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Hematologic Disorders NCLEX Detailed Questions And Expert Answers

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Instelling Hematologic Disorders
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Hematologic Disorders NCLEX Detailed Questions
And Expert Answers

You are preparing the client for a bone marrow aspiration and biopsy. Which of
the following statements, if made by the patient, indicates the need for further
teaching?

A) After the procedure I should avoid ambulating for 24-48 hours

B) Pain and discomfort is expected after the surgery. I can take some Tylenol for
the discomfort.

C) I should not take a bath for about 24 hours

D) The surgeon will collect the samples from my hip bone - ANS Answer: A. There
is no need to avoid ambulation after the biopsy. Some discomfort at the site can
occur for about a day or two. Tylenol can be given in this case but aspirin based
medications should be avoid d/t risk for bleeding. The patient should be advised to
avoid taking a bath or submerging the site in any other way with water. The
specimen is typically taken from the iliac crest, part of the hip bone.

The patient who underwent a bone biopsy yesterday calls the office thinking
something is wrong. Which of the following would be cause for concern by the
nurse? SATA:

A) Swelling and redness at the site

B) Red streaks spreading away from the area

C) T of 99.5

D) Pain in the area

,E) Small amount of blood on dressing - ANS Answer: A and B. These are signs of
possible bleeding or infection at the site. A temperature of 99.5 is still considered
WNL. Pain in the area would be expected (unusual or increased pain should be
reported). A small amount of blood on dressing would be expected. Any pus found
in the drainage should be reported.

Nurse Kelly is caring for a patient who is 65 years old with a platelet count of 7,000
resulting from myelodysplastic syndrome. At 10 p.m. the patient complains of a
headache. What should be the nurse's immediate action?

A) Administer aspirin per prn orders

B) Administer acetaminophen per orders

C) Notify the health care provider

D) Administer a nonpharmacological intervention like a cool compress - ANS
Answer: C. A platelet count less than 10,000 puts the client a severe risk for
spontaneous bleed. The nurse should be aware of any signs such as HA, changing
mentation, irritability, restlessness, changes in vision, abdominal distention, or any
other signs of bleeding anywhere in the body.

A young mother of three with history of Type 1 diabetes comes into the clinic c/o
of fatigue and says "my Fitbit has been rating my heart rate higher than it used to
be" Her Hgb is taken and found to be 11 g/dL. Which of the following factors most
likely influenced this patient's ability to feel anemia symptoms (fatigue)?

A) Hx of diabetes

B) Stressful lifestyle

C) Lack of exercise

, D) Multipara status - ANS Answer: B. People with stressful and active lifestyles are
much more likely to feel symptoms of anemia such as fatigue. Any increased
demand for oxygen is going to increase symptoms in a patient. A patient with a
heart defect or pulmonary disease would be more likely to experience symptoms
of anemia rather than a patient with hypothyroidism who has a decreased demand
for O2

The patient diagnosed with iron deficiency anemia tells you that she constantly
feels tired and exhausted. She tells you that she is concerned about this problem.
What is the nurse's best initial response?

A) Keep taking your supplements and report back to me in a couple to days

B) How has this affected your life?

C) You are going to need to take a break from those things for a period of time to
rest

D) Try to help get rid of the stress in your life. This will help with the tired feeling -
ANS Answer: B. Asking this client explain how the fatigue is affecting her life will
help open up the conversation and build rapport. Fatigue is a real life-changing
issue for patients with anemia and should not be dismissed. Telling her that she
must take a break from "things" is not an understanding response and may not
solve the underlying problem. Clients should not be instructed to get rid of all the
stress in life.

Which medication might the nurse question if administered to the client with
anemia?

A) Cipro

B) Lisinopril

C) Acetaminophen

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