Hematologic Disorders NCLEX Questions
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Question 1 of 5.
When assessing the client who is recovering from a radical hysterectomy with vulvectomy, the nurse notes lymphedema of the lower extremities. Which intervention should be implemented by the nurse?
A. Elevate the head of the client's bed to 45 degrees.
B. Increase the client's intake of fluids high in sodium.
C. Encourage the client to exercise the lower extremities.
D. Apply splints to both of the client's lower extremities.
Explanation: A. Elevating the head of the bed to a 45-degree angle may increase lymphedema of the lower extremities. B. Intake of fluids high in sodium will cause fluid retention. C. Leg exercises will improve drainage when lymphedema is present. D. Lower-extremity splints can cause skin breakdown of edematous tissue.
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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