Chapter 34-Management of Patients with Hematologic Neoplasms!!!!!! Exam 2
13. A nurse is caring for a patient with Hodgkin lymphoma at the oncology clinic. The nurse should be aware of what main goal of care? A) Cure of the disease B) Enhancing quality of life C) Controlling symptoms D) Palliation
Ans: A
40. A nurse is caring for patient whose diagnosis of multiple myeloma is being treated with bortezomib. The nurse should assess for what adverse effect of this treatment? A) Stomatitis B) Nephropathy C) Cognitive changes D) Peripheral neuropathy
Ans: D
1. An oncology nurse is providing health education for a patient who has recently been diagnosed with leukemia. What should the nurse explain about commonalities between all of the different subtypes of leukemia? A) The different leukemias all involve unregulated proliferation of WBC B) The different leukemias all have unregulated proliferation of red blood cells and decreased bone marrow function. C) The different leukemias all result in a decrease in the production of white blood cells. D) The different leukemias all involve the development of cancer in the lymphatic system.
Ans: A
18. A patient with a diagnosis of acute myeloid leukemia (AML) is being treated with induction therapy on the oncology unit. What nursing action should be prioritized in the patient's care plan? A) Protective isolation and vigilant use of standard precautions B) Provision of a high-calorie, low-texture diet and appropriate oral hygiene C) Including the family in planning the patient's activities of daily living D) Monitoring and treating the patient's pain
Ans: A
2. A nurse is caring for a patient who has a diagnosis of acute leukemia. What assessment most directly addresses the most common cause of death among patients with leukemia? A) Monitoring for infection B) Monitoring nutritional status C) Monitor electrolyte levels D) Monitoring liver function
Ans: A
20. A 60-year-old patient with chronic myeloid leukemia will be treated in the home setting and the nurse is preparing appropriate health education. What topic should the nurse emphasize? A) The importance of adhering to the prescribed drug regimen B) The need to ensure that vaccinations are up to date C) The importance of daily physical activity D) The need to avoid shellfish and raw foods
Ans: A
22. A patient has been found to have an indolent neoplasm. The nurse should recognize what implication of this condition? A) The patient faces a significant risk of malignancy. B) The patient has a myeloid form of leukemia. C) The patient has a lymphocytic form of leukemia. D) The patient has a major risk factor for hemophilia.
Ans: A
3. An oncology nurse is caring for a patient with multiple myeloma who is experiencing bone destruction. When reviewing the patient's most recent blood tests, the nurse should anticipate what imbalance? A) Hypercalcemia B) Hyperproteinemia C) Elevated serum viscosity D) Elevated RBC count
Ans: A
9. A patient with leukemia has developed stomatitis and is experiencing a nutritional deficit. An oral anesthetic has consequently been prescribed. What health education should the nurse provide to the patient? A) Chew with care to avoid inadvertently biting the tongue. B) Use the oral anesthetic 1 hour prior to meal time. C) Brush teeth before and after eating. D) Swallow slowly and deliberately.
Ans: A
25. An oncology nurse recognizes a patient's risk for fluid imbalance while the patient is undergoing treatment for leukemia. What relevant assessments should the nurse include in the patient's plan of care? Select all that apply. A) Monitoring the patient's electrolyte levels B) Monitoring the patient's hepatic function C) Measuring the patient's weight on a daily basis D) Measuring and recording the patient's intake and output E) Auscultating the patient's lungs frequently
Ans: A, C, D, E
10. A patient diagnosed with acute myelogenous leukemia has just been admitted to the oncology unit. When writing this patient's care plan, what potential complication should the nurse address? A) Pancreatitis B) Hemorrhage C) Arteritis D) Liver dysfunction
Ans: B
15. An adult patient has presented to the health clinic with a complaint of a firm, painless cervical lymph node. The patient denies any recent infectious diseases. What is the nurse's most appropriate response to the patient's complaint? A) Call 911. B) Promptly refer the patient for medical assessment. C) Facilitate a radiograph of the patient's neck and have the results forwarded to the patient's primary care provider. D) Encourage the patient to track the size of the lymph node and seek care in 1 week.
Ans: B
16. A nurse practitioner is assessing a patient who has a fever, malaise, and a white blood cell count that is elevated. Which of the following principles should guide the nurse's management of the patient's care? A) There is a need for the patient to be assessed for lymphoma. B) Infection is the most likely cause of the patient's change in health status. C) The patient is exhibiting signs and symptoms of leukemia. D) The patient should undergo diagnostic testing for multiple myeloma.
Ans: B
19. A nurse is caring for a patient who has been diagnosed with leukemia. The nurse's most recent assessment reveals the presence of ecchymoseson the patient's sacral area and petechiae in her forearms. In addition to informing the patient's primary care provider, the nurse should perform what action? A) Initiate measures to prevent venous thromboembolism (VTE). B) Check the patient's most recent platelet level. C) Place the patient on protective isolation. D) Ambulate the patient to promote circulatory function.
Ans: B
21. An older adult patient is undergoing diagnostic testing for chronic lymphocytic leukemia (CLL). What assessment finding is certain to be present if the patient has CLL? A) Increased numbers of blast cells B) Increased lymphocyte levels C) Intractable bone pain D) Thrombocytopenia with no evidence of bleeding
Ans: B
24. A patient who is undergoing consolidation therapy for the treatment of leukemia has been experiencing debilitating fatigue. How can the nurse best meet this patient's needs for physical activity? A) Teach the patient about the risks of immobility and the benefits of exercise. B) Assist the patient to a chair during awake times, as tolerated. C) Collaborate with the physical therapist to arrange for stair exercises. D) Teach the patient to perform deep breathing and coughing exercises.
Ans: B
36. An adult patient's abnormal complete blood count (CBC) and physical assessment have prompted the primary care provider to order a diagnostic workup for Hodgkin lymphoma. The presence of what assessment finding is considered diagnostic of the disease? A) Schwann cells B) Reed-Sternberg cells C) Lewy bodies D) Loops of Henle
Ans: B
39. A patient has a diagnosis of multiple myeloma and the nurse is preparing health education in preparation for discharge from the hospital. What action should the nurse promote? A) Daily performance of weight-bearing exercise to prevent muscle atrophy B) Close monitoring of urine output and kidney function C) Daily administration of warfarin (Coumadin) as ordered D) Safe use of supplementary oxygen in the home setting
Ans: B
6. A nursing student is caring for a patient with acute myeloid leukemia who is preparing to undergo induction therapy. In preparing a plan of care for this patient, the student should assign the highest priority to which nursing diagnoses? A) Activity Intolerance B) Risk for Infection C) Acute Confusion D) Risk for Spiritual Distress
Ans: B
11. An emergency department nurse is triaging a 77-year-old man who presents with uncharacteristic fatigue as well as back and rib pain. The patient denies any recent injuries. The nurse should recognize the need for this patient to be assessed for what health problem? A) Hodgkin disease B) Non-Hodgkin Lymphoma C) Multiple Myeloma D) Acute Thrombocytopenia
Ans: C
23. A nurse is caring for a patient who is being treated for leukemia in the hospital. The patient was able to maintain her nutritional status for the first few weeks following her diagnosis but is now exhibiting early signs and symptoms of malnutrition. In collaboration with the dietitian, the nurse should implement what intervention? A) Arrange for total parenteral nutrition (TPN). B) Facilitate placement of a percutaneous endoscopic gastrostomy (PEG) tube. C) Provide the patient with several small, soft-textured meals each day. D) Assign responsibility for the patient's nutrition to the patient's friends and family.
Ans: C
26. After receiving a diagnosis of acute lymphocytic leukemia, a patient is visibly distraught, stating, I have no idea where to go from here. How should the nurse prepare to meet this patient's psychosocial needs? A) Assess the patient's previous experience with the health care system. B) Reassure the patient that treatment will be challenging but successful. C) Assess the patient's specific needs for education and support. D) Identify the patient's plan of medical care.
Ans: C
37. A young adult patient has received the news that her treatment for Hodgkin lymphoma has been deemed successful and that no further treatment is necessary at this time. The care team should ensure that the patient receives regular health assessments in the future due to the risk of what complication? A) Iron-deficiency anemia B) Hemophilia C) Hematologic cancers D) Genitourinary cancers
Ans: C
38. The clinical nurse educator is presenting health promotion education to a patient who will be treated for non-Hodgkin lymphoma on an outpatient basis. The nurse should recommend which of the following actions? A) Avoiding direct sun exposure in excess of 15 minutes daily B) Avoiding grapefruit juice and fresh grapefruit C) Avoiding highly crowded public places D) Using an electric shaver rather than a razor
Ans: C
4. A nurse is planning the care of a patient who has been admitted to the medical unit with a diagnosis of multiple myeloma. In the patient's care plan, the nurse has identified a diagnosis of Risk for Injury. What pathophysiologic effect of multiple myeloma most contributes to this risk? A) Labyrinthitis B) Left ventricular hypertrophy C) Decreased bone density D) Hypercoagulation
Ans: C
5. A patient with advanced leukemia is responding poorly to treatment. The nurse finds the patient tearful and trying to express his feelings, but he is clearly having difficulty. What is the nurse's most appropriate action? A) Tell him that you will give him privacy and leave the room. B) Offer to call pastoral care. C) Ask if he would like you to sit with him while he collects his thoughts. D) Tell him that you can understand how he's feeling.
Ans: C
7. A 77-year-old male is admitted to a unit with a suspected diagnosis of acute myeloid leukemia (AML). When planning this patient's care, the nurse should be aware of what epidemiologic fact? A) Early diagnosis is associated with good outcomes. B) Five-year survival for older adults is approximately 50%. C) Five-year survival for patients over 75 years old is less than 2%. D) Survival rates are wholly dependent on the patient's pre-illness level of health.
Ans: C
12. A home health nurse is caring for a patient with multiple myeloma. Which of the following interventions should the nurse prioritize when addressing the patient's severe bone pain? A) Implementing distraction techniques B) Educating the patient about the effective use of hot and cold packs C) Teaching the patient to use NSAIDs effectively D) Helping the patient manage the opioid analgesic regimen
Ans: D
14. A patient with non-Hodgkin's lymphoma is receiving information from the oncology nurse. The patient asks the nurse why she should stop drinking and smoking and stay out of the sun. What would be the nurse's best response? A) Everyone should do these things because they're health promotion activities that apply to everyone. B) You don't want to develop a second cancer, do you? C) You need to do this just to be on the safe side. D) It's important to reduce other factors that increase the risk of second cancers.
Ans: D
17. Diagnostic testing has resulted in a diagnosis of acute myeloid leukemia (AML) in an adult patient who is otherwise healthy. The patient and the care team have collaborated and the patient will soon begin induction therapy. The nurse should prepare the patient for which of the following? A) Daily treatment with targeted treatment medications B) Radiation therapy on a daily basis C) Hematopoietic stem cell transplantation D) An aggressive course of chemotherapy
Ans: D
27. A patient has completed the full course of treatment for acute lymphocytic leukemia and has failed to respond appreciably. When preparing for the patient's subsequent care, the nurse should perform what action? A) Arrange a meeting between the patient's family and the hospital chaplain. B) Assess the factors underlying the patient's failure to adhere to the treatment regimen. C) Encourage the patient to vigorously pursue complementary and alternative medicine (CAM). D) Identify the patient's specific wishes around end-of-life care.
Ans: D
8. A 35-year-old male is admitted to the hospital complaining of severe headaches, vomiting, and testicular pain. His blood work shows reduced numbers of platelets, leukocytes, and erythrocytes, with a high proportion of immature cells. The nurse caring for this patient suspects a diagnosis of what? A) AML B) CML C) MDS D) ALL
Ans: D
