NCLEX-PN
Hematology NCLEX Practice Questions Questions
Extract:
Question 1 of 5
The client is diagnosed with congestive heart failure and anemia. The HCP ordered a transfusion of two (2) units of packed red blood cells. The unit has 250 mL of red blood cells plus 45 mL of additive. At what rate should the nurse set the IV pump to infuse each unit of packed red blood cells?
Correct Answer: 74
Rationale: Each unit = 250 mL RBC + 45 mL additive = 295 mL. Standard transfusion time is 4 hours max. 295 mL ÷ 4 hr = 73.75 mL/hr, rounded to 74 mL/hr for pump precision.
Question 2 of 5
The client hospitalized with cervical cancer is receiving radiation therapy via a temporary radioactive cervical implant. Which nursing actions would be appropriate for this client?
Correct Answer: A, C, D
Rationale: A. Safety measures for caring for someone undergoing internal radiation therapy include limiting time, distance, and shielding. It would be important to make the client aware of the time and distance limitations to help ease anxiety. B. A personal, not shared, film badge should be worn so cumulative radiation exposure can be measured accurately. C. Organizing care would be appropriate in order to limit the exposure to radiation. D. Shielding is important for keeping caregivers safe from potential radiation exposure. E. The implant is placed in the vaginal canal and has no impact on oral mucosa.
Question 3 of 5
The client is hospitalized with a diagnosis of sickle cell crisis. Which findings should prompt the nurse to consider that the client is ready for discharge?
Correct Answer: A, B, C, D
Rationale: leukocyte count of 7500/mm3 is within normal range (5000 to 10,000/mm3 indicates the absence of an infection). B. Keeping warm and avoiding chills will help to prevent infection. Cold causes vasoconstriction, slowing blood flow and aggravating the Sickling process. C. Acute pain is due to tissue hypoxia from the agglutination of sickled cells within blood vessels. D. The absence of symptoms of complication such as acute chest syndrome and pulmonary hypertension indicates readiness for discharge. E. RBC transfusions may help to prevent complications, but transfusions do not alter the person’s body from producing the deformed erythrocytes. F. Hydroxyurea (Hydrea) can decrease the permanent formation of sickled cells. A side effect (not therapeutic effect) of hydroxyurea is suppression of leukocyte formation.
Question 4 of 5
The client is diagnosed with leukemia and has leukocytosis. Which laboratory value would the nurse expect to assess?
Correct Answer: D
Rationale: Leukocytosis in leukemia causes elevated WBCs (
D). Hb (
A) is low, ESR (
B) is elevated, and RDW (
C) is unrelated.
Question 5 of 5
The nurse writes a client problem of 'activity intolerance' for a client diagnosed with anemia. Which intervention should the nurse implement?
Correct Answer: A
Rationale: Pacing activities (
A) conserves energy in anemia-related activity intolerance. Supplements (
B) and transfusions (
C) are medical, and vitals (
D) are routine, not primary.