Hematology NCLEX questions

Hematology NCLEX questions 12 studiers today 5.0 (4 reviews) Students also studied Terms in this set (62) York UniversityBScN, Nursing Save Hematology NCLEX 33 terms araymer22Preview Med Surg Gastrointestinal NCLEX Q...86 terms Jasmine_Lawson4 Preview Fluid and Electrolytes NCLEX Quest...33 terms Alex_Hassiepen Preview Hemato 110 term tok A nurse in a clinic is caring for a client who has suspected anemia. Which of the following laboratory test results should the nurse expect?

• Iron 90 mcg/dL
• RBC 6.5 million/uL
• WBC 4,800 mm3
• Hgb 10 g/dL
• An iron level of 90 mcg/dL is within the expected reference

range and is not an expected finding of anemia.

• RBC count of 6.5 million/uL is above the expected reference

range. A decreased RBC count is an expected finding of anemia.

• WBC count of 4800 mm3

is below the expected reference range and is not an expected finding of anemia.

D. CORRECT: Hgb of 10 g/dL is below the expected

reference range and is an expected finding of anemia.A nurse is caring for a client who is receiving warfarin for anticoagulation therapy. Which of the following laboratory test results indicates to the nurse that the client needs an increase in the dosage?

• aPTT 38 seconds

B. INR 1.1

• PT 22 seconds
• D‑dimer negative
• aPTT is monitored for clients receiving heparin therapy. An aPTT of 38 seconds

is within the expected reference range for clients not receiving heparin therapy.

• CORRECT: INR of 1.1 is within the expected reference range for a client who is

not receiving warfarin. However, this value is subtherapeutic for anticoagulation therapy. The nurse should expect the client to receive an increased dosage of warfarin until the INR is 2 to 3.

• PT of 22 seconds is above the expected reference range for a client receiving

warfarin therapy. This result indicates the client is at an increased risk for bleeding.

• A negative D‑dimer test indicates the absence of a pulmonary embolus or deep

vein thrombosis and is not used to determine the dosage needs for warfarin therapy.

A nurse is providing teaching for a client who is scheduled for a bone marrow biopsy of the iliac crest.Which of the following statements made by the client indicates an understanding of the teaching?

• "This test will be performed while I am lying flat on my

back."

• "I will need to stay in bed for about an hour after the

test." C."This test will determine which antibiotic I should take for treatment." D."I will receive general anesthesia for the test."

• The nurse should inform the client that he will be placed in a prone or

side‑lying position during the test in order to expose the iliac crest.

B. CORRECT: The nurse should inform the client of the need to stay on bed rest

for 30 to 60 min following the test to reduce the risk for bleeding.

• The nurse should inform the client that a culture and sensitivity test determines

the type of antibiotics needed to treat an infection.

• The nurse should inform the client that he will receive a sedative prior to the

test and that a local anesthetic will be used at the site.

• A nurse is preparing to administer

packed RBCs to a client who has a Hgb of 8 g/dL. Which of the following actions should the nurse plan to take during the first 15 min of the transfusion?

• Obtain consent from the

client for the transfusion.

• Assess for an acute

hemolytic reaction.

• Explain the transfusion

procedure to the client.

• Obtain blood culture

specimens to send to the lab

• The nurse should obtain consent from the client for

the transfusion prior to initiating the transfusion.

B. CORRECT: The nurse should assess for an acute hemolytic reaction

during the first 15 min of the transfusion. This form of a reaction can occur following the transfusion of as little as 10 mL of blood product.

• The nurse should explain the transfusion procedure

to the client prior to initiating the transfusion.

• The nurse should obtain blood culture specimens
• A nurse is caring for a client who

is receiving a blood transfusion.Which of the following actions should the nurse expect if an allergic transfusion reaction is suspected? (Select all that apply.)

• Stop the transfusion.
• Monitor for hypertension.
• Maintain an IV infusion with

0.9% sodium chloride.

• Position the client in an

upright position with the feet lower than the heart.

• Administer diphenhydramine.

A. CORRECT: The nurse should immediately stop the infusion if an allergic

transfusion reaction is suspected.

• The nurse should monitor for hypotension if an allergic transfusion reaction is

suspected due to the risk for shock.

C. CORRECT: The nurse should administer 0.9% sodium chloride solution

through new IV tubing if an allergic transfusion reaction is suspected.

• The nurse should position the client in an upright position with the feet lower

than the level of the heart if a circulatory overload is suspected.

E. CORRECT: The nurse should administer an antihistamine, such as

diphenhydramine, if an allergic transfusion reaction is suspected.

• A nurse is monitoring a client

who began receiving a unit of packed RBCs 10 min ago.Which of the following findings should the nurse identify as an indication of a febrile transfusion reaction? (Select all that apply.)

• Temperature change from

37° C (98.6° F) pretransfusion to 37.2° C (99.0° F)

• Current blood pressure

178/90 mm Hg

• Heart rate change from 88/min

pretransfusion to 120/min

• Client report of itching
• Client appears flushed
• A temperature increase of 1° F (0.5° C) is an indication of a febrile transfusion

reaction.

• Hypotension is an indication of a febrile transfusion reaction.

C. CORRECT: Tachycardia is an indication of a febrile transfusion reaction.

• The client’s report of itching is an indication of an allergic transfusion reaction.

E. CORRECT: A flushed appearance of the client can indicate a febrile

transfusion reaction

• A nurse is providing preoperative

teaching for a client who requests autologous donation in preparation for a scheduled orthopedic surgical procedure. Which of the following statements should the nurse include in the teaching?

• "You should make an

appointment to donate blood

• weeks prior to the surgery."
• "If you need an autologous

transfusion, the blood your brother donates can be used." C."You can donate blood each week if your hemoglobin is stable." D."Any unused blood that is donated can be us

• The client should donate blood for an autologous

transfusion no sooner than 6 weeks prior to surgery.

• An autologous donation refers to the client’s

donation of blood for his own personal use.

C. CORRECT: Beginning 6 weeks prior to surgery, the

client can donate blood each week for autologous transfusion if his Hgb and Hct remain stable.

• An autologous donation is for use only by the client.

• A nurse preceptor is observing a

newly licensed nurse on the unit who is preparing to administer a blood transfusion to an older adult client.Which of the following actions by the newly licensed nurse indicates an understanding of the procedure?

• Inserts an 18‑gauge IV

catheter in the client

• Verifies blood compatibility

and expiration date of the blood with an assistive personnel (AP)

• Administers dextrose 5%

in 0.9% sodium chloride IV with the transfusion

• Obtains vital signs

every 15 min throughout the procedure.

• The nurse should use no larger than a 19‑gauge

needle in the older adult client.

• The nurse should verify the client’s identity and blood compatibility,

and expiration date of the blood with another nurse. This task is beyond the scope of practice for an assistive personnel.

• The nurse should administer blood products with 0.9% sodium

chloride. IV solutions containing dextrose cannot be used.

D. CORRECT: The nurse should check the older adult client’s

vital signs every 15 min throughout the transfusion to allow for early detection of fluid overload or other transfusion reaction.

• An individual who lives at a high altitude may normally

have an increased RBC count because

• high altitudes cause vascular fluid loss, leading to

hemoconcentration.

• hypoxia caused by decreased atmospheric oxygen

stimulates erythropoiesis.

• the function of the spleen in removing old RBCs is

impaired at high altitudes.

• impaired production of leukocytes and platelets leads

to proportionally higher red cell counts.

• hypoxia caused by decreased atmospheric oxygen stimulates erythropoiesis.
• Malignant disorders that arise from granulocytic cells in

the bone marrow will have the primary effect of causing

• risk for hemorrhage.
• altered oxygenation.
• decreased production of antibodies.
• decreased phagocytosis of bacteria.
• decreased phagocytosis of bacteria.
• An anticoagulant such as warfarin (Coumadin) that

interferes with prothrombin production will alter the clotting mechanism during

• platelet aggregation.
• activation of thrombin.
• the release of tissue thromboplastin.
• stimulation of factor activation comple
• activation of thrombin.
• When reviewing laboratory results of an 83-year-old

patient with an infection, the nurse would expect to find

• minimal leukocytosis.
• decreased platelet count.
• increased hemoglobin and hematocrit levels.
• decreased erythrocyte sedimentation rate (ESR).
• minimal leukocytosis.