AMSN Hematological and Oncological Nursing

Question 1

A patient receiving chemotherapy develops a neutrophil count of 400 cells/mm³. Which intervention is the HIGHEST priority?

Accepted Answer

Initiate neutropenic precautions and reverse isolation

Answer

Administer prophylactic antiemetics

Answer

Encourage oral fluid intake

Answer

Obtain a routine CBC in 24 hours

Question 2

Which assessment finding is MOST consistent with a patient experiencing sickle cell crisis?

Accepted Answer

Severe localized bone pain and fever

Answer

Bradycardia and hypotension

Answer

Petechiae and prolonged bleeding

Answer

Jaundice and elevated platelet count

Question 3

A nurse is caring for a patient with thrombocytopenia (platelet count 18,000/mm³). Which action should the nurse AVOID?

Accepted Answer

Administering aspirin for headache

Answer

Applying firm pressure after venipuncture

Answer

Administering stool softeners

Answer

Using a soft-bristled toothbrush

Question 4

A patient is receiving a blood transfusion and develops chills, fever, and back pain 15 minutes after initiation. What is the FIRST nursing action?

Accepted Answer

Stop the transfusion and keep the IV line open with normal saline

Answer

Slow the infusion rate and notify the provider

Answer

Administer acetaminophen and continue the transfusion

Answer

Draw blood cultures and continue monitoring

Question 5

Which laboratory value requires IMMEDIATE intervention in a patient with multiple myeloma?

Accepted Answer

Serum calcium 13.8 mg/dL

Answer

Hemoglobin 10.2 g/dL

Answer

BUN 24 mg/dL

Answer

Platelet count 150,000/mm³

Question 6

A patient with leukemia is being discharged after chemotherapy. Which statement by the patient indicates a need for FURTHER teaching?

Accepted Answer

'I can visit my grandchildren even if they have a cold; they need me.'

Answer

'I will wash my hands frequently throughout the day.'

Answer

'I will avoid fresh fruits and salads until my counts recover.'

Answer

'I will take my temperature daily and report a reading above 100.4°F.'

Question 7

Which finding is characteristic of disseminated intravascular coagulation (DIC)?

Accepted Answer

Prolonged PT, prolonged aPTT, and elevated D-dimer

Answer

Elevated fibrinogen and decreased D-dimer

Answer

Thrombocytosis and shortened bleeding time

Answer

Decreased PT with elevated fibrinogen levels