Nokea
The client with O+ blood is in need of an emergency transfusion but the laboratory does not have any O+ blood available. Which potential unit of blood could be given to the client?
- A. The O- unit.
- B. The A+ unit.
- C. The B+ unit.
- D. Any Rh+ unit.
Correct Answer: A
Rationale: O- is the universal donor (A), safe for O+ clients. A+ (B), B+ (C), and other Rh+ (D) risk reactions due to antigens.
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The nurse assesses the client diagnosed with acute myeloid leukemia. Which finding should be the nurse’s priority for implementing interventions?
- A. Pain from mucositis and oral tissue injury
- B. Weakness and fatigue with slight activity
- C. T 99°F, P 100, R 22, BP 132/64 mm Hg
- D. Ecchymosis and petechiae noted on arms
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.
The nurse and the licensed practical nurse (LPN) are caring for clients on an oncology floor. Which client should not be assigned to the LPN?
- A. The client newly diagnosed with chronic lymphocytic leukemia.
- B. The client who is four (4) hours postprocedure bone marrow biopsy.
- C. The client who received two (2) units of (PRBCs) on the previous shift.
- D. The client who is receiving multiple intravenous piggyback medications.
Correct Answer: D
Rationale: IV piggyback medications (D) require complex assessment (e.g., chemotherapy), beyond LPN scope. New diagnosis (A), post-biopsy (B), and post-transfusion (C) are stable for LPN care.
The nurse and an unlicensed assistive personnel (UAP) are caring for clients on an oncology floor. Which nursing task would be delegated to the UAP?
- A. Assess the urine output on a client who has had a blood transfusion reaction.
- B. Take the first 15 minutes of vital signs on a client receiving a unit of PRBCs.
- C. Auscultate the lung sounds of a client prior to a transfusion.
- D. Assist a client who received 10 units of platelets in brushing the teeth.
Correct Answer: B
Rationale: Taking initial vital signs (B) during transfusion is within UAP scope. Assessing urine (A), lung sounds (C), and brushing teeth post-platelets (D) require nursing judgment.
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 client diagnosed with leukemia is scheduled for bone marrow transplantation. Which interventions should be implemented to prepare the client for this procedure? Select all that apply.
- A. Administer high-dose chemotherapy.
- B. Teach the client about autologous transfusions.
- C. Have the family members' HLA typed.
- D. Monitor the complete blood cell count daily.
- E. Provide central line care per protocol.
Correct Answer: A,C,D,E
Rationale: High-dose chemotherapy (A) ablates marrow, HLA typing (C) identifies donors, CBC monitoring (D) tracks counts, and central line care (E) prevents infection. Autologous transfusions (B) are irrelevant (donor marrow used).