Hematologic System NCLEX Questions
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Question 1 of 5.
The client diagnosed with sickle cell anemia is experiencing a vaso-occlusive sickle cell crisis secondary to an infection. Which medical treatment should the nurse anticipate the HCP ordering for the client?
A. Administer meperidine (Demerol) intravenously.
B. Admit the client to a private room and keep in reverse isolation.
C. Infuse D5W 0.33% NS at 150 mL/hr via pump.
D. Insert a 22-French Foley catheter with a urimeter.
Explanation: Hydration with IV fluids (C) prevents sickling in vaso-occlusive crisis. Meperidine (A) is avoided (risks seizures), isolation (B) is excessive, and Foley (D) is unnecessary.
Question 2 of 5.
The client diagnosed with leukemia is scheduled for bone marrow transplantation. Which interventions should be implemented to prepare the client for this procedure? Select all that apply.
A. Administer high-dose chemotherapy.
B. Teach the client about autologous transfusions.
C. Have the family members' HLA typed.
D. Monitor the complete blood cell count daily.
E. Provide central line care per protocol.
Explanation: High-dose chemotherapy (A) ablates marrow, HLA typing (C) identifies donors, CBC monitoring (D) tracks counts, and central line care (E) prevents infection. Autologous transfusions (B) are irrelevant (donor marrow used).
Question 3 of 5.
The nurse and the licensed practical nurse (LPN) are caring for clients on an oncology floor. Which client should not be assigned to the LPN?
A. The client newly diagnosed with chronic lymphocytic leukemia.
B. The client who is four (4) hours postprocedure bone marrow biopsy.
C. The client who received two (2) units of (PRBCs) on the previous shift.
D. The client who is receiving multiple intravenous piggyback medications.
Explanation: IV piggyback medications (D) require complex assessment (e.g., chemotherapy), beyond LPN scope. New diagnosis (A), post-biopsy (B), and post-transfusion (C) are stable for LPN care.
Question 4 of 5.
Which client is at highest risk for developing a lymphoma?
A. The client diagnosed with chronic lung disease who is taking a steroid.
B. The client diagnosed with breast cancer who has extensive lymph involvement.
C. The client who received a kidney transplant several years ago.
D. The client who has had ureteral stent placements for a neurogenic bladder.
Explanation: Immunosuppression post-transplant (C) increases lymphoma risk (e.g., PTLD). Steroids (A) are lower risk, breast cancer (B) involves metastasis, and stents (D) are unrelated.
Question 5 of 5.
Which clinical manifestation of Stage I non-Hodgkin's lymphoma would the nurse expect to find when assessing the client?
A. Enlarged lymph tissue anywhere in the body.
B. Tender left upper quadrant.
C. No symptom in this stage.
D. Elevated B-cell lymphocytes on the CBC.
Explanation: Stage I NHL is often asymptomatic (C), with localized node involvement. Enlarged nodes (A) are later, LUQ tenderness (B) suggests spleen, and B-cell elevation (D) is lab-based, not clinical.
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