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HESI LPN · HESI LPN Medical Surgical Nursing · HESI Hematological System

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Showing all 5 practice questions with expert explanatory rationales.

Question 1 of 5

A patient who underwent lymphangiography the day before asks the licensed practical nurse (LPN), “Why does my urine look blue?” What should the LPN respond to this patient's concern?

A. It is nothing to be concerned about.
B. I will notify the RN and physician immediately.
C. This indicates that the procedure found abnormal results.
D. The dye used in the procedure may cause bluish skin and urine for 2 days.

Expert Explanatory Rationale

Correct Answer: The dye used in the procedure may cause bluish skin and urine for 2 days.

Question 2 of 5

A 3-year-old boy with X-linked chronic granulomatosis disease is day +25 after haploidentical bone marrow transplant (father donor) using posttransplant cyclophosphamide as graft-versus-host disease (GVHD) prophylaxis. He engrafted on day +16 and was preparing for discharge when cytomegalovirus (CMV) was noted to be positive on PCR, and he developed a fever and mild rash. His counts have fallen to a WBC of 0.1 and he remains transfusion dependent. What diagnostic evaluations/treatments should you pursue?

A. Rule out infection by sending blood cultures, start broad spectrum antibiotics, and obtain other diagnostic workup as appropriate. Consider skin biopsy and treat with steroids for likely acute GVHD (aGHVD).
B. Initiate an infectious workup and treat with broad-spectrum antibiotics. Consult with the PICU team because the low blood counts are likely a preseptic presentation.
C. Test for possible rejection with rapid FISH chimerism and consider withdrawal of immune suppression if donor chimerism is low.
D. Send blood cultures, start antibiotics, and treat his CMV with foscarnet. Send rapid chimerism by STR to assess for possible rejection. If donor chimerism is low or absent, work on obtaining an alternative donor for a second procedure.

Expert Explanatory Rationale

Correct Answer: Send blood cultures, start antibiotics, and treat his CMV with foscarnet. Send rapid chimerism by STR to assess for possible rejection. If donor chimerism is low or absent, work on obtaining an alternative donor for a second procedure.

Question 3 of 5

A nurse should assess a client who has a megaloblastic anemia for indications of which of the following vitamin deficiencies?

A. Vitamin C
B. Vitamin K
C. Vitamin B12
D. Vitamin D

Expert Explanatory Rationale

Correct Answer: Vitamin B12

Question 4 of 5

A patient is presented with pallor, fatigue and dyspnea. Physical examination shows koilonychias and angular cheilitis. Which of the following is not expected in the laboratory finding of this patient?

A. Low total iron binding capacity
B. High serum transferrin
C. Low iron: total iron binding capacity ratio
D. Low serum ferritin

Expert Explanatory Rationale

Correct Answer: Low total iron binding capacity

Question 5 of 5

A patient is admitted to determine why red blood cells are being quickly destructed in the body. What finding should the nurse associate with this patient's health problem?

A. Jaundice
B. Bleeding
C. Diarrhea
D. Cyanosis

Expert Explanatory Rationale

Correct Answer: Jaundice

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