NCLEX-PN
Hematology NCLEX Questions Questions
Extract:
Question 1 of 5
The HCP has ordered one (1) unit of packed RBCs for the client who is right-handed. Which area would be the best place to insert the intravenous catheter?
Correct Answer: C
Rationale: For a right-handed client, the non-dominant (left) arm is preferred for IV access (
C) to maintain function. Specific sites (A, B,
D) depend on image, but C is typically left forearm/antecubital.
Question 2 of 5
The nurse is preparing the client for a bone marrow biopsy of the iliac crest. Place the nurse’s actions in order of priority.
Order the Items
Source Container
Correct Answer: D, F, B, A, C, E:
Rationale: Verify that the HCP has explained the procedure. The HCP should include the purpose, intended outcomes, and potential complications. F. Teach what may be expected during the procedure, including that pressure or discomfort may be experienced. B. Obtain a signed informed consent. This is obtained only after the HCP has met with the client and teaching is completed. A. Premedicate with lorazepam (Ativan). Midazolam (Versed) is another option for sedation. A local anesthetic is used at the site, and some clients may not need sedation. C. Position prone and provide emotional support. The client should be prone because the iliac crest is the site being used for this biopsy, but the position will vary with the site. Holding the client’s hand and using guided imagery help support the client. E. Check for signs of bleeding every 2 hours for 24 hours. A pressure dressing is applied by the HCP after the procedure. Ice can be applied to reduce bruising and for comfort.
Question 3 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.
Question 4 of 5
Following morning shift report, the nurse identifies care needs for four clients. Which client should be the nurse’s priority?
Correct Answer: B
Rationale: A. No time is noted for the administration of ondansetron (Zofran) prior to chemotherapy treatment; this client is not the nurse’s priority. B. The client with neutropenia should be the nurse’s priority. If seen first, microorganisms from other clients would be less likely to be transmitted to the client. This client is at risk for infection and severe sepsis because the absolute neutrophil count is less than 1001mm3 (normal = 1500 to 8000/mm3). C. This client is stable; another person can take this client to radiation therapy, and the nurse’s assessment can wait until the client returns. D. The tube feeding can be initiated after the needs of the most critical client are met.
Question 5 of 5
The client diagnosed with von Willebrand’s disease calls a clinic after experiencing hemarthrosis. The client states that factor concentrate is infusing. Which intervention should the nurse recommend now?
Correct Answer: B
Rationale: A. Aspirin (Ecotrin) and NSAIDs are contraindicated because they interfere with platelet aggregation. B. Hemarthrosis is bleeding into the joint. The pressure of the ice pack and cold will reduce the bleeding and swelling. The ice pack should be covered with a cloth. C. The client and family are usually taught how to administer factor concentrates at home at the first sign of bleeding. D. The splint should be left on initially to control bleeding. The client should be instructed on how to assess for adequate tissue perfusion.