Hematologic System NCLEX Questions
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Question 1 of 5.
The nurse is collecting data from the client undergoing testing for possible basal cell carcinoma (BCC). Which information in the client's health history should the nurse identify as risk factors for BCC?
A. Taking immune-suppressing medications
B. 10-pack-year history of cigarette smoking
C. Has fair skin color, red hair, and blue eyes
D. Had bone exposure to high radon gas levels
E. Works as a laborer in road construction
Explanation: Immune-suppressing drugs weaken the immune system, and cellular changes can occur more aggressively. B. Smoking history is a risk factor for lung cancer, not BCC. C. Persons with fair skin, blond or red hair, and blue, green, or gray eyes have a higher risk for BCC due to the ease of sunburn with sun exposure if the skin is not protected. D. Exposure to indoor radon gas is a risk factor for lung cancer, not BCC. Radon is a radioactive colorless, odorless, tasteless, and chemically inert gas. It is formed by the natural radioactive decay of uranium in rock, soil, and water. E. Frequent participation in outdoor activities with exposure to sunlight is a risk for BCC due to the damage caused by UV light. UV light damages DNA.
Question 2 of 5.
The client diagnosed with leukemia is scheduled for bone marrow transplantation. Which interventions should be implemented to prepare the client for this procedure? Select all that apply.
A. Administer high-dose chemotherapy.
B. Teach the client about autologous transfusions.
C. Have the family members' HLA typed.
D. Monitor the complete blood cell count daily.
E. Provide central line care per protocol.
Explanation: High-dose chemotherapy (A) ablates marrow, HLA typing (C) identifies donors, CBC monitoring (D) tracks counts, and central line care (E) prevents infection. Autologous transfusions (B) are irrelevant (donor marrow used).
Question 3 of 5.
The nurse and the licensed practical nurse (LPN) are caring for clients on an oncology floor. Which client should not be assigned to the LPN?
A. The client newly diagnosed with chronic lymphocytic leukemia.
B. The client who is four (4) hours postprocedure bone marrow biopsy.
C. The client who received two (2) units of (PRBCs) on the previous shift.
D. The client who is receiving multiple intravenous piggyback medications.
Explanation: IV piggyback medications (D) require complex assessment (e.g., chemotherapy), beyond LPN scope. New diagnosis (A), post-biopsy (B), and post-transfusion (C) are stable for LPN care.
Question 4 of 5.
Which client is at highest risk for developing a lymphoma?
A. The client diagnosed with chronic lung disease who is taking a steroid.
B. The client diagnosed with breast cancer who has extensive lymph involvement.
C. The client who received a kidney transplant several years ago.
D. The client who has had ureteral stent placements for a neurogenic bladder.
Explanation: Immunosuppression post-transplant (C) increases lymphoma risk (e.g., PTLD). Steroids (A) are lower risk, breast cancer (B) involves metastasis, and stents (D) are unrelated.
Question 5 of 5.
Which clinical manifestation of Stage I non-Hodgkin's lymphoma would the nurse expect to find when assessing the client?
A. Enlarged lymph tissue anywhere in the body.
B. Tender left upper quadrant.
C. No symptom in this stage.
D. Elevated B-cell lymphocytes on the CBC.
Explanation: Stage I NHL is often asymptomatic (C), with localized node involvement. Enlarged nodes (A) are later, LUQ tenderness (B) suggests spleen, and B-cell elevation (D) is lab-based, not clinical.