NCLEX-PN
Hematologic System NCLEX Questions Questions
Extract:
Question 1 of 5
Which laboratory result would the nurse expect in the client diagnosed with DIC?
Correct Answer: B
Rationale: DIC consumes clotting factors, lowering fibrinogen (
B). PT is prolonged (
A), platelets decrease (
C), and WBCs (
D) are nonspecific.
Question 2 of 5
The client is symptomatic with a Hgb of 7.8 g/dL, but refuses blood and blood products transfusions for religious reasons. The nurse should prepare the client that the HCP may prescribe which alternatives?
Correct Answer: A, B,
Rationale: Epoetin alfa (erythropoietin growth factor; Procrit) promotes erythropoiesis (production of RBCs), thus decreasing the need for transfusions. B. Folic acid promotes erythropoiesis and production of WBCs and platelets. C. Albumin is a blood product. D. Platelets are blood products. E. Plasma is a blood product. F. Granulocytes are blood products.
Question 3 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 4 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 5 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.