patho 24
While taking a history on a pediatric client who appears to have Burkitt lymphoma, which question to the client and/or the family is likely to correlate with this diagnosis?
"Have you recently been diagnosed with Epstein-Barr virus (EBV)?"
A child has been home from camp for 2 weeks and reports a sore throat, low-grade fever, and enlarged cervical lymph nodes. After testing, it is determined the child has Epstein-Barr virus (EBV)-associated infectious mononucleosis. The parent asks, "How did my child acquire this type of infection?" Which is the best response by the nurse?
"The infection is acquired primarily through contact with infected oral secretions."
The nurse evaluating a client's blood work determines that a client has an increased risk for infection based on which lab result?
Absolute neutrophil count of 800/μL (0.80 x 109/L)
The nurse is caring for a client with chronic myelogenous leukemia (CML) and notes that the client has splenomegaly and an increased basophil count as well as night sweats, bone pain, and a low grade fever. The nurse interprets the symptoms as indicating that the client is in which phase of the clinical course of CML?
Accelerated
A client diagnosed with systemic lupus erythematosus (SLE) has been experiencing a low neutrophil count. How would this type of neutropenia be classified?
Acquired, autoimmune secondary neutropenia
Which client is most likely to have a workup to rule out Hodgkin lymphoma?
Adult client concerned about an enlarged lymph node in the axilla
Select the option that best describes the production of T lymphocytes.
Bone marrow → thymus → lymph nodes
The nurse caring for a client in the early stage of multiple myeloma would anticipate the client to report which symptom?
Bone pain
What is the first symptom of multiple myeloma that a client typically presents with on a visit to the primary care provider?
Bone pain
Which clinical manifestations are associated with acute leukemia? Select all that apply.
Bone pain,Bleeding gums,Fever,Epistaxis
Which types of leukemias originate from the B cells? Select all that apply.
Chronic lymphocytic leukemia,Acute lymphocytic leukemia
In which conditions are Bence Jones proteins not found in the lab analysis? Select all that apply.
Chronic lymphocytic leukemia,Chronic myelogenous leukemia,Hodgkin lymphoma
The nurse is caring for a client who has a low level of T lymphocytes. The nurse plans care for a client with:
Decreased immune response
A teenage client has been diagnosed with infectious mononucleosis and asks the health care provider what caused the condition. Which response is most accurate for the nurse to share with this client?
Epstein-Barr virus (EBV)
A 16-year-old boy has enlarged lymph nodes and a sore throat. His girlfriend was recently diagnosed with infectious mononucleosis. While educating this teenager, the nurse emphasizes that infectious mononucleosis is caused by which pathogen and usually transmitted via:
Epstein-Barr virus; saliva
The nurse's plan of care for a client with multiple myeloma should include interventions to prevent:
Fractures
A client with acute leukemia has developed gout and asks the nurse, "Why did this happen?" Which response is most accurate?
High uric acid levels
A lymph node biopsy pathology report notes the presence of Reed-Sternberg cells on a client suspected of having a lymphoma. The nurse interprets the report as indicating:
Hodgkin lymphoma
The pathologist notes that the client has Reed-Sternberg cells. He knows that these cells are a diagnostic hallmark for which disorder?
Hodgkin lymphoma
Which therapies are part of the treatment for acute lymphocytic leukemia (ALL)? Select all that apply.
Intensification,Maintenance,Induction
A client with Hodgkin lymphoma is exhibiting some central nervous system (CNS) involvement. Which treatment measures will the health care provider likely prescribe?
Irradiation and chemotherapy
The nurse conducting a community education program on mononucleosis determines the participants are understanding the information when they make which statement? Select all that apply.
It is a self-limiting disorder.,It is caused by the Epstein-Barr virus.
A young adult client presents with an enlarged, firm cervical lymph node on the right side of the neck. Palpation of the node is painless. The nurse should document this assessment finding and anticipate preparing the client for which diagnostic procedure to confirm diagnosis?
Lymph node biopsy
The nurse is conducting education for a client who is scheduled to undergo diagnostic testing for non-Hodgkin lymphoma (NHL). The nurse includes information on:
Lymph node biopsy
A client has been diagnosed with non-Hodgkin lymphoma (NHL), a form of malignancy that originates in which body site?
Lymph nodes
When collecting a client's history the client states that he is receiving treatment to maintain remission from leukemia. What does the nurse document that the client is receiving?
Maintenance therapy
A 26-year-old female client has a neutrophil count of 750/μL (0.75 x 109/L). Which description best correlates with the neutrophil count?
Moderate neutropenia
A 12-year-old child has contracted a bacterial infection at school and the body has responded by increasing leukocyte production. Place the following components of white blood cell production in the correct chronological order. Use all the options.
Myeloid stem cell Myeloblast Promyelocyte Metamyelocyte Neutrophilic band cells
The nurse is conducting the initial assessment on a client with newly diagnosed Hodgkin lymphoma. Which symptoms should the nurse interpret as manifestation of the disease process? Select all that apply.
Night sweats,Pruritus,Weight loss
A group of nursing students were studying for their pathophysiology exam by quizzing each other about disorders of WBCs and lymphoid tissue. When asked to name the first chromosomal abnormality that identifies cancer, one student correctly answered:
Philadelphia
A client is admitted with a suspected diagnosis of Hodgkin lymphoma (HL). Which diagnostic test would the nurse look for to confirm the diagnosis?
Presence of Reed-Sternberg cells
A young adult is preparing to begin treatment for non-Hodgkin lymphoma (NHL), a disease that has disseminated widely. What is the most likely treatment regimen for this client?
Radiation, chemotherapy, and biotherapy
The nurse is caring for a client with multiple myeloma with Bence Jones proteins. With this "light chain" form of the disease, it is important for the nurse to include assessment for:
Renal disease
A client's history and physical documents the presence of an indolent lymphoma. The nurse plans care for which type of lymphoma?
Slow-growing
When assessing the mouth of a client receiving chemotherapy, which of the following should the nurse interpret as a possible indicator of neutropenia?
Stomatitis
The student is studying the body's lymphatic system. Which of the following is true of this system?
T lymphocytes travel to the thymus to complete the differentiation process.
The nurse is admitting a client who is documented to be in the terminal blast crisis phase of chronic myelogenous leukemia (CML). What interpretation should the nurse make, given this information?
The CML has evolved to acute leukemia.
What is the reason why bed rest and analgesics are expected treatments for infectious mononucleosis?
To relieve fever, headache, and sore throat
Drug-induced neutropenia is a disease that has significantly increased in incidence over the last several decades. What is the attributing factor in the increased incidence of drug-induced neutropenia?
Treatment of cancer by chemotherapeutic drugs
The nurse is providing a client with education on taking the medication clozapine. The nurse includes the importance of:
Weekly blood work
A client has been experiencing anemia and thrombocytopenia. Subsequent diagnostic testing has revealed the presence of immature granulocyte types and the Philadelphia chromosome. This client is likely to experience:
a prolonged chronic phase of leukemia.
The nursing caring for a 62-year-old client with diffuse large B-cell lymphoma plans care based on the knowledge that this client's lymphoma is:
aggressive.
The nurse is planning a prevention program for infectious mononucleosis. The best target audience for the program is:
college students living in a dorm.
The nurse evaluating the blood work of a client with chronic lymphocytic leukemia (CLL) notes the following: white blood count 22,000/μL (22 x 109/L); lymphocytes 90% (0.90); and hemoglobin 6 g/dL (60 g/L). The nurse should:
communicate to the physician an unexpected low hemoglobin.
A client is prescribed the recumbent granulocyte colony-stimulating factor (CSF) filgrastim. The nurse evaluates the effectiveness by monitoring which laboratory value?
complete blood count (CBC)/differential
A client who is being treated for small-cell lung cancer has been placed in protective isolation due to neutropenia. The most likely cause of this client's neutropenia is:
the effects of chemotherapy on white blood cell development.
