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Which clinical manifestation of Stage I non-Hodgkin’s lymphoma would the nurse expect to find when assessing the client?
- A. Enlarged lymph tissue anywhere in the body.
- B. Tender left upper quadrant.
- C. No symptom in this stage.
- D. Elevated B-cell lymphocytes on the CBC.
Correct Answer: C
Rationale: Stage I NHL is often asymptomatic (C), with localized node involvement. Enlarged nodes (A) are later, LUQ tenderness (B) suggests spleen, and B-cell elevation (D) is lab-based, not clinical.
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The client diagnosed with sickle cell anemia is experiencing a vaso-occlusive sickle cell crisis secondary to an infection. Which medical treatment should the nurse anticipate the HCP ordering for the client?
- A. Administer meperidine (Demerol) intravenously.
- B. Admit the client to a private room and keep in reverse isolation.
- C. Infuse D5W 0.33% NS at 150 mL/hr via pump.
- D. Insert a 22-French Foley catheter with a urimeter.
Correct Answer: C
Rationale: Hydration with IV fluids (C) prevents sickling in vaso-occlusive crisis. Meperidine (A) is avoided (risks seizures), isolation (B) is excessive, and Foley (D) is unnecessary.
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 diagnosed with iron-deficiency anemia is prescribed ferrous gluconate orally. Which should the nurse teach the client?
- A. Take Imodium, an antidiarrheal, over-the-counter (OTC) for diarrhea.
- B. Limit exercise for several weeks until a tolerance is achieved.
- C. The stools may be very dark, and this can mask blood.
- D. Eat only red meats and organ meats for protein.
Correct Answer: C
Rationale: Ferrous gluconate darkens stools (C), potentially masking GI bleeding. Imodium (A) is premature, exercise (B) is encouraged, and diet (D) should be varied, not meat-only.
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.
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.