Hematologic System NCLEX Questions

Hematologic System NCLEX Questions Related

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The client diagnosed with acute myeloid leukemia receives a bone marrow transplant. Which medication to prevent graft-versus-host disease (GVHD) should the nurse plan to administer?

  • A. A cephalosporin antibiotic, such as ceftazidime
  • B. An immunosuppressant, such as cyclosporine
  • C. A chemotherapeutic agent, such as cisplatin
  • D. Peginterferon alfa-2a for prevention and treatment of hepatitis
Correct Answer: B

Rationale: A. Antibiotics such as ceftazidime (Fortaz) are administered to prevent infection. B. GVHD occurs when the T lymphocytes proliferate from the transplanted donor marrow and mount an immune response against the recipient’s tissues. An immunosuppressant such as cyclosporine (Neoral) prevents the immune response. C. Cisplatin (Platinol AQ) is administered mainly to treat metastatic testicular, ovarian, and cervical carcinoma; advanced bladder cancer; and head and neck cancer. D. Interferons such as peginterferon alfa-2a (Pegasys) have antiviral activity, which decrease the progression of hepatic damage associated with hepatitis A and B. This would only be administered if the transplanted cells transmitted the disease. The biological agent interferon is used to treat follicular low-grade lymphomas.

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Which sign would the nurse expect to assess in the client diagnosed with idiopathic thrombocytopenic purpura (ITP)?

  • A. Petechiae on the anterior chest, arms, and neck.
  • B. Capillary refill of less than three (3) seconds.
  • C. An enlarged spleen.
  • D. Pulse oximeter reading of 95%.
Correct Answer: A

Rationale: ITP causes low platelets, leading to petechiae (A). Capillary refill (B) is normal, splenomegaly (C) is not primary, and SpO2 95% (D) is normal.

Which laboratory result would the nurse expect in the client diagnosed with DIC?

  • A. A decreased prothrombin time.
  • B. A low fibrinogen level.
  • C. An increased platelet count.
  • D. An increased white blood cell count.
Correct Answer: B

Rationale: DIC consumes clotting factors, lowering fibrinogen (B). PT is prolonged (A), platelets decrease (C), and WBCs (D) are nonspecific.

The client is diagnosed with severe iron-deficiency anemia. Which statement is the scientific rationale regarding oral replacement therapy?

  • A. Iron supplements are well tolerated without side effects.
  • B. There is no benefit from oral preparations; the best route is IV.
  • C. Oral iron preparations cause diarrhea if not taken with food.
  • D. Very little of the iron supplement will be absorbed by the body.
Correct Answer: D

Rationale: Oral iron has low absorption (D), requiring high doses. Side effects (A) include GI upset, IV (B) is for severe cases, and diarrhea (C) is not primary (constipation is common).

The nurse is transcribing the HCP’s order for an iron supplement on the MAR. At which time should the nurse schedule the daily dose?

  • A. 900
  • B. 1000
  • C. 1200
  • D. 1630
Correct Answer: A

Rationale: Iron supplements are best taken in the morning (0900, A) with food to reduce GI upset and enhance absorption. Later times (B, C, D) are less optimal.

The client is diagnosed with Hodgkin’s disease. Which data are diagnostic for Hodgkin’s disease?

  • A. Night sweats and low-grade fever.
  • B. Cavitation noted on the chest x-ray.
  • C. Reed-Sternberg cells found on biopsy.
  • D. Weight loss and palpable inguinal lymph nodes.
Correct Answer: C

Rationale: Reed-Sternberg cells on biopsy (C) are diagnostic for Hodgkin’s. Night sweats/fever (A) and weight loss/nodes (D) are supportive, and cavitation (B) suggests TB.

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