Hematology NCLEX Questions
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Question 1 of 5.
The client diagnosed with von Willebrand's disease calls a clinic after experiencing hemarthrosis. The client states that factor concentrate is infusing. Which intervention should the nurse recommend now?
A. “Take two 325-mg aspirin tablets every 4 hours for pain.â€
B. “Apply a cold pack to the area for 30 minutes every 1 to 2 hours.â€
C. “Come to the clinic; you need an infusion of fresh frozen plasma.â€
D. “If wearing a splint, remove it to avoid compartment syndrome.â€
Explanation: A. Aspirin (Ecotrin) and NSAIDs are contraindicated because they interfere with platelet aggregation. B. Hemarthrosis is bleeding into the joint. The pressure of the ice pack and cold will reduce the bleeding and swelling. The ice pack should be covered with a cloth. C. The client and family are usually taught how to administer factor concentrates at home at the first sign of bleeding. D. The splint should be left on initially to control bleeding. The client should be instructed on how to assess for adequate tissue perfusion.
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.