Hematology NCLEX Questions
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Question 1 of 5.
Extract: The following scenario applies to the next 1 items The nurse is assessing a client receiving a transfusion of packed red blood cells. Item 1 of 1 Nurses' Notes 1800: Prescribed PRBC infusion started. Client was educated to notify the RN of any manifestations regarding a transfusion reaction. Pretransfusion vital signs were obtained: T 98° F (36.7° C), P 62, RR 18, BP 130/86, pulse oximetry reading 98% on room air. 1815: Client reports no manifestations of a transfusion-related reaction. Denies any headache, nausea, chills, or backache. Vital signs: T 98.4° F (36.9° C), P 69, RR 17, BP 128/83, pulse oximetry reading 98% on room air. 1855: Client alerted the nurse that "something is wrong with my IV." On assessment, the client reported pain at the peripheral vascular access device as a 5/10 on the Numerical Rating Scale. Swelling was observed at the vascular access insertion site.
The nurse should initially ………….. Once this is done, the nurse should then ……….. for a client receiving a transfusion of packed red blood cells with pain and swelling at the IV site.
A. discontinue the blood transfusion.
B. obtain assistance from another nurse
C. pause the transfusion and remove the peripheral vascular access device.
D. pause the transfusion and contact the physician
E. start a new peripheral vascular access device and resume the transfusion.
F. send the unit of blood and tubing to the blood bank.
G. verify the client's blood type with the unit of blood being transfused.
Explanation: Pain and swelling suggest infiltration or extravasation. Pausing the transfusion and removing the IV device is the initial step, followed by starting a new IV site to safely resume the transfusion.
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.