BLOOD/LYMPH NCLEX QUESTIONS FROM INCREADILBLY EASY BOOK

WHEN PROTECTIVE ISOLATION ISNT INDICATED, WHICH ACTIVITY IS RECOMMENDED FOR A CLIENT RECEIVING CHEMOTHERAPY?

ACTIVITY AS TOLERATED

A BELOW THAN NORMAL HgB INDICATES?

ANEMIA RECENT HEMORRHAGE FLUID RETENTION CAUSING HEMODILUTION

BELOW THAN NORMAL HCT INDICATES?

ANEMIA OR HEMODILUTION

WHICH LAB TEST BESIDES A PLATELET COUNT BEST CONFIRMS THE DIAGNOSIS OF ESSENTIAL THROMBOCYTOPENIA?

BLEEDING TIME(PROLONGED)

WHICH BODY SUBSTANCES MOST EASILY TRANSMIT HIV?

BLOOD & SEMEN

THE NURSE IS CARING FOR A 43 YEAR OLD CLIENT UNDERGOING COLON CANCER TREATMENT. THE CLEINT HAS DEVELOPED THROMBOCYTOPENIA. WHICH OF THE FOLLOWING OBSERVATIONS CAN THE NURSE EXPECT?

BRUISES ON THE SKIN

WHAT SYMPTOMS ARE CLASSIC FOR THROMBOCYTOPENIA?

BRUISING PETECHIAE

A PLATELET LEVEL BELOW 50,000 INDICATES?

CAN RESULT IN SPONTANEOUS BLEEDING

WHICH FOOD SHOULD A NEURTROPENIC CLIENT WITH LEUKEMIA AVOID?

CARROT STICKS

WHICH INTERVENTION HAS THE MOST IMPACT IN DELAYING THE DEVELOPMENT OF AIDS ONCE A CLIENT HAS BEEN INFECTED WITH HIV?

COMPLIANCE WITH COMPLETE THERAPEUTIC REGIMEN

WHAT DRUG WOULD BE ORDERED TO IMPROVE PLATELET COUNT IN A CLIENT WITH IDIOPATHIC THROMBOCYTOPENIC PURPURA?

CORTICOSTEROIDS (DECREASES ANTIBODY FORMATION & PHAGOCYTOSIS OF ANTIBODY COATED PLATELETS)

THIS TEST IS USED TO HELP DIAGNOSE DIC BY CONFIRMING THE PRESENCE OF FIBRIN SPLIT PRODUCTS?

D-DIMER

WHAT ARE THE EXPECTED LAB FINDINGS FOR DIC?

DECREASED PLATELETS < 100,000 DECREASE FIBROGEN < 150 MG/DL INCREASED FIBRIN DEGRADATION > 100 MCG PROLONGED PT > 15 SECS PROLONGED PTT > 60 SECS DECREASED URINE < 30 ML/HR (OLIGURIA) ELEVATED BUN > 25 ELEVATED SERUM CREATININE > 1.3 MG/DL

A ABOVE THAN NORMAL HgB INDICATES?

DEHYDRATION HEMOCONCENTRATION DUE TO POLYCYTHEMIA

THIS TEST IS USED TO INVESTIGATE HEMOLYTIC TRANSFUSION REACTIONS & AID DIFFERENTIAL DIAGNOSIS OF ANEMIAS, WHICH MAY RESULT FROM AN AUTOIMMUNE REACTION OR A DRUG'S ADVERSE EFFECT. IT IS USED TO DETECT IMMUNOGLOBULINS(ANTIBODIES) ON RBC SURFACES?

DIRECT COOMBS TEST

WHAT ARE SOME SIGNS & SYMPTOMS OF DIC?

DYSPNEA OLIGURIA SEIZURES COMA SHOCK MUSCLE, BACK & ABDOMEN PAIN ACROCYANOSIS CUTANEOUS OOZING PETECHIAE ECCHYMOSES HEMATOMAS BLEEDING FROM SURGICAL SITES

WHICH PRECAUTIONS SHOULD THE NURSE INCLUDE IN THE CARE PLAN FOR A NEUTROPENIC CLIENT WITH LYMPHOMA?

ELIMINATE FRESH FRUITS & VEGGIES AVOID USING ENEMAS PRACTICE FREQ. HAND WASHING

WHICH BLOOD TEST IS USED FIRST TO IDENTIFY A RESPONSE TO HIV INFECTION?

ELISA ENZYME LINKED IMMUNOSORBENT ASSAY

A NURSE IS REVIEWING THE LAB RESULTS OF A CLIENT WITH ANEMIA. IN WHICH BLOOD COMPONENT WOULD SHE EXPECT TO SEE A REDUCED VALUE?

ERYTHROCYTES

INSTRUCTIONS FOR A CLIENT WITH SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) WOULD INCLUDE INFORMATION ABOUNT WHICH BLOOD DYSCRASIA?

ESSENTIAL THROMBOCYTOPENIA

A 32 YEAR OLD CLIENT IS ADMITTED WITH AIDS. THE PRELIMINARY REPORT OF BIOPSIES DONE ON HIS FACIAL LESIONS INDICATES KAPOSI'S SARCOMA. WHIC APPROACH WOULD BE MOST APPROPRIATE?

EXPLORE THE CLIENT'S FEELINGS ABOUT HIS FACIAL DISFIGUREMENT

STAGE IV HODGKIN'S INVOLVES?

EXTRALYMPHATIC ORGANS OR TISSUES

CHRISTMAS DISEASE OR HEMOPHILIA B RESULTS IN WHAT TYPE OF DEFICIENCY?

FACTOR IX DEFICIENCY

WHICH STATEMENT IS CORRECT ABOUT THE RATE OF CELL GROWTH IN RELATION TO CHEMOTHERAPY?

FASTER GROWING CELLS ARE MORE SUSCEPTIBLE TO CHEMOTHERAPY

WHAT SHOULD YOU KNOW REGARDING FERROUS SULFATE?

FOR IRON DEFICIENCY CAUSES NAUSEA, EPIGASTRIC PAIN, VOMITING, BLACK STOOLS GIVE LIQUID PREPARATIONS WITH ORANGE JUICE OR WATER NOT MILK OR ANTACIDS, GIVE STRAW BECAUSE IT STAINS TEETH, GIVE BETWEEN MEALS

WHICH TREATMENT IS MOST APPROPRIATE FOR THE CLIENT WITH TUMOR LYSIS SYNDROME?

GIVE IV HYDRATION

THE NURSE IS REVIEWING A CLIENT'S LAB VALUES AND NOTES A DEFICIENCY OF FACTOR VIII. WHICH OF THE FOLLOWING CONDITIONS IS MOST CONSISTENT WITH THIS RESULT?

HEMOPHILIA A

A CLIENT HAD CORONARY ARTERY BY GRAFT (CABG) SURGERY 3 DAYS AGO. WHICH CONDITION IS SUSPECTED WHEN A DECREASE IN PLATELET COUNT FROM 230,000 ML TO 5000 ML IS NOTED?

HEPARIN ASSOCIATED THROMBOSIS & THROMBOCYTOPENIA (HATT) MAY OCCUR AFTER CABG DUE TO USE OF HEPARIN DURING SURGERY

A CLIENT IS COMPLAINING OF FEVER, DRENCHING NIGHT SWEATS AND UNEXPLAINED WEIGHT LOSS OVER THE PAST 3 MONTHS. PHYSICAL EXAMINATION REVEALS A SINGLE ENLARGED SUPRACLAVICULAR LYMPH NODE. WHICH ILLNESS IS THE MOST PROBABLE DIAGNOSIS?

HODGKINS DISEASE

WHICH STATEMENT MADE BY A CLIENT INDICATES THAT HE UNDERSTANDS THE RESULTS OF A NEGATIVE HIV ANTIBODY TEST?

I HAVENT PRODUCED ANTIBODIES TO HIV (TAKES 3 WEEKS -6 MONTHS TO DEVELOP)

THE NURSE IS TEACHING A CLIENT ABOUT THE METHOD OF TRANSMISSION THAT HAS THE MOST RISK FOR EXPOSURE TO HIV. WHICH OF THE FOLLOWING STATEMENTS BY THE CLIENT BEST DEMONSTRATES THAT HE UNDERSTANDS THE TEACHING ABOUT EXPOSURE RISKS?

I SHOULD NOT ENGAGE IN INTERCOURSE WITH A NEW PARTNER WITHOUT A CONDOM

A CLIENT IS ABOUT TO START CHEMO FOR ACUTE LYMPHOCYTIC LEUKEMIA. WHICH STATEMENT SHOWS THAT HE REQUIRES FURTHER TEACHING ABOUT THIS PHASE OF CHEMOTHERAPY?

ILL HAVE TREATMENTS ONLY ONCE A MONTH

IMMEDIATELY AFTER GIVING AN INJECTION, A NURSE IS ACCIENTALLY STUCK WITH THE NEEDLE WHEN A CLIENT BECOMES AGITATED. WHEN IS THE BEST TIME FOR THE EMPLOYER TO TEST THE NURSE FOR HIV ANTIBODIES TO DETERMINE IF SHE BECAME INFECTED AS A RESULT OF THE NEEDLE STICK?

IMMEDIATELY AND THEN AGAIN IN 3 MONTHS

DURING DISCHARGE TEACHING FOR CORTICOSTEROIDS THE CLIENT ASKS THE NURSE WHAT THE DRUGS SUPPRESS. WHICH RESPONSE SHOULD THE NURSE GIVE?

IMMUNE RESPONSE

WHICH SUBSTANCE HAS ABNORMAL VALUES EARLY IN THE COURSE OF MULTIPLE MYELOMA?

IMMUNOGLOBULINS

A CLIENT WITH AIDS IS ADMITTED WITH PNEUMOCYSTIS CARINII PNEUMONIA. DURING THE ADMISSION ASSESSMENT, THE NURSE NOTES A 3 CM FOOT ULCER ON HIS LEFT GREAT TOE. WHICH IS THE MOST CRITICAL NURSING DIAGNOSIS?

IMPAIRED GAS EXCHANGE

WHILE ASSESSING A CLIENT WITH DIC THE NURSE SUSPECTS THE CLIENT HAS DEVELOPED INTERNAL BLEEDING, WHICH OF THE FOLLOWING SYMPTOMS WOULD INDICATE THIS CONDITION?

INCREASING ABDOMINAL GIRTH

WHAT IS THE 1ST STAGE OF CHEMOTHERAPY AND WHAT DOES IT INCLUDE?

INDUCTION DESIGNED TO PUT THE PATIENT INTO REMISSION BY GIVING HIGH DOSES OF THE DRUG TREATMENTS WILL BE CLOSE TOGETHER AND MORE THAN ONCE A MONTH

FOR AN ADULT CLIENT TO BE DIAGNOSED WITH AIDS, WHICH CONDITION HAS TO BE PRESENT?

INFECTION WITH HIV, A HISTORY OF ACUTE HIV INFECTION & A CD4 T-CELL COUNT BELOW 200 CELLS/ml

ACCORDING TO A STANDARD STAGING CLASSIFICATION OF HODGKIN'S DISEASE, WHICH CRITERION REFLECTS STAGE II?

INVOLVEMENT OF 2 OR MORE LYMPH NODE REGIONS OR STRUCTURES

WHICH EXPLANATION ABOUT THE ACTION OF HEPARIN SHOULD THE NURSE PROVIDE A CLIENT WHO HAS JUST STARTED BEING ADMINISTERED THIS DRUG?

IT SLOWS THE TIME IT TAKES FOR THE BLOOD TO CLOT

WHILE CARING FOR A CLIENT WITH AIDS WHO IS RECEIVING ZIDOVUDINE THE NURSE IS ASKED "HOW DOES THIS DRUG WORK?" AFTER TEACHING THE CLIENT, THE NURSE INTERPRETS WHICH RESPONSE BY THE CLIENT TO INDICATE AN UNDERSTANDING OF THE MEDICATION?

IT SUPPRESSES THE HIV VIRUS

WHAT IS THE TREATMENT FOR DIC IF PT IS ACTIVELY BLEEDING?

IV HEPARRIN FFP PLATELETS PRBC'S

A 19 YEAR OLD ADMITTED WIT A HEAT STROKE BEGINS TO SHOW SIGNS OF DIC WHICH LAB VALUE IS MOST CONSISTENT WIT DIC?

LOW PLATELET COUNT (FIBRIN INCREASES)

WHICH GROUP OR FACTOR IS LINKED TO HIGHER MORBIDITY & MORTALITY IN HIV INFECTED CLIENTS?

LOWER SOCIOECONOMIC STATUS

STAGE III HODGKIN'S INVOLVES?

LYMPH NODES ON BOTH SIDES OF DIAPHRAGM

WHAT CONDITION OR FACTOR MAY CAUSE AIDS?

MEDICAL TREATMENTS(MEDS, RADIATION, TRANSPLANTS)

NORMAL HCT LEVELS?

MEN 42-52% WOMEN 36-48% CHILDREN 30-42%

WHAT DRUG CAN CAUSE THROMBOCYTOPENIA?

METHOTREXATE

THE NURSE WOULD INSTRUCT A CLIENT WITH HIV WHO HAS FREQUENT BOUTS OF DIARRHEA TO AVOID CONSUMING WHICH OF THE FOLLOWING?

MILK

THE NURSE IS ASSESSING A CLIENT NEWLY DIAGNOSED WITH STAGE II HODGKINS LYMPHOMA. WHICH AREA OF THE BODY WOULD THE NURSE MOST LIKELY FIND INVOLVED?

NECK

WHICH SYMPTOM IS MOST COMMONLY AN EARLY INDICATION OF STAGE I HODGKINS DISEASE?

NIGHT SWEATS, ENLARGED LYMPH NODES, UNEXPLAINED FEVER, MALAISE, GENERALIZED PRURITIS

A YOUNG AFRICAN AMERICAN FEMALE CLIENT WITH A HISTORY OF SICKLE CELL DISEASE IS COMPALINING OF SEVERE ABDOMINAL PAIN. WHICH NURSING INTERVENTION IS THE MOST IMPORTANT FOR THIS PATIENT?

OBTAINING A HISTORY OF THE SEQUENCE OF SYMPTOMS

A CLIENT WITH ANEMIA MAY BE TIRED DUE TO A TISSUE DEFICIENCY OF WHICH SUBSTANCE?

OXYGEN

WHICH ADDITIONAL PHYSICIAN ORDER SHOULD A NURSE ANTICIPATE FOR A CLIENT WHO HAS BEEN PRESCRIBED CORTICOSTEROIDS?

PERFORM BLOOD GLUCOSE CHECKS EVERY 6 HOURS

THIS TEST IS USED TO MEASURE HOW QUICKLY A CLOT FORMS AFTER A STANDARD AMOUNT OF BOVINE THROMBIN IS ADDED TO A PLATELET POOR PLASMA SAMPLE FROM THE PATIENT & TO A NORMAL PLASMA CONTROL SAMPLE. IT IS USED TO DETECT A FIBRINOGEN DEFICIENCY OR DEFECT, DIC, & HEPATIC DISEASE & MONITOR HEPARIN OR THROMBOLYTIC THERAPY?

PLASMA THROMBIN TIME

WHICH STATEMENT INDICATES THAT A CLIENT WITH THROMBOCYTOPENIA UNDERSTANDS THE FUNCTION OF PLATELETS IN HER BODY?

PLATELETS STOP THE BLEEDING WHEN ARTERIES & VEINS ARE INJURED

ABOVE THAN NORMAL HCT INDICATES?

POLYCYTHEMIA HEMOCONCENTRATION DUE TO BLOOD LOSS

WHAT IS THE PREFERED SITE FOR BONE MARROW BIOPSY?

POSTERIOR SUPERIOR ILIAC CREST

A PLATELET LEVEL BELOW 5000 INDICATES?

POTENTIAL FOR MASSIVE HEMORRHAGE

WHAT TEST IS BEST FOR MONITORING ORAL ANTICOAGULANT THERAPY?

PT

THIS TEST IS USED TO EVALUATE ALL INTRINSIC PATHWAY CLOTTING FACTORS BY MEASURING THE TIME NEEDED FOR A FIBRIN CLOT TO FORM AFTER CALCIUM & PHOSPHOLIPID EMULSION IS ADDED TO A PLASMA SAMPLE. IT IS COMMONLY USED TO MONITOR HEPARIN THERAPY?

PTT

A PT WITH HYPOVOLEMIC SHOCK IS BEING GIVEN PLASMA PROTEIN THEY TO EXPERIECE HYPOTENSION, WHAT SHOULD BE THE NURSES NEXT STEP?

REDUCE INFUSION RATE

THE NURSE IS PLANNING CARE FOR A 67 YEAR OLD CLIENT WHO RECENTLY HAD ABDOMINAL AORTIC ANEURYSM REPAIR SURGERY. THE CLIENT HAS DEVELOPED DIC. WHICH IS THE MOST CRITICAL NURSING DIAGNOSIS FOR THE PATIENT?

RISK FOR INEFFECTIVE CEREBRAL TISSUE PERFUSION

A CLIENT WITH THROMBOCYTOPENIA SECONDARY TO LEUKEMIA DEVELOPS EPISTAXIS. THE NURSE SHOULD INSTRUCT THE CLIENT TO DO WHICH OF THE FOLLOWING?

SIT UPRIGHT AND LEAN FORWARD SLIGHTLY

A NURSE IS TEACHING A CLIENT WITH MICROCYTIC ANEMIA ABOUT CHOOSING COMBINATIONS OF FOODS TO INCREASE NON-HEME IRON ABSORBTION. SHE SHOULD INCLUDE?

SPLIT PEA SOUP WITH HAM

THE NURSE IS REVIEWING A 52 YEAR OLD CLIENT'S LAB VALUES. THE PLATELET COUNT IS 25000, THIS VALUE INDICATES?

THROMBOCYTOPENIA

THE NURSE IS REVIEWING LAB VALUES, WHICH OF THE FOLLOWING RESULTS WOULD MOST LIKELY BE PRESENT IN A CLIENT RECENTLY DIAGNOSED WITH CHRONIC LYMPHOCYTIC LEUKEMIA?

THROMBOCYTOPENIA & INCREASED LYMPHOCYTES

BEFORE STARTING TREATMENT FOR LEUKEMIA A CLIENT RECEIVES IV FLUIDS AND ALLOPURINOL (ZYLOPRIM). THE GOAL OF THESE INTERVENTIONS IS TO REDUCE THE RISK OF WHICH COMPLICATION OF CHEMOTHERAPY?

TUMOR LYSIS SYNDROME

WHAT SHOULD YOU KNOW REGARDING SERUM ALBUMIN & PLASMA PROTEINS?

USED FOR HYPOVOLEMIC SHOCK CAUSES FLUID TO SHIFT INTO VASCULAR SYSTEM SIDE EFFECTS: VASCULAR OVERLOAD AFTER RAPID INFUSION, HYPOTENSION, NAUSEA, VOMITING, SOB, PULMONARY EDEMA, CHILLS, FEVER DONT USE IF SOLUTION IS CLOUDY OR HAS SEDIMENT DONT GIVE MORE THAN 250 G IN 48 HRS

WHAT SHOULD YOU KNOW REGARDING CORTICOSTEROIDS?

USED FOR IMMUNE MEDIATED DISORDERS FOR INFLAMMATION CAUSES LEUKOPENIA(DECREASED BONE MARROW) USE CAUTIOUSLY IN PTS WITH GI ULCERS, RENAL DISEASE, HYPERTENSION, DM, PSYCHOTIC PTS

WHICH PRECAUTION MUST A NURSE TAKE WHEN TAKING THE BLOOD PRESSURE OF AN HIV-POSITIVE CLIENT?

WASHING HANDS

FOR A CLIENT WIT AIDS THE NURSE SHOULD FOLLOW STANDARD PRECAUTIONS & TAKE WHICH ACTION TO PROTECT HERSELF WHEN PERFORMING MOUTH CARE ON THE CLIENT?

WEAR GLOVES

A PT IS GIVEN A MEDICATION AND THE PT BEGINS TO EXPERIENCE AN AUTOIMMUNE REACTION, WHAT SHOULD BE THE NURSE'S FIRST PRIORITY?

WITHHOLD MEDICATION

NORMAL PLATELET COUNT IS?

140,000-400,000

WHAT IS THE NORMAL RANGE FOR PTT?

25-36 SECS

WHICH CLIENT IS MOST AT RISK FOR DEVELOPING MALIGNANT LYMPHOMA?

A 22 YEAR OLD WITH HISTORY OF MONOUCLEOSIS

WHICH CLIENT IS MOST AT RISK FOR DEVELOPING ACUTE LYMPHOCYTIC LEUKEMIA?

A 4 YEAR OLD WHITE FEMALE THIS IS FOUND IN PEDI'S

WHICH CLIENT HAS THE HIGHEST RISK OF DEVELOPING ANEMIA?

A CLIENT WHO HAD A GASTRECTOMY(LACK ON INTRINSIC FACTOR)

WHICH CLIENT IS MOST AT RISK FOR DEVELOPING MULTIPLE MYELOMA?

60 YEAR OLD BLACK MALE

A NURSE IS TEACHING A CLIENT ABOUT IDIOPATHIC THROMBOCYTOPENIA. WHAT SHOULD SHE TELL THE CLIENT IS THE NORMAL LIFE SPAN FOR PLATELETS?

7-10 DAYS