Chapter 12- Disorders of White Blood Cells

If Reed-Sternberg cells are noted on a biopsy sample, which of the following is the most likely diagnosis? A. Hodgkin's lymphoma B. Acute lymphocytic leukemia C. Non-Hodgkin's lymphoma D. Multiple myeloma

A. Hodgkin's lymphoma

A nurse is told that her patient has severe leukopenia. Which of the following can the nurse expect? A. Increased infection risk Rationale: Decreased WBC numbers can increase infection risk. B. Significant elevation in all white blood cell (WBC) values C. Neutrophilia D. Normal complete blood count (CBC) values

A. Increased infection risk Rationale: Decreased WBC numbers can increase infection risk.

What are some symptoms associated with white blood cell neoplasms? Select all that apply. A. Thrombocytopenia B. Bone Pain C. Multiple myeloma D. Splenomegaly E. Anemia

A. Thrombocytopenia B. Bone Pain D. Splenomegaly E. Anemia

A nursing student is asking about which general signs and symptoms may be present in cases of leukemia. Which of the following are appropriate responses by the nurse educator? Select all that apply. A. No overt signs or symptoms are present. B. Bone pain C. General leukopenia on completed blood count (CBC) D. Splenomegaly E. Anemia

B. Bone pain Rationale: Overproliferation of cells can cause pain in the bone marrow. D. Splenomegaly Rationale: Overproduced cells can be sequestered in the spleen, causing splenomegaly. E. Anemia Rationale: Overproduction of white blood cells (WBCs) can result in lower-than-normal red blood cells (RBCs).

A lymph node biopsy of a lymphoma reveals no Reed-Sternberg cells. Which of the following is most likely? A. Hodgkin's lymphoma B. Non-Hodgkin's lymphoma C. Multiple myeloma D. Myelogenous leukemia

B. Non-Hodgkin's lymphoma Rationale: The lack of Reed-Sternberg cells increases the likelihood that this is a Non-Hodgkin's lymphoma.

Which form of leukemia presents with immature T or B cells? A. Chronic myelogenous leukemia B. Chronic lymphocytic leukemia C. Acute lymphocytic leukemia D. Acute myelogenous leukemia

C. Acute lymphocytic leukemia

A nurse learns that a young child, under age 8, has been diagnosed with leukemia. Which type of leukemia is a child most likely to have been diagnosed with? A. Acute myelogenous leukemia B. Chronic lymphocytic leukemia C. Acute lymphocytic leukemia D. Chronic myelogenous leukemia

C. Acute lymphocytic leukemia Rationale: Acute lymphocytic leukemia is more common in children.

A nursing student is learning about leukemias. Which information would be correct to share about acute myelogenous leukemia (AML)? Select all that apply. A. Acute myelogenous leukemia is a form of lymphoma. B. Acute myelogenous leukemia is more common in children. C. Acute myelogenous leukemia cause proliferation of undifferentiated myeloid blast cells. D. Acute myelogenous leukemia is the most common form of leukemia in the United States. E. Acute myelogenous leukemia development is associated with radiation exposure.

C. Acute myelogenous leukemia cause proliferation of undifferentiated myeloid blast cells. Rationale: High levels of undifferentiated myeloid cells are a hallmark of AML. E. Acute myelogenous leukemia development is associated with radiation exposure. Rationale: Radiation exposure has been associated with increased risk of developing AML.

A patient diagnosed with leukemia is prescribed a tyrosine kinase inhibitor. What is the purpose of this medication? A. Decrease pain B. Prevent cachexia C. Decrease unregulated cell growth D. Decrease cell destruction due to chemotherapy

C. Decrease unregulated cell growth Rationale: Tyrosine kinase activity increases cell proliferation.

A client who has an infection was brought to the hospital. The result of the complete blood count with differential report shows a white blood cell count of 12,000 cells/microliter. Normal is 5,000-10,000 cells/microliter. Which condition has the client developed? A. Leukopenia B. Neutropenia C. Leukocytosis D. Lymphopenia

C. Leukocytosis

A patient wants to know if there is a difference between a lymphoma and leukemia. Which statement should the nurse share? A. Lymphomas develop due to a disorder of red blood cells, while leukemias are disorders of white blood cells (WBCs). B. Lymphomas are neoplasms, and leukemias are not. C. Lymphomas develop in the lymph nodes while leukemias are present in the blood. D. Lymphomas develop in adults, while leukemias develop in children.

C. Lymphomas develop in the lymph nodes while leukemias are present in the blood. Rationale: Lymphomas develop in lymph nodes, while leukemia is due to disorder of WBCs in blood.

In which condition are abnormal plasma cells, immunoglobulins, or immunoglobulin fragments present? A. Non-Hodgkin's lymphoma B. Chronic myelogenous leukemia C. Multiple myeloma D. Acute lymphocytic leukemia

C. Multiple myeloma

A patient wants to know the difference between Hodgkin's lymphoma and non-Hodgkin's lymphoma. Which of the following would be correct in formation to share with the patient? Select all that apply. A. These types of lymphomas develop in different lymph nodes. B. Hodgkin's lymphomas occur only in children. C. Non-Hodgkin's lymphoma is the more common type of lymphoma. D. Non-Hodgkin's lymphoma has only one type, while there are 20 types of Hodgkin's lymphomas. E. Non-Hodgkin's lymphoma develops from several cell types, while Hodgkin's lymphoma develops from one cell type.

C. Non-Hodgkin's lymphoma is the more common type of lymphoma. Rationale: Non-Hodgkin's lymphomas account for 80% of lymphomas. E. Non-Hodgkin's lymphoma develops from several cell types, while Hodgkin's lymphoma develops from one cell type. Rationale: Hodgkin's lymphoma develops from B cells while Non-Hodgkin's lymphoma develops from B, T and NK cells.

A laboratory technician is looking at a lymph node biopsy sample. The appearance of which cell type would help to diagnose Hodgkin's lymphoma? A. Apoptotic cells B. Sickle cells C. Reed-Sternberg cells D. B cells

C. Reed-Sternberg cells Rationale: Reed-Sternberg cells may appear in Hodgkin's lymphoma.

Which of the following white blood cell (WBC) levels would indicate that a patient has leukocytosis? A. 1200 cells per microliter B. 1800 cells per microliter C. 5000 cells per microliter D. 12,000 cells per microliter

D. 12,000 cells per microliter Rationale: Leukocytosis is elevated WBC count above 11,000 cells per microliter.

A patient presents with a white blood cell (WBC) count of 20,000 cells per microliter. Which of the following interpretations would be correct for the nurse to make? A. The WBC count is so high that the patient will never have to worry about an infection. B. The patient's results are diagnostic for allergies or autoimmune disorders. C. The patient likely has anemia, and the elevated WBC level is attempting to compensate. D. Although elevated, the WBCs may be poorly functioning, increasing a patient's risk for infection.

D. Although elevated, the WBCs may be poorly functioning, increasing a patient's risk for infection.

An elderly patient's laboratory results reveal lymphocytosis with white blood cell (WBC) count greater than 20,000 cells per microliter. Which leukemia type is most likely? A. Acute myelogenous leukemia B. Chronic myelogenous leukemia C. Acute lymphocytic leukemia (ALL) D. Chronic lymphocytic leukemia

D. Chronic lymphocytic leukemia Rationale: Diagnosis of CLL is lymphocytosis with a WBC count greater than 20,000/uL.

A patient presents with the following complaint: "This one gland in my groin area is so swollen. It bothers me a little bit, but I am not sure if I should be worried." What is an appropriate response by the nurse? A. You likely have a severe infection in the groin area. B. Do not worry. A single lymph node swelling is common and shouldn't concern you. C. Surgery is an option for removal of the lymph node. D. Let us discuss further signs and symptoms and what the possibilities are for examining the lymph node.

D. Let us discuss further signs and symptoms and what the possibilities are for examining the lymph node. Rationale: This response addresses the patient's concern and speaks of further evaluation needed.