Hematologic Disorders NCLEX Questions
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Question 1 of 5.
The client has a blood type of B negative. The client's family asks if they can donate blood for the client. The nurse informs the family that they would need to be of which blood type to be considered for a directed donation of RBCs for this client?
A. Type A positive
B. Type B positive
C. Type B negative
D. Type O positive
E. Type O negative
F. Type AB positive
Explanation: Blood type A positive has the D antigen on the RBC, making it incompatible with blood type B negative. B. Blood type B positive has the D antigen on the RBC, making it incompatible with blood type B negative. C. The client with B negative blood type has B antigen on the RBC and does not have an Rh (or D) antigen on the cell. Because the client can receive RBCs of the same blood type, a person with type B negative blood could be considered for a directed donation. D. Blood type O positive has the D antigen, making it incompatible with blood type B negative. E. Type O negative has no antigens on the RBC so a directed donation from a person with type O negative blood could also be considered. F. Blood type AB positive has the D antigen on the RBC, making it incompatible with blood type B negative.
Question 2 of 5.
The nurse is assessing a client diagnosed with acute myeloid leukemia. Which assessment data support this diagnosis?
A. Fever and infections.
B. Nausea and vomiting.
C. Excessive energy and high platelet counts.
D. Cervical lymph node enlargement and positive acid-fast bacillus.
Explanation: AML causes neutropenia, leading to fever/infections (A). Nausea (B) is nonspecific, high platelets/energy (C) are incorrect (AML causes thrombocytopenia/fatigue), and acid-fast bacillus (D) indicates TB, not AML.
Question 3 of 5.
The laboratory results for a male client diagnosed with leukemia include RBC count 2.1 x 106/mm3, WBC count 150 x 103/mm3, platelets 22 x 103/mm3, K+ 3.8 mEq/L, and Na+ 139 mEq/L. Based on these results, which intervention should the nurse teach the client?
A. Encourage the client to eat foods high in iron.
B. Instruct the client to use an electric razor when shaving.
C. Discuss the importance of limiting sodium in the diet.
D. Instruct the family to limit visits to once a week.
Explanation: Low platelets (22,000) increase bleeding risk; an electric razor (B) prevents cuts. Iron (A) is for anemia, sodium (C) is normal (139), and limiting visits (D) is excessive.
Question 4 of 5.
The client asks the nurse, 'They say I have cancer. How can they tell if I have Hodgkin's disease from a biopsy?' The nurse's answer is based on which scientific rationale?
A. Biopsies are nuclear medicine scans that can detect cancer.
B. A biopsy is a laboratory test that detects cancer cells.
C. It determines which kind of cancer the client has.
D. The HCP takes a small piece out of the tumor and looks at the cells.
Explanation: A biopsy identifies Hodgkin's via Reed-Sternberg cells (C). It's not a scan (A), not just a lab test (B), and involves microscopic cell analysis (D is partial but less precise).
Question 5 of 5.
Which client should be assigned to the experienced medical-surgical nurse who is in the first week of orientation to the oncology floor?
A. The client diagnosed with non-Hodgkin's lymphoma who is having daily radiation treatments.
B. The client diagnosed with Hodgkin's disease who is receiving combination chemotherapy.
C. The client diagnosed with leukemia who has petechiae covering both anterior and posterior body surfaces.
D. The client diagnosed with diffuse histolytic lymphoma who is to receive two (2) units of packed red blood cells.
Explanation: Leukemia with extensive petechiae (C) indicates severe thrombocytopenia, requiring experienced assessment for bleeding. Radiation (A), chemotherapy (B), and transfusions (D) are less complex.
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