Chapter 30 Hinkle

A nurse prepares teaching for a group of clients with chronic myeloid leukemia (CML). When planning the teaching on medication adherence, which factors associated with lower oral therapy adherence will the nurse keep in mind? Select all that apply. Lower self-report of functional status Taking medication independent of meals Living alone Not participating in a clinical trial Low socioeconomic status

Living alone Low socioeconomic status Not participating in a clinical trial Taking medication independent of meals

A client has completed induction therapy and has diarrhea and severe mucositis. What is the appropriate nursing goal? Address issues of negative body image. Maintain nutrition. Place the client in reverse isolation. Administer pain medication.

Maintain nutrition.

What assessment finding best indicates that the client has recovered from induction therapy? No evidence of edema Neutrophil and platelet counts within normal limits Vital signs within normal ranges Absence of bone pain

Neutrophil and platelet counts within normal limits

The nurse is discussing disorders of the hematopoietic system when a client asked about erythrocytosis. What disease will the nurse mention with a primary characteristic of erythrocytosis? polycythemia vera sickle cell disease aplastic anemia pernicious anemia

polycythemia vera

The nurse is assessing a client admitted with a deep vein thrombosis with an elevated red blood cell count. The admitting diagnosis is polycythemia vera. What is the hallmark clinical sign of PV? pale body color splenomegaly weight gain peripheral edema

splenomegaly

A client is being tested for acute myeloid leukemia (AML). The nurse knows that which diagnostic test will be used as the hallmark for the diagnosis? Complete blood count Bone marrow analysis Alkaline phosphatase level Clotting factors

Bone marrow analysis

The nurse cares for a client with acute myeloid leukemia with severe bone pain. What pathophysiological concept does the nurse understand is the reason for the client's pain? Abnormal blood cells crystalize. Abnormal blood cells deposit in small vessels. Bone marrow expands. Lymph nodes expand.

Bone marrow expands.

A nurse cares for a client with early Hodgkin lymphoma. While assessing the client, the nurse will most likely find painless enlargement of which lymph node? Cervical Axillary Inguinal Popliteal

Cervical

A client with multiple myeloma is complaining about pain. What instructions will the nurse give the client to help to reduce pain during activity? Do not lift more than 10 pounds. Limit fluids to prevent going to the bathroom. Stay in bed as much as possible. Limit activity to once a day.

Do not lift more than 10 pounds.

A client who is being treated for AML has bruises on both legs. What is the nurse's most appropriate action? Keep the client on bed rest. Evaluate the client's platelet count. Ask the client whether they have recently fallen. Evaluate the client's INR.

Evaluate the client's platelet count.

A patient with acute myeloid leukemia (AML) is having hematopoietic stem cell transplantation (HSCT) with radiation therapy. In which complication do the donor's lymphocytes recognize the patient's body as foreign and set up reactions to attack the foreign host? Graft-versus-host disease Acute respiratory distress syndrome Bone marrow depression Remission

Graft-versus-host disease

When assessing a female client with a disorder of the hematopoietic or the lymphatic system, which assessment is most essential? Lifestyle assessments, such as exercise routines Health history, such as bleeding, fatigue, or fainting Age and gender Menstrual history

Health history, such as bleeding, fatigue, or fainting

Which patient assessed by the nurse is most likely to develop myelodysplastic syndrome (MDS)? A 72-year-old patient with a history of cancer A 24-year-old female taking oral contraceptives A 52-year-old patient with acute kidney injury A 40-year-old patient with a history of hypertension

A 72-year-old patient with a history of cancer

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? Hydroxyurea Asparaginase Allopurinol Filgrastim

Allopurinol

The nurse is interacting with a family that has been caring for a client with cancer for several months. What are the best interventions to assist in relieving caregiver stress in this family? Select all that apply. Suggest the family go to church more often. Educate the family about medications and side effects. Suggest support for household maintenance. Allow family members to express feelings. Suggest the prescription of antianxiety medications.

Educate the family about medications and side effects. Allow family members to express feelings. Suggest support for household maintenance.

Which term refers to a form of white blood cell involved in immune response? Granulocyte Thrombocyte Lymphocyte Spherocyte

Lymphocyte

A client was admitted to the hospital with a pathologic pelvic fracture. The client informs the nurse that he has been having a strange pain in the pelvic area for a couple of weeks that was getting worse with activity prior to the fracture. What does the nurse suspect may be occurring based on these symptoms? Leukemia Hemolytic anemia Polycythemia vera Multiple myeloma

Multiple myeloma

The nurse is caring for a client with multiple myeloma. Why would it be important to assess this client for fractures? Osteopathic tumors destroy bone causing fractures. Osteosarcomas form producing pathologic fractures. Osteolytic activating factor weakens bones producing fractures. Osteoclasts break down bone cells so pathologic fractures occur.

Osteoclasts break down bone cells so pathologic fractures occur.

Which laboratory test results indicate to the nurse that the client is experiencing symptoms of acute lymphocytic leukemia (ALL)? Select all that apply. Hemoglobin 16 Granulocyte count 0.8 Platelet count of 20,000 Blastocyte count 94 Erythocyte count 2.5

Platelet count of 20,000 Erythocyte count 2.5 Granulocyte count 0.8

The nurse is performing an assessment on a patient with acute myeloid leukemia (AML) and observes multiple areas of ecchymosis and petechiae. What laboratory study should the nurse be concerned about? Hematocrit of 38% Creatinine level of 1.0 mg/dL Platelet count of 9,000/mm3 WBC count of 4,200 cells/uL

Platelet count of 9,000/mm3 explanation: Major hemorrhages also may develop when the platelet count drops to less than 10,000/mm3.

For a client with Hodgkin lymphoma, who is at a risk for ineffective airway clearance and impaired gas exchange, the nurse places the client in a high Fowler's position to: reduce deficits in the blood oxygen concentration. anticipate the need for airway management. increase lung expansion. detect compromised ventilation.

increase lung expansion.

The nurse cares for an older adult client with unprovoked back pain and increased serum protein. Which hematologic neoplasm does the nurse suspect the client has? Hodgkin lymphoma Multiple myeloma Non-Hodgkin lymphoma Chronic myeloid leukemia

Multiple myeloma Explanation: Any older adult with unprovoked or unexplained back pain and increased protein in the serum should be assessed for multiple myeloma

A client with multiple myeloma reports severe paresthesia in the feet. When planning care for the client, which priority nursing diagnosis will the nurse choose? Risk for falls Impaired tissue integrity Sensory-perception disturbance Acute pain

Risk for falls

The nurse is teaching the client about consolidation. What statement should be included in the teaching plan?

"Consolidation therapy is administered to reduce the chance of leukemia recurrence."

A client with chronic lymphocytic leukemia (CLL) experiences frequent bacterial infections. Which medication will the nurse anticipate being prescribed for this client? Dasatinib Acyclovir Clotrimazole Asceniv

Asceniv

The nurse is caring for a client at high risk for thrombocythemia. Which treatments will the nurse anticipate being prescribed for this client? Select all that apply. Hydroxyurea Anagrelide Diphenhydramine Interferon-alfa Aspirin

Aspirin Anagrelide Hydroxyurea Interferon-alfa

A client presents with peripheral neuropathy and hypoesthesia of the feet. What is the best nursing intervention? Encourage ambulation. Keep the feet cool. Assess for signs of injury. Elevate the client's legs.

Assess for signs of injury.

A nurse is caring for a client with multiple myeloma. Which laboratory value is the nurse most likely to see? Hypercalcemia Hypermagnesemia Hypernatremia Hyperkalemia

Hypercalcemia

A patient with AML is having aggressive chemotherapy to attempt to achieve remission. The patient is aware that hospitalization will be necessary for several weeks. What type of therapy will the nurse explain that the patient will receive? Antimicrobial therapy Supportive therapy Standard therapy Induction therapy

Induction therapy

Which term refers to an abnormal decrease in white blood cells, red blood cells, and platelets? Leukopenia Thrombocytopenia Anemia Pancytopenia

Pancytopenia

Clients with multiple myeloma have abnormal plasma cells that proliferate in the bone marrow where they release osteoclast-activating factor, resulting in the formation of osteoclasts. What is the most common complication of the pathology resulting from this process? Osteoporosis Increased mobility Pathologic fractures Calcified bones

Pathologic fractures Explanation: Osteoclasts are cells that break down and remove bone cells, which results in increased blood calcium and pathologic fractures.

The hospitalized client is experiencing gastrointestinal bleeding with a platelets at 9,000/mm³. The client is receiving prednisone and azathioprine. What action will the nurse take? Request a prescription of diphenoxylate and atropine for loose stools. Perform a neurologic assessment with vital signs. Use contact precautions with this client. Teach the client to vigorously floss the teeth to prevent infections.

Perform a neurologic assessment with vital signs.

A client is awaiting test results to diagnose Hodgkin lymphoma. The nurse knows that which result is the hallmark for the diagnosis of this condition? Reed-Sternberg cells Elevated platelet count Increased basophils Misshaped red blood cells

Reed-Sternberg cells

The nursing instructor is discussing disorders of the hematopoietic system with the pre-nursing pathophysiology class. What disease would the instructor list with a primary characteristic of erythrocytosis? Polycythemia vera Sickle cell disease Aplastic anemia Pernicious anemia

Polycythemia vera

A nurse is caring for a client with multiple myeloma. Which nursing intervention is most appropriate for this client? Monitoring respiratory status Restricting fluid intake Balancing rest and activity Preventing bone injury

Preventing bone injury

A client with polycythemia vera reports gouty arthritis symptoms in the toes and fingers. What is the nurse's best understanding of the pathophysiological reason for this symptom? The dead red blood cells release excess uric acid. Excess red blood cells produce extracellular toxins that build up. The dead red blood cells occlude the small vessels in the joints. Excess red blood cells cause vascular injury in the joints.

The dead red blood cells release excess uric acid.

The clinic nurse is caring for a client diagnosed with leukopenia. What does the nurse know this client has? Too many erythrocytes A general reduction in neutrophils and basophils A decrease in granulocytes A general reduction in all white blood cells

A general reduction in all white blood cells

The nurse is reviewing the treatment options with a client diagnosed with myelodysplastic syndromes (MDS). Which therapy will the nurse emphasize as the option to cure the condition? Erythropoiesis-stimulating agents Blood transfusions Allogeneic hematopoietic stem cell transplantation Hypomethylating agents

Allogeneic hematopoietic stem cell transplantation

A client receiving treatment for acute myeloid leukemia (AML) develops elevated potassium, uric acid, and phosphate levels. Which treatments will the nurse anticipate being prescribed to reduce this client's risk for kidney stone formation? Select all that apply. Intravenous fluids Allopurinol Acetaminophen Antibiotics Anticoagulants

Allopurinol Intravenous fluids