Pass NUR 231 Exam 4 – Adult Nursing
II (2026) Actual Questions & Verified
Answers Illinois State University (A+
Guarantee)
Hematology & Oncology
1.
A client receiving induction chemotherapy for acute leukemia has an ANC of 300/mm³. Which
finding requires the nurse's immediate attention?
A. Fatigue
B. Temperature of 38.3°C (101°F)
C. Mild nausea
D. Decreased appetite
Answer: B
Rationale: Severe neutropenia combined with fever may indicate a life-threatening infection
and requires immediate evaluation.
2.
Which intervention is appropriate for a client with severe thrombocytopenia?
A. Use an electric razor
B. Administer IM injections
C. Encourage aspirin for pain
D. Use a firm-bristled toothbrush
Answer: A
Rationale: An electric razor decreases the risk of cuts and bleeding.
3.
Which laboratory finding is expected with tumor lysis syndrome?
,A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypermagnesemia
Answer: B
Rationale: Rapid destruction of tumor cells releases intracellular potassium, causing
hyperkalemia.
4.
A client receiving chemotherapy develops painful oral mucositis. Which intervention is
appropriate?
A. Use an alcohol-based mouthwash
B. Eat spicy foods
C. Use a soft toothbrush
D. Brush vigorously
Answer: C
Rationale: Gentle oral care reduces trauma to damaged mucous membranes.
5.
Which finding is most concerning in a client receiving chemotherapy?
A. Alopecia
B. Mild fatigue
C. Temperature of 38.5°C
D. Altered taste
Answer: C
Rationale: Fever during significant chemotherapy-induced neutropenia may indicate infection.
6.
A client with multiple myeloma is at increased risk for:
A. Pathologic fractures
B. Severe hypoglycemia
C. Appendicitis
D. Pneumothorax
,Answer: A
Rationale: Multiple myeloma causes destructive bone lesions and increases fracture risk.
7.
Which assessment is particularly important for a client with multiple myeloma?
A. Serum calcium and renal function
B. Visual acuity only
C. Hearing assessment only
D. Blood glucose every 15 minutes
Answer: A
Rationale: Multiple myeloma may cause hypercalcemia and renal impairment.
8.
A client with chronic myeloid leukemia is prescribed imatinib. The nurse understands that this
medication is a:
A. Beta blocker
B. Tyrosine kinase inhibitor
C. Corticosteroid
D. Calcium-channel blocker
Answer: B
Rationale: Imatinib is a tyrosine kinase inhibitor commonly used for BCR-ABL-positive CML.
9.
Which precaution is most important for a client with severe neutropenia?
A. Avoid fresh flowers and potentially contaminated food sources according to facility policy
B. Encourage crowded social activities
C. Encourage raw eggs
D. Avoid hand hygiene
Answer: A
Rationale: Reducing exposure to potential pathogens is important when neutrophil counts are
severely reduced.
, 10.
A client receiving chemotherapy has a platelet count of 15,000/mm³. Which action should the
nurse avoid?
A. Applying prolonged pressure after venipuncture
B. Using a soft toothbrush
C. Administering an IM injection
D. Monitoring for bleeding
Answer: C
Rationale: IM injections can cause bleeding and hematoma formation in severe
thrombocytopenia.
11.
Which finding suggests tumor lysis syndrome?
A. Hyperuricemia
B. Hypophosphatemia
C. Hypercalcemia
D. Hypokalemia
Answer: A
Rationale: Tumor lysis syndrome commonly produces hyperuricemia, hyperkalemia,
hyperphosphatemia, hypocalcemia, and acute kidney injury.
12.
Which medication may be prescribed to reduce uric acid during tumor lysis syndrome risk?
A. Allopurinol
B. Warfarin
C. Furosemide only
D. Metformin
Answer: A
Rationale: Allopurinol reduces uric acid production. Rasburicase may also be used in selected
high-risk clients.
13.
II (2026) Actual Questions & Verified
Answers Illinois State University (A+
Guarantee)
Hematology & Oncology
1.
A client receiving induction chemotherapy for acute leukemia has an ANC of 300/mm³. Which
finding requires the nurse's immediate attention?
A. Fatigue
B. Temperature of 38.3°C (101°F)
C. Mild nausea
D. Decreased appetite
Answer: B
Rationale: Severe neutropenia combined with fever may indicate a life-threatening infection
and requires immediate evaluation.
2.
Which intervention is appropriate for a client with severe thrombocytopenia?
A. Use an electric razor
B. Administer IM injections
C. Encourage aspirin for pain
D. Use a firm-bristled toothbrush
Answer: A
Rationale: An electric razor decreases the risk of cuts and bleeding.
3.
Which laboratory finding is expected with tumor lysis syndrome?
,A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypermagnesemia
Answer: B
Rationale: Rapid destruction of tumor cells releases intracellular potassium, causing
hyperkalemia.
4.
A client receiving chemotherapy develops painful oral mucositis. Which intervention is
appropriate?
A. Use an alcohol-based mouthwash
B. Eat spicy foods
C. Use a soft toothbrush
D. Brush vigorously
Answer: C
Rationale: Gentle oral care reduces trauma to damaged mucous membranes.
5.
Which finding is most concerning in a client receiving chemotherapy?
A. Alopecia
B. Mild fatigue
C. Temperature of 38.5°C
D. Altered taste
Answer: C
Rationale: Fever during significant chemotherapy-induced neutropenia may indicate infection.
6.
A client with multiple myeloma is at increased risk for:
A. Pathologic fractures
B. Severe hypoglycemia
C. Appendicitis
D. Pneumothorax
,Answer: A
Rationale: Multiple myeloma causes destructive bone lesions and increases fracture risk.
7.
Which assessment is particularly important for a client with multiple myeloma?
A. Serum calcium and renal function
B. Visual acuity only
C. Hearing assessment only
D. Blood glucose every 15 minutes
Answer: A
Rationale: Multiple myeloma may cause hypercalcemia and renal impairment.
8.
A client with chronic myeloid leukemia is prescribed imatinib. The nurse understands that this
medication is a:
A. Beta blocker
B. Tyrosine kinase inhibitor
C. Corticosteroid
D. Calcium-channel blocker
Answer: B
Rationale: Imatinib is a tyrosine kinase inhibitor commonly used for BCR-ABL-positive CML.
9.
Which precaution is most important for a client with severe neutropenia?
A. Avoid fresh flowers and potentially contaminated food sources according to facility policy
B. Encourage crowded social activities
C. Encourage raw eggs
D. Avoid hand hygiene
Answer: A
Rationale: Reducing exposure to potential pathogens is important when neutrophil counts are
severely reduced.
, 10.
A client receiving chemotherapy has a platelet count of 15,000/mm³. Which action should the
nurse avoid?
A. Applying prolonged pressure after venipuncture
B. Using a soft toothbrush
C. Administering an IM injection
D. Monitoring for bleeding
Answer: C
Rationale: IM injections can cause bleeding and hematoma formation in severe
thrombocytopenia.
11.
Which finding suggests tumor lysis syndrome?
A. Hyperuricemia
B. Hypophosphatemia
C. Hypercalcemia
D. Hypokalemia
Answer: A
Rationale: Tumor lysis syndrome commonly produces hyperuricemia, hyperkalemia,
hyperphosphatemia, hypocalcemia, and acute kidney injury.
12.
Which medication may be prescribed to reduce uric acid during tumor lysis syndrome risk?
A. Allopurinol
B. Warfarin
C. Furosemide only
D. Metformin
Answer: A
Rationale: Allopurinol reduces uric acid production. Rasburicase may also be used in selected
high-risk clients.
13.
