Hematology NCLEX Questions
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Question 1 of 5.
The nurse is administering vesicant chemotherapy medications such as doxorubicin hydrochloride to clients. Which nursing actions should the nurse implement to prevent extravasation?
A. Give through an IV catheter in a large peripheral vein if infusing in less than 60 minutes.
B. Check patency every 5 to 10 minutes during infusion and ask about IV site discomfort.
C. Check the IV pump and alarm for indications of an infiltration of the medication.
D. Check for blood return in a central venous catheter prior to administration of the vesicant.
E. Use small-gauged syringes with small barrels when flushing any access devices with saline.
Explanation: A peripheral IV catheter may be used for a vesicant if administration time is less than 60 minutes, a large vein is used, and there is careful monitoring of the IV site. B. Checking for patency and asking about discomfort at the IV site will help prevent an infiltration. C. IV pumps and alarms cannot be relied upon to detect extravasation because infiltration usually does not cause sufficient pressure to trigger an alarm. D. Checking for blood return in the central venous catheter prior to administration will help ensure that the medication is being administered into a vessel and not into tissues. E. Small-gauge syringes with small barrels produce high pressures and may cause injury to the blood vessel or may damage a central line catheter and should not be used.
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.