NCLEX-PN
Hematologic System NCLEX Questions Questions
Extract:
Question 1 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 2 of 5
The client diagnosed with acute myeloid leukemia receives a bone marrow transplant. Which medication to prevent graft-versus-host disease (GVHD) should the nurse plan to administer?
Correct Answer: B
Rationale: A. Antibiotics such as ceftazidime (Fortaz) are administered to prevent infection. B. GVHD occurs when the T lymphocytes proliferate from the transplanted donor marrow and mount an immune response against the recipient’s tissues. An immunosuppressant such as cyclosporine (Neoral) prevents the immune response. C. Cisplatin (Platinol AQ) is administered mainly to treat metastatic testicular, ovarian, and cervical carcinoma; advanced bladder cancer; and head and neck cancer. D. Interferons such as peginterferon alfa-2a (Pegasys) have antiviral activity, which decrease the progression of hepatic damage associated with hepatitis A and B. This would only be administered if the transplanted cells transmitted the disease. The biological agent interferon is used to treat follicular low-grade lymphomas.
Question 3 of 5
The client diagnosed with sickle cell anemia is experiencing a vaso-occlusive sickle cell crisis secondary to an infection. Which medical treatment should the nurse anticipate the HCP ordering for the client?
Correct Answer: C
Rationale: Hydration with IV fluids (
C) prevents sickling in vaso-occlusive crisis. Meperidine (
A) is avoided (risks seizures), isolation (
B) is excessive, and Foley (
D) is unnecessary.
Question 4 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 5 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.