NCLEX-PN
Hematologic System NCLEX Questions Questions
Question 1 of 5
Which action should the nurse expect to perform after a client has a bone marrow biopsy taken from the iliac crest?
Correct Answer: C
Rationale: Applying an adhesive bandage to the site after a bone marrow biopsy prevents bleeding and protects the area. Pressure is typically applied for longer, narcotics are not routine, and recumbent positioning is not required.
Question 2 of 5
The client undergoing intensive chemotherapy for Hodgkin’s lymphoma (HL) is hospitalized with fever and depressed immune system functioning. The nurse is administering filgrastim subcutaneously daily. Which laboratory value should the nurse monitor to determine the medication’s effectiveness?
Correct Answer: C
Rationale: A. Epoetin alfa, not filgrastim, is used to treat anemia that is associated with cancer, and its effectiveness would be reflected in the Hgb values. B. Oprelvekin (Neumega), not filgrastim, enhances the synthesis of platelets. C. The nurse should monitor the ANC. Filgrastim (Neupogen) is usually discontinued when the client’s absolute neutrophil count (AN
C) is above 1000 cells/mm3. Filgrastim, a granulocyte colony-stimulating factor (G-CSF) analog, is used to stimulate the proliferation and differentiation of granulocytes and treat neutropenia. D. Reed-Sternberg cells are found in lymph node biopsy cells and are indicative of Hodgkin’s lymphoma; they are not monitored to determine the effectiveness of filgrastim, which is used to treat neutropenia.
Question 3 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.
Correct Answer: A,C,D,E
Rationale: 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 4 of 5
Which clinical manifestation of Stage I non-Hodgkin’s lymphoma would the nurse expect to find when assessing the client?
Correct Answer: C
Rationale: 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.
Question 5 of 5
The client’s CBC indicates an RBC 6 (x106/mm3), Hb 14.2 g/dL, Hct 42%, and platelets 69 (x103/mm3). Which intervention should the nurse implement?
Correct Answer: A
Rationale: Platelets 69,000 indicate thrombocytopenia; a soft-bristle toothbrush (
A) prevents gum bleeding. Fever (
B), BP (
C), and brief pressure (
D) are insufficient for bleeding risk.