Hematologic Disorders NCLEX Questions
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Question 1 of 5.
The nurse is caring for the client who had a left modified radical mastectomy (a total mastectomy with axillary node dissection and removal of the lining over the pectoralis major muscle). Which action by the nurse is appropriate?
A. Have the client elevate the left arm above the head
B. Ensure that IV access sites are only on the right side
C. Have the client view the incision site as soon as possible
D. Initiate left arm strengthening within 24 hours of surgery
Explanation: A. The arm on the operative side should be elevated on a pillow, but not above the head. B. All IV access sites should be located on the nonoperative side to prevent circulatory impairment. C. Having the client look at the incision should be at the client's readiness, not as soon as possible. D. Only ROM to the lower arm should be carried out for the first few days after surgery, with exercises and ROM to the shoulder after the drains are removed.
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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