Hematology NCLEX Questions With Complete Solutions
A 30-year-old patient has undergone a splenectomy as a result of
injuries suffered in a motor vehicle accident. Which phenomena
are likely to result from the absence of the patient's spleen
(select all that apply)?
A. Impaired fibrinolysis
B. Increased platelet levels
C. Increased eosinophil levels
D. Fatigue and cold intolerance
E. Impaired immunologic function Correct Answer B.
Increased platelet levels
E. Impaired immunologic function
Splenectomy can result in increased platelet levels and impaired
immunologic function as a consequence of the loss of storage
and immunologic functions of the spleen. Fibrinolysis, fatigue,
and cold intolerance are less likely to result from the loss of the
spleen since coagulation and oxygenation are not primary
responsibilities of the spleen.
A 36-year-old female patient suspected to have leukemia is
scheduled for a bone marrow aspiration. What statement in the
patient's health history requires immediate follow up by the
nurse?
A. "I had a bad reaction to iodine before and almost died."
B. "I am taking an antibiotic to treat a urinary tract infection."
C. "I have rheumatoid arthritis and take aspirin for joint pain."
D. "I have dialysis for chronic renal failure three times a week."
Correct Answer C. "I have rheumatoid arthritis and take aspirin
for joint pain."
,Complications of bone marrow aspiration are minimal, but there
is a possibility of damaging underlying structures (especially if
the sternum site is used). Other complications include
hemorrhage (particularly if the patient is thrombocytopenic) and
infection (particularly if the patient is leukopenic). The risk of
hemorrhage is increased if the patient takes aspirin because it
promotes bleeding by inhibiting platelet aggregation. Contrast
dye is not used during a bone marrow aspiration. A bone
marrow aspiration is not contraindicated in patients who have
chronic renal failure (on dialysis) or a urinary tract infection (on
an antibiotic)
A 36-year-old mother of two children has anemia related to
inadequate intake of essential nutrients. Which intervention
would be appropriate for the nurse to include in the plan of care
for this woman?
A. Plan for 30 minutes of rest before and after every meal.
B. Encourage foods high in protein, iron, vitamin C, and folate.
C. Instruct the patient to select soft, bland, and nonacidic foods.
D. Give the patient a list of medications that inhibit iron
absorption. Correct Answer B. Encourage foods high in
protein, iron, vitamin C, and folate.
Increased intake of protein, iron, folate, and vitamin C provides
nutrients needed for maximum iron absorption and hemoglobin
production. The other interventions do not address the patient's
identified problem of inadequate intake of essential nutrients.
Selection of foods that are soft, bland, and nonacidic is
appropriate if the patient has oral mucosal irritation. Scheduled
rest is an appropriate intervention if the patient has fatigue
,related to anemia. Providing information about medications that
may inhibit iron absorption (e.g., antacids, tetracycline, soft
drinks, tea, coffee, calcium, phosphorus, and magnesium salts)
is important but does not address the patient's problem of
inadequate intake of essential nutrients.
A 50-year-old man with an acute peptic ulcer and major blood
loss requires an immediate transfusion with packed red blood
cells. Which task is appropriate for the nurse to delegate to
unlicensed assistive personnel (UAP)?
A. Confirm the IV solution is 0.9% saline.
B. Obtain the vital signs before the transfusion is initiated.
C. Monitor the patient for shortness of breath and back pain.
D. Double check the patient identity and verify the blood
product. Correct Answer B. Obtain the vital signs before the
transfusion is initiated
The registered nurse (RN) may delegate tasks such as taking
vital signs to unlicensed assistive personnel (UAP). Assessments
(e.g., monitoring for signs of a blood transfusion reaction
[shortness of breath and back pain]) are within the scope of
practice of the RN and may not be delegated to UAP. The RN
must also assume responsibility for ensuring the correct IV fluid
is used with blood products. Verification of the patient's identity
and the blood product data must be completed by a licensed
nurse.
A 57-year-old patient has been diagnosed with acute
myelogenous leukemia (AML). The nurse explains to the patient
that collaborative care will focus on what?
A. Leukapheresis
, B. Attaining remission
C. One chemotherapy agent
D. Waiting with active supportive care Correct Answer B.
Attaining remission
Attaining remission is the initial goal of collaborative care for
leukemia. The methods to do this are decided based on age and
cytogenetic analysis. The treatments include leukapheresis or
hydroxyurea to reduce the WBC count and risk of leukemia-
cell-induced thrombosis. A combination of chemotherapy agents
will be used for aggressive treatment to destroy leukemic cells in
tissues, peripheral blood, and bone marrow and minimize drug
toxicity. In nonsymptomatic patients with chronic lymphocytic
leukemia (CLL), waiting may be done to attain remission, but
not with AML.
A 62-year-old male patient with disseminated intravascular
coagulation (DIC) after urosepsis has a platelet count of
48,000/μL. The nurse should assess the patient for which
abnormality?
A. Pain
B. Purpura
C. Pruritus
D. Palpitation Correct Answer B. Purpura
The normal range for a platelet count is 150,000 to 400,000/μL.
Purpura is caused by decreased platelets or clotting factors,
resulting in small hemorrhages into the skin and/or mucous
membranes. Pain is not a manifestation of low platelet counts.
Pruritus is an intense itching sensation. Palpitation is a sensation
of feeling the heart beat, flutter, or pound in the chest.
A 30-year-old patient has undergone a splenectomy as a result of
injuries suffered in a motor vehicle accident. Which phenomena
are likely to result from the absence of the patient's spleen
(select all that apply)?
A. Impaired fibrinolysis
B. Increased platelet levels
C. Increased eosinophil levels
D. Fatigue and cold intolerance
E. Impaired immunologic function Correct Answer B.
Increased platelet levels
E. Impaired immunologic function
Splenectomy can result in increased platelet levels and impaired
immunologic function as a consequence of the loss of storage
and immunologic functions of the spleen. Fibrinolysis, fatigue,
and cold intolerance are less likely to result from the loss of the
spleen since coagulation and oxygenation are not primary
responsibilities of the spleen.
A 36-year-old female patient suspected to have leukemia is
scheduled for a bone marrow aspiration. What statement in the
patient's health history requires immediate follow up by the
nurse?
A. "I had a bad reaction to iodine before and almost died."
B. "I am taking an antibiotic to treat a urinary tract infection."
C. "I have rheumatoid arthritis and take aspirin for joint pain."
D. "I have dialysis for chronic renal failure three times a week."
Correct Answer C. "I have rheumatoid arthritis and take aspirin
for joint pain."
,Complications of bone marrow aspiration are minimal, but there
is a possibility of damaging underlying structures (especially if
the sternum site is used). Other complications include
hemorrhage (particularly if the patient is thrombocytopenic) and
infection (particularly if the patient is leukopenic). The risk of
hemorrhage is increased if the patient takes aspirin because it
promotes bleeding by inhibiting platelet aggregation. Contrast
dye is not used during a bone marrow aspiration. A bone
marrow aspiration is not contraindicated in patients who have
chronic renal failure (on dialysis) or a urinary tract infection (on
an antibiotic)
A 36-year-old mother of two children has anemia related to
inadequate intake of essential nutrients. Which intervention
would be appropriate for the nurse to include in the plan of care
for this woman?
A. Plan for 30 minutes of rest before and after every meal.
B. Encourage foods high in protein, iron, vitamin C, and folate.
C. Instruct the patient to select soft, bland, and nonacidic foods.
D. Give the patient a list of medications that inhibit iron
absorption. Correct Answer B. Encourage foods high in
protein, iron, vitamin C, and folate.
Increased intake of protein, iron, folate, and vitamin C provides
nutrients needed for maximum iron absorption and hemoglobin
production. The other interventions do not address the patient's
identified problem of inadequate intake of essential nutrients.
Selection of foods that are soft, bland, and nonacidic is
appropriate if the patient has oral mucosal irritation. Scheduled
rest is an appropriate intervention if the patient has fatigue
,related to anemia. Providing information about medications that
may inhibit iron absorption (e.g., antacids, tetracycline, soft
drinks, tea, coffee, calcium, phosphorus, and magnesium salts)
is important but does not address the patient's problem of
inadequate intake of essential nutrients.
A 50-year-old man with an acute peptic ulcer and major blood
loss requires an immediate transfusion with packed red blood
cells. Which task is appropriate for the nurse to delegate to
unlicensed assistive personnel (UAP)?
A. Confirm the IV solution is 0.9% saline.
B. Obtain the vital signs before the transfusion is initiated.
C. Monitor the patient for shortness of breath and back pain.
D. Double check the patient identity and verify the blood
product. Correct Answer B. Obtain the vital signs before the
transfusion is initiated
The registered nurse (RN) may delegate tasks such as taking
vital signs to unlicensed assistive personnel (UAP). Assessments
(e.g., monitoring for signs of a blood transfusion reaction
[shortness of breath and back pain]) are within the scope of
practice of the RN and may not be delegated to UAP. The RN
must also assume responsibility for ensuring the correct IV fluid
is used with blood products. Verification of the patient's identity
and the blood product data must be completed by a licensed
nurse.
A 57-year-old patient has been diagnosed with acute
myelogenous leukemia (AML). The nurse explains to the patient
that collaborative care will focus on what?
A. Leukapheresis
, B. Attaining remission
C. One chemotherapy agent
D. Waiting with active supportive care Correct Answer B.
Attaining remission
Attaining remission is the initial goal of collaborative care for
leukemia. The methods to do this are decided based on age and
cytogenetic analysis. The treatments include leukapheresis or
hydroxyurea to reduce the WBC count and risk of leukemia-
cell-induced thrombosis. A combination of chemotherapy agents
will be used for aggressive treatment to destroy leukemic cells in
tissues, peripheral blood, and bone marrow and minimize drug
toxicity. In nonsymptomatic patients with chronic lymphocytic
leukemia (CLL), waiting may be done to attain remission, but
not with AML.
A 62-year-old male patient with disseminated intravascular
coagulation (DIC) after urosepsis has a platelet count of
48,000/μL. The nurse should assess the patient for which
abnormality?
A. Pain
B. Purpura
C. Pruritus
D. Palpitation Correct Answer B. Purpura
The normal range for a platelet count is 150,000 to 400,000/μL.
Purpura is caused by decreased platelets or clotting factors,
resulting in small hemorrhages into the skin and/or mucous
membranes. Pain is not a manifestation of low platelet counts.
Pruritus is an intense itching sensation. Palpitation is a sensation
of feeling the heart beat, flutter, or pound in the chest.
