NCLEX-PN
Hematologic System NCLEX Questions Questions
Extract:
Question 1 of 5
The client is diagnosed with polycythemia vera. The nurse would prepare to perform which intervention?
Correct Answer: C
Rationale: Polycythemia vera requires phlebotomy (
C) to reduce blood viscosity. Transfusions (
A) worsen hyperviscosity, petechiae (
B) are for thrombocytopenia, and Hb/Hct (
D) are elevated.
Question 2 of 5
The client diagnosed with atrial fibrillation is admitted with warfarin (Coumadin) toxicity. Which HCP order would the nurse anticipate?
Correct Answer: D
Rationale: Warfarin toxicity causes bleeding; vitamin K (
D) reverses it. Protamine (
A) reverses heparin, heparin/Lovenox (B,
C) worsen bleeding.
Question 3 of 5
The nurse assesses that the client with hemolytic anemia has weakness, fatigue, malaise, and skin and mucous membrane pallor. Which finding should the nurse also associate with hemolytic anemia?
Correct Answer: A
Rationale: A. Jaundice occurs in hemolytic anemia from the shortened life span of the RBC and the breakdown of Hgb. About 80% of heme is converted to bilirubin, conjugated in the liver, and excreted in the bile. The increased bilirubin in the blood causes the jaundice. B. A smooth, red tongue is seen with iron-deficiency anemia. C. A craving for ice is seen with iron-deficiency anemia. D. Folate deficiency occurs in people who rarely eat fresh vegetables.
Question 4 of 5
The nurse assesses the client diagnosed with acute myeloid leukemia. Which finding should be the nurse’s priority for implementing interventions?
Correct Answer: A
Rationale: A. Pain control is priority. The altered VS (other than temperature) could be related to pain. B. Weakness and fatigue are due to anemia and also the disease process. It is important to allow rest, but if pain is not controlled the client may not be able to rest. C. The temperature warrants further monitoring because it could indicate a developing infection; the other VS may decrease if pain is controlled. D. Ecchymosis and petechiae are associated with low platelet counts. The nurse should check the laboratory report for the platelet level, but this is an assessment and not an intervention.
Question 5 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.