Free practice questions › Hematologic & Oncologic
Hematologic & Oncologic NCLEX practice questions
Five NCLEX-style questions on anemia, sickle cell disease, leukemia, chemotherapy, neutropenia and transfusions. Pick your answer, then open it to see the right choice and why. New questions every week.
Question 1
A nurse is assessing a patient who is receiving a platelet transfusion. Which of the following findings is an adverse effect of the transfusion?
- A.Nystagmus.
- B.Bradycardia.
- C.Chills.
- D.Hypothermia.
Show answer and rationale ▾Answer and rationale ▴
Answer: C. Chills.
Nystagmus, which is involuntary eye movement, is not a common adverse effect of a platelet transfusion. Bradycardia, or a slow heart rate, is not typically associated with platelet transfusions. Chills can be an adverse effect of a platelet transfusion. This could be a sign of a reaction to the transfusion, such as an allergic reaction or a febrile non-hemolytic transfusion reaction. Hypothermia is not a common adverse effect of a platelet transfusion.
Question 2
A nurse is preparing a patient for home care following cancer treatment.
- A.He is discussing the use of the fentanyl patch.
- B.Which of the following would be the most important instruction regarding safety?
- C.Store fentanyl patches in a locked cabinet.
- D.Prepare the skin by cleaning it with an antiseptic scrub solution.
Show answer and rationale ▾Answer and rationale ▴
Answer: C. Store fentanyl patches in a locked cabinet.
rationale:Storing fentanyl patches in a locked cabinet is a good practice to prevent unauthorized access and to keep them out of reach of children or individuals who should not have access to the medication. However, it is not the most critical safety instruction. Proper application and usage are more important. rationale:While preparing the skin by cleaning with an antiseptic scrub solution is a necessary step when applying a transdermal medication like a fentanyl patch, it is not the most critical safety instruction. It is a standard part of the application process but does not address the overarching safety concerns related to fentanyl use. rationale:The most crucial instruction regarding the safety of fentanyl patches is to apply them as directed by the primary care provider. Fentanyl is a potent opioid medication, and its misuse or improper application can lead to serious health risks, including overdose. Therefore, following the prescriber's instructions is of utmost importance to ensure the patient's safety. rationale:Using fentanyl patches as needed for breakthrough pain without clear guidance from a healthcare provider is not a safe practice. Fentanyl is a potent medication with a high risk of overdose, and its use should always be closely monitored and directed by a healthcare professional. Self-adjusting the dosage without medical supervision can lead to serious safety issues.
Question 3
The nurse is caring for a client with leukemia and notes that the client has poor skin turgor and flat neck and hand veins. The nurse suspects hypernatremia. Which sign/symptom would the nurse expect to note in this client if hypernatremia is present?
- A.Polyuria
- B.Dry mucous membranes
- C.Diarrhea
- D.Intense thirst
Show answer and rationale ▾Answer and rationale ▴
Answer: B. Dry mucous membranes
This is incorrect because polyuria is a sign of hyponatremia, not hypernatremia. Polyuria is the excessive production of urine, which can cause fluid loss and sodium dilution. This is correct because dry mucous membranes are a sign of hypernatremia. Dry mucous membranes are caused by dehydration, which can occur in hypernatremia due to fluid shifting from the intracellular to the extracellular space. This is incorrect because diarrhea is a sign of hyponatremia, not hypernatremia. Diarrhea is the frequent and watery passage of stool, which can cause fluid and electrolyte loss. This is incorrect because intense thirst is a sign of both hyponatremia and hypernatremia. Intense thirst is a result of the body's attempt to restore fluid balance and osmolarity. This is incorrect because vomiting is a sign of both hyponatremia and hypernatremia. Vomiting is a reflex action that expels the contents of the stomach, which can cause fluid and electrolyte loss or imbalance.
Question 4
A nurse is caring for a client who had radiation therapy and is experiencing painful dermatitis. The nurse should identify the client is experiencing which of the following types of pain?
- A.Cancer pain
- B.Acute pain
- C.Chronic pain
- D.Neuropathic pain
Show answer and rationale ▾Answer and rationale ▴
Answer: B. Acute pain
The nurse should identify that the client is experiencing acute pain. Acute pain is typically sudden in onset, temporary, and has a direct cause, such as tissue injury or damage. It usually resolves as the underlying cause heals. In this case, the painful dermatitis resulting from radiation therapy is considered acute pain because it is directly related to the recent tissue damage caused by the radiation. Cancer pain typically refers to pain directly resulting from tumor growth, tissue invasion, or nerve compression caused by the malignancy itself. Chronic pain persists beyond the expected time for tissue healing, typically longer than 3 to 6 months, and does not fit the description of an acute, treatment-related reaction like radiation dermatitis. Neuropathic pain results from damage to or dysfunction of the central or peripheral nervous system, often presenting as shooting, burning, or tingling sensations, rather than pain from superficial tissue inflammation.
Question 5
An oncologist has recommended that a hospice patient receives palliative radiation to reduce the pain of bony metastases. The patient reacts with anger, saying, "l don't want any more treatments that don't cure my cancer!" The hospice nurse tells the patient that the use of radiation:
- A.Of this type is not curative and may help reduce the pain he is experiencing
- B.Will be used as a single treatment measure. Previous medications will be discontinued.
- C.May disqualify him from receiving hospice care.
- D.May halt the metastatic process
Show answer and rationale ▾Answer and rationale ▴
Answer: A. Of this type is not curative and may help reduce the pain he is experiencing
Of this type is not curative and may help reduce the pain he is experiencing: This response provides accurate information about the purpose of palliative radiation therapy for bony metastases. It acknowledges the patient's concerns about treatment not curing the cancer while emphasizing the potential benefit of radiation therapy in reducing pain and improving quality of life. Will be used as a single treatment measure. Previous medications will be discontinued: This statement is inaccurate and may cause confusion for the patient. Palliative radiation therapy is often used in conjunction with other pain management strategies, and discontinuing previous medications without a proper assessment and plan may not be appropriate. May disqualify him from receiving hospice care: This statement is incorrect. Receiving palliative radiation therapy does not automatically disqualify a patient from hospice care. Hospice care focuses on providing comfort and support to terminally ill patients, and decisions about treatments such as radiation therapy are made based on the patient's goals and preferences. May halt the metastatic process: Palliative radiation therapy is not typically used with the intention of halting the metastatic process. Its primary goal is to alleviate symptoms such as pain and improve the patient's quality of life. While radiation therapy may shrink tumors in some cases, it is not considered a curative treatment for metastatic cancer.
Practice 479 hematologic & oncologic questions
Short tests with a full rationale on every answer, and a score that shows how ready you are for hematologic & oncologic after five tests. Start free, no card needed.
Start practicing free