Hematologic Disorders NCLEX Questions
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Question 1 of 5.
The nurse is caring for the client placed on neutropenic precautions. Which interventions should the nurse implement?
A. Apply pressure for at least 5 minutes to any site that is bleeding.
B. Prevent anyone from bringing fresh flowers into the client's room.
C. Teach the client to avoid eating unwashed fruit and vegetables.
D. Perform hand hygiene before touching any of the client's belongings.
E. Inform the client that fresh water will be delivered every hour.
F. Stop visitors from entering the room if observed to be coughing.
Explanation: Pressure should be applied to an area that is bleeding when the client has thrombocytopenia, not neutropenia. B. Fresh flowers harbor microorganisms that can cause an infection. C. Unwashed fruits and vegetables have been found to be colonized with various bacteria, particularly gram-negative enteric organisms, as well as pseudomonas and fungi. Recent research indicates that well-washed fresh fruits and vegetables may be eaten. D. Hand hygiene reduces microbial counts on hands and helps to prevent the transmission of microorganisms to the client's belongings. E. The client should not consume any liquids that have been standing at room temperature for longer than an hour due to risk of microbial colonization. F. Visitors with a transmittable infection place the client at a high risk for becoming infected due to the client's depressed immune system.
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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