NCLEX RN Hematology and Oncology
Practice Exam 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026
1. A client with iron-deficiency anemia is prescribed oral ferrous sulfate.
Which instruction should the nurse provide?
A. Take the medication with milk.
B. Take the medication with orange juice.
C. Take the medication with an antacid.
D. Stop the medication when fatigue improves.
Answer: B. Take the medication with orange juice.
Rationale: Vitamin C enhances iron absorption. Milk and antacids can
decrease iron absorption. Therapy should continue as prescribed even after
symptoms improve.
2. Which assessment finding is most characteristic of iron-deficiency
anemia?
A. Ruddy complexion
B. Increased energy
C. Fatigue and pallor
D. Bradycardia
Answer: C. Fatigue and pallor
Rationale: Iron deficiency decreases hemoglobin production, resulting in
reduced oxygen-carrying capacity and manifestations such as fatigue,
weakness, pallor, and exertional dyspnea.
3. A client with pernicious anemia is prescribed vitamin B12 therapy. Which
route may be required initially?
,A. Intramuscular
B. Topical
C. Inhaled
D. Sublingual only
Answer: A. Intramuscular
Rationale: Pernicious anemia involves impaired absorption of vitamin B12
because of intrinsic-factor deficiency. Parenteral vitamin B12 may be
required, particularly during initial treatment.
4. Which finding should the nurse associate with vitamin B12 deficiency?
A. Paresthesias
B. Excessive clotting
C. Hypertension
D. Polyuria
Answer: A. Paresthesias
Rationale: Vitamin B12 deficiency can cause neurologic manifestations,
including paresthesias, impaired balance, weakness, and cognitive changes.
5. A client with sickle cell disease reports severe generalized pain. Which
intervention is the priority?
A. Restrict fluids.
B. Encourage hydration and administer prescribed analgesia.
C. Apply ice packs to painful areas.
D. Encourage strenuous exercise.
Answer: B. Encourage hydration and administer prescribed analgesia.
Rationale: A vaso-occlusive crisis causes tissue ischemia and severe pain.
Hydration and effective pain management are major components of
treatment.
6. Which intervention is appropriate for a client experiencing a sickle cell
crisis?
A. Encourage adequate fluid intake.
B. Restrict oxygen administration.
,C. Place the client on a high-protein-only diet.
D. Apply cold compresses routinely.
Answer: A. Encourage adequate fluid intake.
Rationale: Hydration helps reduce blood viscosity and supports circulation.
Oxygen may be administered when hypoxemia is present, and cold exposure
should be avoided because vasoconstriction can worsen sickling.
7. A client with sickle cell disease is admitted with chest pain, fever, cough,
and hypoxemia. Which complication should the nurse suspect?
A. Acute chest syndrome
B. Appendicitis
C. Peptic ulcer disease
D. Nephrotic syndrome
Answer: A. Acute chest syndrome
Rationale: Acute chest syndrome is a serious complication of sickle cell
disease characterized by respiratory symptoms, chest pain, fever, and
pulmonary infiltrates or hypoxemia.
8. Which teaching is most important for a client with sickle cell disease?
A. Avoid all physical activity.
B. Maintain adequate hydration.
C. Follow a low-fluid diet.
D. Avoid routine vaccinations.
Answer: B. Maintain adequate hydration.
Rationale: Dehydration increases blood viscosity and promotes sickling.
Adequate hydration is an important preventive measure.
9. A client with hemophilia is experiencing bleeding into the knee joint.
Which treatment should the nurse anticipate?
A. Vitamin K only
B. Factor replacement therapy
C. Aspirin therapy
D. Platelet destruction
, Answer: B. Factor replacement therapy
Rationale: Hemophilia results from deficiencies of specific clotting factors.
Replacement of the deficient factor is the primary treatment for significant
bleeding.
10.Which medication should a client with hemophilia avoid unless
specifically prescribed?
A. Acetaminophen
B. Aspirin
C. Factor VIII
D. Desmopressin
Answer: B. Aspirin
Rationale: Aspirin inhibits platelet function and can increase bleeding risk.
Clients with bleeding disorders should generally avoid aspirin unless
specifically directed by the healthcare provider.
11.Which laboratory value is most directly associated with monitoring
warfarin therapy?
A. INR
B. Serum sodium
C. Hemoglobin A1c
D. Serum amylase
Answer: A. INR
Rationale: The international normalized ratio (INR) is used to monitor the
anticoagulant effect of warfarin and guide dosing.
12.A client receiving heparin develops a significant decrease in platelet
count. Which complication should the nurse suspect?
A. Hemophilia
B. Heparin-induced thrombocytopenia
C. Iron-deficiency anemia
D. Pernicious anemia
Answer: B. Heparin-induced thrombocytopenia
Practice Exam 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026
1. A client with iron-deficiency anemia is prescribed oral ferrous sulfate.
Which instruction should the nurse provide?
A. Take the medication with milk.
B. Take the medication with orange juice.
C. Take the medication with an antacid.
D. Stop the medication when fatigue improves.
Answer: B. Take the medication with orange juice.
Rationale: Vitamin C enhances iron absorption. Milk and antacids can
decrease iron absorption. Therapy should continue as prescribed even after
symptoms improve.
2. Which assessment finding is most characteristic of iron-deficiency
anemia?
A. Ruddy complexion
B. Increased energy
C. Fatigue and pallor
D. Bradycardia
Answer: C. Fatigue and pallor
Rationale: Iron deficiency decreases hemoglobin production, resulting in
reduced oxygen-carrying capacity and manifestations such as fatigue,
weakness, pallor, and exertional dyspnea.
3. A client with pernicious anemia is prescribed vitamin B12 therapy. Which
route may be required initially?
,A. Intramuscular
B. Topical
C. Inhaled
D. Sublingual only
Answer: A. Intramuscular
Rationale: Pernicious anemia involves impaired absorption of vitamin B12
because of intrinsic-factor deficiency. Parenteral vitamin B12 may be
required, particularly during initial treatment.
4. Which finding should the nurse associate with vitamin B12 deficiency?
A. Paresthesias
B. Excessive clotting
C. Hypertension
D. Polyuria
Answer: A. Paresthesias
Rationale: Vitamin B12 deficiency can cause neurologic manifestations,
including paresthesias, impaired balance, weakness, and cognitive changes.
5. A client with sickle cell disease reports severe generalized pain. Which
intervention is the priority?
A. Restrict fluids.
B. Encourage hydration and administer prescribed analgesia.
C. Apply ice packs to painful areas.
D. Encourage strenuous exercise.
Answer: B. Encourage hydration and administer prescribed analgesia.
Rationale: A vaso-occlusive crisis causes tissue ischemia and severe pain.
Hydration and effective pain management are major components of
treatment.
6. Which intervention is appropriate for a client experiencing a sickle cell
crisis?
A. Encourage adequate fluid intake.
B. Restrict oxygen administration.
,C. Place the client on a high-protein-only diet.
D. Apply cold compresses routinely.
Answer: A. Encourage adequate fluid intake.
Rationale: Hydration helps reduce blood viscosity and supports circulation.
Oxygen may be administered when hypoxemia is present, and cold exposure
should be avoided because vasoconstriction can worsen sickling.
7. A client with sickle cell disease is admitted with chest pain, fever, cough,
and hypoxemia. Which complication should the nurse suspect?
A. Acute chest syndrome
B. Appendicitis
C. Peptic ulcer disease
D. Nephrotic syndrome
Answer: A. Acute chest syndrome
Rationale: Acute chest syndrome is a serious complication of sickle cell
disease characterized by respiratory symptoms, chest pain, fever, and
pulmonary infiltrates or hypoxemia.
8. Which teaching is most important for a client with sickle cell disease?
A. Avoid all physical activity.
B. Maintain adequate hydration.
C. Follow a low-fluid diet.
D. Avoid routine vaccinations.
Answer: B. Maintain adequate hydration.
Rationale: Dehydration increases blood viscosity and promotes sickling.
Adequate hydration is an important preventive measure.
9. A client with hemophilia is experiencing bleeding into the knee joint.
Which treatment should the nurse anticipate?
A. Vitamin K only
B. Factor replacement therapy
C. Aspirin therapy
D. Platelet destruction
, Answer: B. Factor replacement therapy
Rationale: Hemophilia results from deficiencies of specific clotting factors.
Replacement of the deficient factor is the primary treatment for significant
bleeding.
10.Which medication should a client with hemophilia avoid unless
specifically prescribed?
A. Acetaminophen
B. Aspirin
C. Factor VIII
D. Desmopressin
Answer: B. Aspirin
Rationale: Aspirin inhibits platelet function and can increase bleeding risk.
Clients with bleeding disorders should generally avoid aspirin unless
specifically directed by the healthcare provider.
11.Which laboratory value is most directly associated with monitoring
warfarin therapy?
A. INR
B. Serum sodium
C. Hemoglobin A1c
D. Serum amylase
Answer: A. INR
Rationale: The international normalized ratio (INR) is used to monitor the
anticoagulant effect of warfarin and guide dosing.
12.A client receiving heparin develops a significant decrease in platelet
count. Which complication should the nurse suspect?
A. Hemophilia
B. Heparin-induced thrombocytopenia
C. Iron-deficiency anemia
D. Pernicious anemia
Answer: B. Heparin-induced thrombocytopenia
