
Kidney failure 3. Helmet cells2. Mucocutaneous hemorrhage 4. Elevated platelet counta.
1, 2, and 3 b. 1 and 3 c. 3 and 4 d. 4 only

83. It is reported that the patient’s hematocrit is 0.52 L/L and his RBC count is 5.8 x
1012/L. What will be theexpected MCV of this patient?a. 86.95 fL b. 0.8966 fL c. 89.66 fL
d. 90.21 fL12 TOPRANK REVIEW ACADEMY
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84. Which of the following tubes contain gel?a. Royal blue top b. Pink top c. White top
d. Light blue top

85. Calculate the WBC count estimate if you were able to observe the following numbers
of leukocytes in 10fields (using 40x high-dry objective): 13, 12, 12, 15, 11, 12, 11, 11, 10
and 13.a. 48, 000/µL c. 24, 000/µLb. 12, 000/µL d. 36, 000/µL

86. From the choices below, identify which one has no nucleus. 1. Basophilic normoblast
2. Polychromatophilic normoblast 3. Orthochromatic normoblast a. 3 only b. 1 and 2 c. 2
and 3 d. None of the choices87. Morula cells are an expected finding in:a. Plasma cell
myeloma c. Chediak-Higashi syndromeb. Hurler syndrome d. Hairy cell leukemia

88. Calculate the WBC count estimate if you were able to observe the following numbers
of leukocytes in 10fields (using 50x oil immersion objective): 7, 8, 9, 10, 8, 10, 9, 10, 10
and 9.a. 18, 000/µL c. 24, 000/µLb. 45,000/µL d. 27, 000/µL

89. After you have correctly confirmed an unconscious patient’s identity, you are now
about to performvenipuncture on him. Which of the following is the appropriate
approach in the performance of your task?

a. Communicate to this unconscious patient each step of the process.b. Start the
venipuncture procedure without disturbing the patient. Do not talk to the patient.c. Call
a nurse to document consent and witness the venipuncture procedure.d. Tap the
patient’s venipuncture site forcefully so that he will be aware of the procedure.

90. Which of the following statements is false concerning the fibrinogen?a. It is the most
concentrated of all the plasma procoagulants.b. It is essential for platelet aggregation.c.
Platelet dense granules absorb, transport and release abundant fibrinogen.d. d. None of
the above

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91. The patient demonstrated a prolonged PT result together with a normal APTT result.
This patient most likely has: a. Factor VII deficiency c. Factor VIII deficiency b. Factor XIII
deficiency d. Christmas disease

92. Which of the following statements is false concerning the DTS (dense tubular
system)? a. It is parallel and closely aligned to the SCCS. b. It sequesters lithium. c. It
bears a series of enzymes that support platelet activation. d. It is considered as the
“control center” for platelet activation.

93. In Owren’s disease , the results in the patient’s coagulation tests will be: a. PT:
normal, APTT: prolonged b. PT: prolonged, APTT: prolonged c. PT: prolonged, APTT:
normal d. PT: normal, APTT: normal

94. Dietary deficiency of vitamin B12 is infrequent. However, this condition is possible
for: a. People who do NOT eat vegetables c. HIV-positive individuals b. Strict vegetarians
d. People who avoid sunlight95. Which of the following types of myeloblasts is rare in
normal marrows, but can be seen in certain types of acute myeloid leukemias? a. Type I
myeloblast c. Type III myeloblasts b. Type II myeloblast d. None of these

96. In the Solubility Test for detecting Hb S, the one that causes the lysis of erythrocytes
in the sample is:a. Sodium dithionite c. Saponinb. Sodium metabisulfite d. Potassium
cyanide

97. You are now about to process a blood specimen taken from a patient who has just
been transfused withRBCs because according to his physician, he is demonstrating
severe anemia. What will be the expected RBChistogram and RDW results of this
patient?
a. RBC histogram will demonstrate a shift to the left and the RDW will be above normal
range.b. RBC histogram will demonstrate a bimodal curve and the RDW will be within
normal range.c. RBC histogram will demonstrate a shift to the right and the RDW will be
above normal range.d. RBC histogram will demonstrate a bimodal curve and the RDW
will be above normal range.

98. While trying to determine the patient’s leukocyte differential count, you were able to
observe 16 nucleatedred cells in the blood film. If the patient’s initial WBC count is
24,530/µL, the corrected WBC count will be:a. 21, 146.55/µL c. 21, 100/µLb. 153,
312.50/µL d. 211.47/µL

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NCLEX*DHA*HAAD* PROMETRIC* UK-CBT

99. Through what manner will the LMWH be administered to patients? a. Subcutaneous
injection b. Oral c. Rectal d. Either A or B

100. Consumption coagulopathy may be associated with:1. Abruptio placenta2. Malaria


infection3. Gram negative septicemia4. AML M3a. 1, 2, and 3 c. 1, 2, 3 and 4b. 2, 3 and 4
d. 3 and 4

15 TOPRANK REVIEW ACADEMY


NURSING*RADTECH*DENTISTRY*CRIMINOLOGY*MIDWIFERY*MEDTEC H
LET*PSYCHOMET*RESPIRATORY THERAPY*CIVIL SERVICE*NAPOLCOM
NCLEX*DHA*HAAD* PROMETRIC* UK-CBT

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