Hematology NCLEX Practice Questions

Hematology NCLEX Practice Questions Related

Review Hematology NCLEX Practice Questions related questions and content

The client is hospitalized with a diagnosis of sickle cell crisis. Which findings should prompt the nurse to consider that the client is ready for discharge?

  • A. Leukocyte count is at 7500/mm3
  • B. Describes the importance of keeping warm
  • C. Pain controlled at 2 on a 0 to 10 scale with analgesics
  • D. Has not had chest pain or dyspnea for past 24 hours
  • E. Blood transfusions effective in diminishing cell Sickling
  • F. Hydroxyurea effective in suppressing leukocyte formation
Correct Answer: A, B, C, D

Rationale: leukocyte count of 7500/mm3 is within normal range (5000 to 10,000/mm3 indicates the absence of an infection). B. Keeping warm and avoiding chills will help to prevent infection. Cold causes vasoconstriction, slowing blood flow and aggravating the Sickling process. C. Acute pain is due to tissue hypoxia from the agglutination of sickled cells within blood vessels. D. The absence of symptoms of complication such as acute chest syndrome and pulmonary hypertension indicates readiness for discharge. E. RBC transfusions may help to prevent complications, but transfusions do not alter the person’s body from producing the deformed erythrocytes. F. Hydroxyurea (Hydrea) can decrease the permanent formation of sickled cells. A side effect (not therapeutic effect) of hydroxyurea is suppression of leukocyte formation.

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The client receiving hospice care has cancer pain and requires treatment with a co-analgesic for pain control. Which medication should the nurse request an HCP to prescribe because it gives the best pain-relieving response when given with opioids?

  • A. Promethazine
  • B. Gabapentin
  • C. Diphenhydramine
  • D. Droperidol
Correct Answer: B

Rationale: Promethazine (Phenergan) is given with pain medications, but it treats nausea and vomiting, not pain. Gabapentin (Neurontin) is often administered with opioid pain medications because of its efficacy in relieving neuropathic pain and its limited adverse effects. Diphenhydramine (Benadryl) is not a co-analgesic but an antihistamine. Droperidol (Inapsine) is not a co-analgesic but an antiemetic to control nausea and vomiting.

Which nursing interventions should the nurse implement when caring for a client diagnosed with hemophilia A? Select all that apply.

  • A. Instruct the client to use a razor blade to shave.
  • B. Avoid administering enemas to the client.
  • C. Encourage participation in noncontact sports.
  • D. Teach the client how to apply direct pressure if bleeding occurs.
  • E. Explain the importance of not flossing the gums.
Correct Answer: B,C,D

Rationale: Avoiding enemas (B), noncontact sports (C), and teaching pressure (D) prevent bleeding in hemophilia. Razor blades (A) and avoiding flossing (E) increase bleeding risk.

The nurse is caring for a client diagnosed with acute myeloid leukemia. Which assessment data warrant immediate intervention?

  • A. T 99, P 102, R 22, and BP 132/68.
  • B. Hyperplasia of the gums.
  • C. Weakness and fatigue.
  • D. Pain in the left upper quadrant.
Correct Answer: D

Rationale: Left upper quadrant pain (D) suggests splenic rupture, a life-threatening AML complication. Vitals (A) are stable, gum hyperplasia (B) is expected, and fatigue (C) is common.

The client diagnosed with sickle cell disease is experiencing a vaso-occlusive crisis. Which priority interventions should the nurse implement?

  • A. Maintain IV fluids and administer pain medication prn.
  • B. Encourage frequent ambulation in the hallways.
  • C. Administer oxygen via nasal cannula at 10 LPM.
  • D. Monitor the client’s red blood cell count every four (4) hours.
Correct Answer: A

Rationale: IV fluids and pain medication (A) prevent sickling and manage vaso-occlusive crisis pain. Ambulation (B) risks hypoxia, 10 LPM oxygen (C) is excessive, and RBC monitoring (D) is not primary.

The client is diagnosed with congestive heart failure and anemia. The HCP ordered a transfusion of two (2) units of packed red blood cells. The unit has 250 mL of red blood cells plus 45 mL of additive. At what rate should the nurse set the IV pump to infuse each unit of packed red blood cells?

Correct Answer: 74

Rationale: Each unit = 250 mL RBC + 45 mL additive = 295 mL. Standard transfusion time is 4 hours max. 295 mL ÷ 4 hr = 73.75 mL/hr, rounded to 74 mL/hr for pump precision.

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