Hematology NCLEX Questions
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Question 1 of 5.
In which order should the nurse address the assessment findings for the client who has undergone a total laryngectomy? Place the findings in the order of priority.
Explanation: . Restless and has a mucus plug in the tracheostomy is priority requiring immediate attention due to the negative impact on air exchange. The client needs immediate suctioning. A. Copious oral secretions and nasal mucus draining from the nose should be next. After a total laryngectomy the mouth does not communicate with the trachea, so copious oral secretions and nasal drainage would not influence air exchange, but these create a source of discomfort for the client. D. Oozing serosanguineous drainage around the tracheostomy tube and saturated dressing should be addressed third. Changing the dressing now would allow the nurse to inspect the site and ensure tube patency. C. NG tube used for intermittent feedings pulled halfway out can be addressed last. There is no indication that a tube feeding is infusing. The HCP should be contacted to reinsert the NG tube to prevent disruption of the suture line in the esophagus.
Question 2 of 5.
The nurse is caring for clients on an oncology unit. Which neutropenia precautions should be implemented?
A. Hold all venipuncture sites for at least five (5) minutes.
B. Limit fresh fruits and flowers.
C. Place all clients in reverse isolation.
D. Have the clients use a soft-bristle toothbrush.
Explanation: Neutropenia increases infection risk; limiting fresh fruits/flowers (B) reduces microbial exposure. Holding venipuncture (A) prevents bleeding, reverse isolation (C) is excessive, and soft toothbrushes (D) prevent gum trauma but are secondary.
Question 3 of 5.
Which medication is contraindicated for a client diagnosed with leukemia?
A. Bactrim, a sulfa antibiotic.
B. Morphine, a narcotic analgesic.
C. Epogen, a biologic response modifier.
D. Gleevec, a genetic blocking agent.
Explanation: Epogen (C) stimulates RBC production, risky in leukemia due to blast proliferation. Bactrim (A) treats infections, morphine (B) manages pain, and Gleevec (D) targets CML.
Question 4 of 5.
The client diagnosed with non-Hodgkin's lymphoma is scheduled for a lymphangiogram. Which information should the nurse teach?
A. The scan will identify any malignancy in the vascular system.
B. Radiopaque dye will be injected between the toes.
C. The test will be done similar to a cardiac angiogram.
D. The test will be completed in about five (5) minutes.
Explanation: Lymphangiogram involves dye injection between toes (B) to visualize lymphatics. It's not vascular (A), unlike cardiac angiogram (C), and takes longer than 5 minutes (D).
Question 5 of 5.
Which test is considered diagnostic for Hodgkin's lymphoma?
A. A magnetic resonance image (MRI) of the chest.
B. A computed tomography (CT) scan of the cervical area.
C. An erythrocyte sedimentation rate (ESR).
D. A biopsy of the cervical lymph nodes.
Explanation: Lymph node biopsy (D) diagnoses Hodgkin's via Reed-Sternberg cells. MRI/CT (A, B) stage disease, ESR (C) is nonspecific.