NCLEX-PN
Hematology NCLEX Practice Questions Questions
Extract:
Question 1 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 2 of 5
The client diagnosed with leukemia is being admitted for an induction course of chemotherapy. Which laboratory values indicate a diagnosis of leukemia?
Correct Answer: C
Rationale: Leukemia causes bone marrow suppression, leading to low Hb/Hct (
C). Left shift (
A) indicates infection, antibiotic response (
B) suggests infection, and large RBCs (
D) indicate megaloblastic anemia.
Question 3 of 5
The nurse teaches a coworker about the treatment for hemophilia. The nurse instructs that the treatment will likely include periodic self-administration of which component?
Correct Answer: C
Rationale: A. Platelets do not contain the deficient clotting factors. B. Although whole blood contains the deficient factors, periodic administration of factor concentrates are safer. C. A person with hemophilia A is deficient in factor VIII; hemophilia B, factor IX; and von Willebrand’s hemophilia, the von Willebrand’s factor and factor VIII. Recombinant forms of the factors are available for the client to self-administer intravenously at home. D. Although fresh frozen plasma contains the deficient factors, periodic administration of factor concentrates are safer.
Question 4 of 5
The client is diagnosed with hemophilia. Which safety precaution should the nurse encourage?
Correct Answer: C
Rationale: Hemophilia requires factor VIII availability (
C) for bleeding emergencies. Contact sports (
A) are risky, antibiotics (
B) are for endocarditis, and ibuprofen (
D) increases bleeding.
Question 5 of 5
The client received two (2) units of packed red blood cells of 250 mL with 63 mL of preservative each during the shift. There was 240 mL of saline remaining in the 500-mL bag when the nurse discarded the blood tubing. How many milliliters of fluid should be documented on the intake and output record?
Correct Answer: 886
Rationale: Each unit = 250 mL RBC + 63 mL preservative = 313 mL. Two units = 313 × 2 = 626 mL. Saline used = 500 – 240 = 260 mL.
Total intake = 626 + 260 = 886 mL.