front 1 The nurse is assessing an older client for any potential hematologic health problem. Which assessment finding is the most significant and would be reported to the primary health care provider? | back 1 Multiple petechiae and large bruises |
front 2 A nurse is assessing a dark-skinned client for pallor. What nursing assessment is best to assess for pallor in this client? | back 2 Assess the conjunctiva of the eye |
front 3 A hospitalized client has a platelet count of 58,000/mm3 (58,000/mm (58x 10/L). What action by the nurse is most appropriate? | back 3 Place the client on safety precautions. |
front 4 A client is having a bone marrow aspiration and biopsy. What action by the nurse takes priority? | back 4 Ensure that valid consent is in the medical record. |
front 5 What is the nurse’s priority when caring for a client who just completed a bone marrow aspiration and biopsy? | back 5 Check the pressure dressing frequently for signs of excessive or active bleeding. |
front 6 A nurse is caring for four clients. After reviewing today’s laboratory results, which client would the nurse assess first? | back 6 Client with a prothrombin time (PT) of 28 seconds |
front 7 A client is having a bone marrow aspiration and biopsy and is extremely anxious. What action by the nurse is the most appropriate | back 7 Assess the client’s fears and coping mechanisms. |
front 8 A client is having a radioisotopic imaging scan. What action by the nurse is most important? | back 8 Teach the client about the procedure. |
front 9 While taking a client history, which factor(s) that place the client at risk for a hematologic health problem will the nurse document? (Select all that apply.) | back 9 Family history of bleeding problems Excessive alcohol consumption Diet high in Vitamin K |
front 10 An older client asks the nurse why “people my age” have weaker immune systems than younger people. What responses by the nurse are best? (Select all that apply.) | back 10 “Bone marrow produces fewer blood cells as you age.” You have lower levels of plasma proteins in the blood.” |
front 11 The nurse is assessing a client experiencing anemia. Which laboratory findings will the nurse expect for this client? (Select all that apply.) | back 11 Decreased red blood cell count Decreased serum iron Decreased hemoglobin |
front 12 A nurse works in a gerontology clinic. What age-related change(s) related to the hematologic system will the nurse expect during health assessment? (Select all that apply.) | back 12 Nail beds may be thickened or discolored. Progressive loss or thinning of hair occurs. |
front 13 A nurse caring for a client with sickle cell disease (SCD) reviews the client’s laboratory test results. Which finding would the nurse report to the primary health care provider? | back 13 Creatinine: 2.9 mg/dL (256 mcmol/L) |
front 14 The nurse is assessing a client in sickle cell disease (SCD) crisis. What priority client problem will the nurse expect? | back 14 Pain |
front 15 A client in sickle cell crisis is dehydrated and in the emergency department. The nurse plans to start an IV. Which fluid choice is best? | back 15 0.45% normal saline |
front 16 A client presents to the emergency department in sickle cell disease crisis. What intervention by the nurse takes priority? | back 16 Administer oxygen. |
front 17 A client hospitalized with sickle cell disease crisis frequently asks for opioid pain medications, often shortly after receiving a dose. The nurses on the unit believe that the client is drug seeking. When the client requests pain medication, what action by the nurse is best? | back 17 Give the client pain medication if it is time for another dose. |
front 18 The nurse is caring for a client experiencing sickle cell disease crisis. Which priority action would help prevent infection? | back 18 Performing frequent handwashing |
front 19 A nurse in a hematology clinic is working with four clients who have polycythemia vera. Which client would the nurse assess first? | back 19 Client who reports shortness of breath |
front 20 The nurse is teaching a client who has pernicious anemia about necessary dietary changes. Which statement by the client indicates understanding about those changes? | back 20 “I’ll increase animal proteins like fish and meat.” |
front 21 An assistive personnel is caring for a client with leukemia and asks why the client is still at risk for infection when the white blood cell count (WBC) is high. What response by the nurse is correct? | back 21 “Those WBCs are abnormal and don’t provide protection.” |
front 22 The family of a neutropenic client reports that the client “is not acting right.” What action by the nurse is the priority? | back 22 Assess the client for infection. |
front 23 A nurse is caring for a client who is about to receive a bone marrow transplant. To best help the client cope with the long recovery period, what action by the nurse is best? | back 23 Help the client find things to hope for each day of recovery. |
front 24 A client asks about the process of graft-versus-host disease. What explanation by the nurse is correct? | back 24 “The donor’s cells are actually attacking the patient’s cells.” |
front 25 The nurse is caring for a patient with leukemia who has severe fatigue. What action by the client best indicates that an important outcome to manage this problem has been met? | back 25 Doing activities of daily living (ADLs) using rest periods |
front 26 A nurse is caring for a young male client with lymphoma who is to begin treatment. What teaching topic is a priority? | back 26 Sperm banking |
front 27 A client has been admitted after sustaining a humerus fracture that occurred when picking up the family cat. What test result would the nurse correlate to this condition? | back 27 Bence-Jones protein in urine |
front 28 A client with multiple myeloma demonstrates worsening bone density on diagnostic scans. About what drug does the nurse plan to teach this client? | back 28 Zoledronic acid |
front 29 A client has a platelet count of 9000/mm3 (9 x 10/L). The nurse finds the client confused and mumbling. What nursing action takes priority at this time? | back 29 Call the Rapid Response Team. |
front 30 A nurse is preparing to administer a blood transfusion. What action is most important? | back 30 Ensure that informed consent is obtained. |
front 31 A nurse is preparing to administer a blood transfusion. Which action is most important? | back 31 Put on a pair of gloves. |
front 32 A client receiving a blood transfusion develops anxiety and low back pain. After stopping the transfusion, what action by the nurse is most important? | back 32 Double-check the client and blood product identification. |
front 33 A client has thrombocytopenia. What statement indicates that the client understands self-management of this condition? | back 33 “I usually put ice on bumps or bruises.” |
front 34 A nurse is caring for four clients with leukemia. After hand-off report, which client would the nurse assess first? | back 34 Client who had two bloody diarrhea stools this morning. |
front 35 Which statement by a client with leukemia indicates a need for further teaching by the nurse? | back 35 “I will take a daily laxative to prevent constipation.” |
front 36 The nurse is assessing a client who has probable lymphoma. What is the most common early assessment finding for clients with this disorder? | back 36 Enlarged painless lymph node(s) |
front 37 The nurse assesses a client’s oral cavity as seen in the photo below: What action by the nurse is most appropriate? | back 37 Teach the client about cobalamin therapy. |
front 38 A nurse working with clients diagnosed with sickle cell disease (SCD) teaches about self-management to prevent exacerbations and sickle cell crises. What factor(s) should clients be taught to avoid? (Select all that apply.) | back 38 Dehydration Extreme stress High altitudes Pregnancy |
front 39 Which risk factor(s) places a client at risk for leukemia? (Select all that apply.) | back 39 Chemical exposure Ionizing radiation exposure Viral infections |
front 40 The nurse is assessing a client with chronic leukemia. Which laboratory test result(s) is (are) expected for this client? (Select all that apply.) | back 40 Decreased hematocrit Abnormal white blood cell count Low platelet count Decreased hemoglobin |
front 41 The nurse is caring for a client being treated for Hodgkin lymphoma. For which side effect(s) of treatment will the nurse assess? (Select all that apply.) | back 41 Severe nausea and vomiting Low platelet count Skin irritation at radiation site Low red blood cell count |
front 42 The nurse is preparing to administer a blood transfusion. Which action(s) by the nurse is (are) most appropriate? (Select all that apply.) | back 42 Hang the blood product using normal saline and a filtered tubing set. Take a full set of vital signs prior to starting the blood transfusion. Use gloves to start the client’s IV if needed and to handle the blood product. |
front 43 Which statement(s) about blood transfusion compatibilities is (are) correct? (Select all that apply.) | back 43 Donor blood type A can donate to recipient blood type AB. Donor blood type O can donate to anyone. |
front 44 The nurse is caring for a client receiving a unit of whole blood. Which nursing action(s) is (are) appropriate regarding infusion administration. (Select all that apply.) | back 44 Use a dedicated filtered blood administration set. Stay with the client for the first 15 to 20 minutes of the infusion. Monitor and document vital signs per agency policy. Infuse the transfusion with intravenous normal saline. |
front 45 A nurse is preparing to administer a packed red blood cell transfusion to an older adult. Understanding age-related changes, what alteration(s) in the usual protocol is (are) necessary for the nurse to implement? (Select all that apply.) | back 45 Assess vital signs at least every 15 minutes. Avoid giving other IV fluids. Assess the client for fluid overload. |
front 46 Which assessment finding(s) may indicate that a client may be experiencing a blood transfusion reaction? (Select all that apply.) | back 46 Tachycardia Tachypnea |
front 47 A client has received a bone marrow transplant and is waiting for engraftment. What action(s) by the nurse are most appropriate? (Select all that apply.) | back 47 Placing the client in protective precautions Teaching visitors appropriate hand hygiene Telling visitors not to bring live flowers or plants |
front 48 A nurse is caring for an older adult receiving multiple packed red blood cell transfusions. Which assessment finding(s) indicate(s) possible transfusion circulatory overload? (Select all that apply.) | back 48 Acute confusion Dyspnea Hypertension Bounding pulse |