NCLEX-PN
Hematologic Disorders NCLEX Questions Questions
Extract:
Question 1 of 5
The HCP orders two (2) units of blood to be administered over eight (8) hours each for a client diagnosed with heart failure. Which intervention(s) should the nurse implement?
Correct Answer: A
Rationale: Blood must infuse within 4 hours to prevent bacterial growth; 8-hour infusion (
B) is unsafe, requiring HCP clarification (
A). Splitting units (
C) is unnecessary, and 4 hours (
D) ignores heart failure needs.
Question 2 of 5
The nurse is caring for the client who had a left modified radical mastectomy (a total mastectomy with axillary node dissection and removal of the lining over the pectoralis major muscle). Which action by the nurse is appropriate?
Correct Answer: B
Rationale: A. The arm on the operative side should be elevated on a pillow, but not above the head. B. All IV access sites should be located on the nonoperative side to prevent circulatory impairment. C. Having the client look at the incision should be at the client’s readiness, not as soon as possible. D. Only ROM to the lower arm should be carried out for the first few days after surgery, with exercises and ROM to the shoulder after the drains are removed.
Question 3 of 5
The new nurse requests information about chronic lymphocytic leukemia (CLL). Which statements should an experienced nurse include?
Correct Answer: A, B, D, F
Rationale: CLL derives from a malignant clone of B lymphocytes. T-lymphocytic CLL is rare. B. Two-thirds of all persons with CLL are older than 60 years at diagnosis. C. Treatment for CLL includes chemotherapy with fludarabine (Fludara), but a major side effect is prolonged bone marrow suppression. D. Clients with CLL are monitored, and treatment is initiated when symptoms are severe (night sweats, painful lymphadenopathy) or the disease progresses to later stages. E. In CLL there is an accumulation of mature-appearing but functionally inactive lymphocytes, and not immature lymphocytes. Excessive accumulation of immature lymphocytes occurs in ALL. F. Because many persons are asymptomatic, it is often diagnosed during a routine physical or during treatment for another condition.
Question 4 of 5
The client has a blood type of B negative. The client’s family asks if they can donate blood for the client. The nurse informs the family that they would need to be of which blood type to be considered for a directed donation of RBCs for this client?
Correct Answer: C, E, A
Rationale: Blood type A positive has the D antigen on the RBC, making it incompatible with blood type B negative. B. Blood type B positive has the D antigen on the RBC, making it incompatible with blood type B negative. C. The client with B negative blood type has B antigen on the RBC and does not have an Rh (or
D) antigen on the cell. Because the client can receive RBCs of the same blood type, a person with type B negative blood could be considered for a directed donation. D. Blood type O positive has the D antigen, making it incompatible with blood type B negative. E. Type O negative has no antigens on the RBC so a directed donation from a person with type O negative blood could also be considered. F. Blood type AB positive has the D antigen on the RBC, making it incompatible with blood type B negative.
Question 5 of 5
The client is placed on neutropenia precautions. Which information should the nurse teach the client?
Correct Answer: A
Rationale: Neutropenia precautions include electric razors and soft toothbrushes (
A) to prevent bleeding/infection. Fresh produce (
B) risks infection, perineal care (
C) is routine, and hematuria (
D) is abnormal.