PrepU- Cancer Emergencies

The nurse is caring for a client with acute myeloid leukemia (AML) with high uric acid levels. What medication does the nurse anticipate administering that will prevent crystallization of uric acid and stone formation? a.) Allopurinol b.) Asparaginase c.) Filgrastim d.) Hydroxyurea

a.) Allopurinol

Which nursing intervention should be incorporated into the plan of care to manage the delayed clotting process due to thrombocytopenia in a client with leukemia? a.) Applying prolonged pressure to needle sites or other sources of external bleeding b.) Monitoring temperature at least once per shift c.) Implementing neutropenic precautions d.) Eliminating direct contact with others who are infectious

a.) Applying prolonged pressure to needle sites or other sources of external bleeding

The nurse is caring for a client with multiple myeloma and communicates to the physician the possibility of hypercalcemia based on which symptoms? Select all that apply. a.) Bone pain b.) Increased respiratory rate associated with heart failure c.) Edema d.) Pain on urination

a.) Bone pain b.) Increased respiratory rate associated with heart failure

An oncology nurse is caring for a client with multiple myeloma who is experiencing bone destruction. When reviewing the client's most recent blood tests, the nurse should anticipate which imbalance? a.) Hypercalcemia b.) Elevated serum viscosity c.) Hyperproteinemia d.) Elevated red blood count (RBC)

a.) Hypercalcemia

When malignant cells are killed (tumor lysis syndrome), intracellular contents are released into the bloodstream. This leads to which of the following? Select all that apply. a.) Hyperuricemia b.) Hyperphosphatemia c.) Hyperkalemia d.) Hypercalcemia

a.) Hyperuricemia b.) Hyperphosphatemia c.) Hyperkalemia

A nurse is teaching a client about the rationale for administering allopurinol with chemotherapy. Which example would be the best teaching by the nurse? a.) It lowers serum and uric acid levels. b.) It treats drug-related anemia. c.) It prevents alopecia. d.) It stimulates the immune system against the tumor cells.

a.) It lowers serum and uric acid levels.

The physician reviews a client's lab results and notes that the neutrophil count is 900/μL (0.90 x 109/L). This is known as: a.) Neutropenia b.) Agranulocytosis c.) Aplastic anemia d.) Leukopenia

a.) Neutropenia

A nurse is reviewing a client's complete blood count (CBC) which indicates thrombocytopenia. Based on this result, which action should the nurse include in the plan of care? a.) Place the client on bleeding precautions. b.) Place the client on contact isolation. c.) Increase intake of iron-rich foods. d.) Encourage increased oral fluids.

a.) Place the client on bleeding precautions.

A 42-year-old client is experiencing chemotherapy-induced thrombocytopenia. The nurse is providing information to the client regarding the medication oprelvekin. Which information would the nurse include in the explanation? a.) "Chemotherapy has caused you to have a low platelet count that puts you at risk for bleeding, and without the drug you will bleed to death tonight." b.) "Chemotherapy has caused you to have a low platelet count, which puts you at risk for bleeding. Oprelvekin is used to increase platelet production to decrease the risk." c.) "Chemotherapy has caused you to have a low platelet count that puts you at risk for bleeding. Oprelvekin is just like aspirin and, in combination with chemotherapy, will reverse the risk for bleeding." d.) "We don't know why, but you have a low platelet count that puts you at risk for bleeding. Oprelvekin is used to increase platelet production to decreas

b.) "Chemotherapy has caused you to have a low platelet count, which puts you at risk for bleeding. Oprelvekin is used to increase platelet production to decrease the risk."

The nurse is preparing to administer rasburicase to a client undergoing chemotherapy. How should the nurse explain the purpose of this medication to the client? a.) "This medication protects your bladder from the toxic effects of chemotherapy." b.) "This drug helps reduce uric acid levels and protect your kidneys." c.) "Rasburicase is a unique antiemetic that will reduce your nausea." d.) "Chemotherapy causes high phosphate and this medication reduces this."

b.) "This drug helps reduce uric acid levels and protect your kidneys."

Which oncologic emergency involves the accumulation of fluid in the pericardial space? a.) Syndrome of inappropriate antidiuretic hormone release (SIADH) b.) Cardiac tamponade c.) Tumor lysis syndrome d.) Disseminated intravascular coagulation (DIC)

b.) Cardiac tamponade

A client on the oncology unit is receiving carmustine, a chemotherapy agent, and the nurse is aware that a significant side effect of this medication is thrombocytopenia. Which symptom should the nurse assess for in clients at risk for thrombocytopenia? a.) Hot flashes b.) Epistaxis c.) Increased weight d.) Interrupted sleep pattern

b.) Epistaxis

A nurse is caring for a client with metastatic breast cancer who is extremely lethargic and very slow to respond to stimuli. The laboratory report indicates a serum calcium level of 12.0 mg/dl, a serum potassium level of 3.9 mEq/L, a serum chloride level of 101 mEq/L, and a serum sodium level of 140 mEq/L. Based on this information, the nurse determines that the client's symptoms are most likely associated with which electrolyte imbalance? a.) Hyperkalemia b.) Hypercalcemia c.) Hypokalemia d.) Hypocalcemia

b.) Hypercalcemia

The health care provider is assessing a client with cancer for the possibility of endocrine disorders. This client would be assessed for which manifestations of an endocrine disorder? Select all that apply. a.) Pheochromocytoma b.) Syndrome of inappropriate antidiuretic hormone (SIADH) c.) Addison disease d.) Hypothyroidism e.) Hypercalcemia f.) Cushing syndrome

b.) Syndrome of inappropriate antidiuretic hormone (SIADH) f.) Hypercalcemia g.) Cushing syndrome

The physician is explaining treatment of acute leukemia to a client. Which statement concerning chemotherapy treatment is most accurate? a.) Induction therapy serves to maintain remission. b.) Tumor lysis syndrome can occur during chemotherapy treatment. c.) Intensification therapy is used to elicit a remission. d.) Maintenance therapy is used to further reduction in leukemic cells after a remission is achieved.

b.) Tumor lysis syndrome can occur during chemotherapy treatment.

The parents bring their 4-year-old child to the emergency department. The child is receiving chemotherapy for acute lymphoblastic leukemia (ALL). The parents report that the child has become lethargic and has had significant episodes of vomiting and diarrhea. What findings would lead the nurse to suspect the child may be experiencing tumor lysis syndrome? Select all that apply. a.) polyuria b.) hyperuricemia c.) hyperkalemia d.) hypocalcemia e.) hypophosphatemia

b.) hyperuricemia c.) hyperkalemia d.) hypocalcemia

A client is undergoing the initial phase of treatment for acute lymphocytic leukemia (ALL). Which life-threatening metabolic disorder(s) can occur because of tumor lysis syndrome? Select all that apply. a.) hypokalemia b.) hypocalcemia c.) alkalosis d.) hyperuricemia e.) acidosis

b.) hypocalcemia d.) hyperuricemia e.) acidosis

A nurse is caring for a client with metastatic breast cancer who is extremely lethargic and very slow to respond to stimuli. The laboratory report indicates a serum calcium level of [12.0 mg/dl (3.0 mmol/L)], a serum potassium level of [3.9 mEq/L (3.9 mmol/L)], a serum chloride level of [101 mEq/L (11 mmol/L)], and a serum sodium level of [140 mEq/L (140 mmol/L)]. Based on this information, the nurse determines that the client will likely need which intervention? a.) calcium gluconate 10% at 10 ml slow I.V. push b.) mithramycin 25 mcg/kg/day c.) sodium polystyrene sulfonate d.) potassium chloride 10 mEq/100ml I.V. infusion

b.) mithramycin 25 mcg/kg/day

Which intervention should the nurse teach a client who is at risk for hypercalcemia? a.) Avoid the use of stool softeners. b.) Restrict calcium intake. c.) Consume 2 to 4 L of fluid daily. d.) Take laxatives daily.

c.) Consume 2 to 4 L of fluid daily.

Your patient is receiving carmustine, a chemotherapy agent. A significant side effect of this medication is thrombocytopenia. What symptom would the nurse assess for in a patient at risk for thrombocytopenia? a.) Interrupted sleep pattern b.) Hot flashes c.) Nose bleed d.) Increased weight

c.) Nose bleed

Which oncologic emergency involves the failure in the negative feedback mechanism that normally regulates the release of antidiuretic hormone (ADH)? a.) Tumor lysis syndrome b.) Disseminated intravascular coagulation (DIC) c.) Syndrome of inappropriate antidiuretic hormone release (SIADH) d.) Cardiac tamponade

c.) Syndrome of inappropriate antidiuretic hormone release (SIADH)

A nurse is assessing a client and finds these results: Areas of bruising (purpura) on the client's arms and legs Pinpoint hemorrhages (petechiae) on the legs Pinpoint hemorrhages (petechiae) in the mouth Platelets level of 90,000/μL (90 ×109/L) What condition should the nurse suspect the client is exhibiting? a.) Thrombocytosis b.) Leukopenia c.) Thrombocytopenia d.) Neutropenia

c.) Thrombocytopenia

The nurse may be asked to administer which medications to a client to counteract the increase in uric acid and subsequent hyperuricemia resulting from the metabolic waste buildup from rapid tumor lysis? a.) mesna b.) leucovorin c.) allopurinol d.) amifostine

c.) allopurinol

A nurse is caring for a client with prostate cancer and assesses bleeding gums and hematuria. What serum indicator should the nurse relate the bleeding? a.) neutrophil count of 40% b.) reticulocyte count of 1% c.) platelet count of 60,000/mm3 d.) lymphocyte count of 30%

c.) platelet count of 60,000/mm3

The nurse is caring for a 6-year-old girl with leukemia who is having an oncologic emergency. Which signs and symptoms would indicate hyperleukocytosis? a.) wheezing and diminished breath sounds b.) bradycardia and distinct S1 and S2 sounds c.) tachycardia and respiratory distress d.) respiratory distress and poor perfusion

c.) tachycardia and respiratory distress

The patient diagnosed with thrombocytopenia is at risk for which of the following adverse effects: a.) Stomatitis b.) Headache c.) Diminished reflexes d.) Bleeding

d.) Bleeding