NCLEX-PN
Hematology NCLEX Questions Questions
Extract:
Question 1 of 5
In which order should the nurse address the assessment findings for the client who has undergone a total laryngectomy? Place the findings in the order of priority.
Correct Answer: B, A, D, C
Rationale: . Restless and has a mucus plug in the tracheostomy is priority requiring immediate attention due to the negative impact on air exchange. The client needs immediate suctioning. A. Copious oral secretions and nasal mucus draining from the nose should be next. After a total laryngectomy the mouth does not communicate with the trachea, so copious oral secretions and nasal drainage would not influence air exchange, but these create a source of discomfort for the client. D. Oozing serosanguineous drainage around the tracheostomy tube and saturated dressing should be addressed third. Changing the dressing now would allow the nurse to inspect the site and ensure tube patency. C. NG tube used for intermittent feedings pulled halfway out can be addressed last. There is no indication that a tube feeding is infusing. The HCP should be contacted to reinsert the NG tube to prevent disruption of the suture line in the esophagus.
Question 2 of 5
Which medication is contraindicated for a client diagnosed with leukemia?
Correct Answer: C
Rationale: 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 3 of 5
The nurse is caring for a client in a sickle cell crisis. Which is the pain regimen of choice to relieve the pain?
Correct Answer: D
Rationale: Morphine PRN (
D) is preferred for severe SCA crisis pain, titrated to relief. Aspirin (
A) and ibuprofen (
B) are insufficient and risk bleeding, and meperidine (
C) risks seizures.
Question 4 of 5
The student nurse asks the nurse, 'What is sickle cell anemia?' Which statement by the nurse would be the best answer to the student’s question?
Correct Answer: D
Rationale: Sickle cell anemia causes RBCs to sickle under low oxygen, thickening blood (
D). Written material (
A) avoids teaching, clotting (
B) is incorrect (SCD causes occlusion), and synovial fluid (
C) is unrelated.
Question 5 of 5
The client with COPD has developed polycythemia vera, and the nurse completes teaching on measures to prevent complications. During a home visit, the nurse evaluates that the client is correctly following the teaching when which actions are noted?
Correct Answer: A, C, D, F
Rationale: Iron supplements, including those in multi-vitamins, should be avoided because the iron stimulates RBC production. B. Alcohol increases the risk of bleeding. C. Increasing fluid intake to 3000 mL daily will help decrease blood viscosity. D. Phlebotomy is performed on a routine or intermittent basis to diminish blood viscosity, deplete iron stores, and decrease the client’s ability to manufacture excess erythrocytes. E. Frequent, small meals are better tolerated, especially if the liver is involved. F. Elevating the legs, avoiding constriction or crossing the legs, and wearing antiembolic stockings help prevent DVT.