Hematology NCLEX
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Question 1 of 5.
The male client with sickle cell anemia comes to the emergency department with a temperature of 101.4°F and tells the nurse that he is having a sickle cell crisis. Which diagnostic test should the nurse anticipate the emergency department doctor ordering for the client?
A. Spinal tap.
B. Hemoglobin electrophoresis.
C. Sickle-turbidity test (Sickledex).
D. Blood cultures.
Explanation: Fever (101.4°F) in SCA crisis suggests infection; blood cultures (D) identify the cause. Spinal tap (A) is for meningitis, electrophoresis (B) confirms SCA, and Sickledex (C) screens for sickle trait.
Question 2 of 5.
The client is diagnosed with chronic lymphocytic leukemia (CLL) after routine laboratory tests during a yearly physical. Which is the scientific rationale for the random nature of discovering the illness?
A. CLL is not serious, and clients die from other causes first.
B. There are no symptoms with this form of leukemia.
C. This is a childhood illness and is self-limiting.
D. In early stages of CLL, the client may be asymptomatic.
Explanation: Early CLL is often asymptomatic (D), detected via routine labs. CLL is serious (A), has symptoms later (B), and is adult-onset (C), not self-limiting.
Question 3 of 5.
The nurse is completing a care plan for a client diagnosed with leukemia. Which independent problem should be addressed?
A. Infection.
B. Anemia.
C. Nutrition.
D. Grieving.
Explanation: Infection (A) is critical in leukemia due to neutropenia, requiring independent nursing actions (e.g., hygiene). Anemia (B), nutrition (C), and grieving (D) are collaborative or secondary.
Question 4 of 5.
The female client recently diagnosed with Hodgkin's lymphoma asks the nurse about her prognosis. Which is the nurse's best response?
A. Survival for Hodgkin's disease is relatively good with standard therapy.
B. Survival depends on becoming involved in an investigational therapy program.
C. Survival is poor, with more than 50% of clients dying within six (6) months.
D. Survival is fine for primary Hodgkin's, but secondary cancers occur within a year.
Explanation: Hodgkin's has a good prognosis with standard therapy (A) (5-year survival >85%). Investigational therapy (B) isn't required, survival isn't poor (C), and secondary cancers (D) are long-term risks.
Question 5 of 5.
The nurse and an unlicensed assistive personnel (UAP) are caring for clients in a bone marrow transplantation unit. Which nursing task should the nurse delegate?
A. Take the hourly vital signs on a client receiving blood transfusions.
B. Monitor the infusion of antineoplastic medications.
C. Transcribe the HCP's orders onto the medication administration record (MAR).
D. Determine the client's response to the therapy.
Explanation: Taking vital signs (A) is within UAP scope during transfusions. Monitoring chemo (B), transcribing orders (C), and evaluating response (D) require nursing judgment.
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