Ch 30: Management of Patients with Hematologic Neoplasms

The nurse is educating a patient taking imatinib mesylate for treatment of leukemia. Which will the nurse be sure to include when educating the patient about the best way to take the medication that will optimize absorption? a) Take the medication with a source of vitamins C to enhance absorption b) Take antacids if needed for gastrointestinal (GI) upset 2 hours after taking the medication c) Take the medication with food to enhance absorption d) Take the medication with acetaminophen to prevent decreased absorption and GI upset

b) Take antacids if needed for gastrointestinal (GI) upset 2 hours after taking the medication

The nurse is assessing a patient with polycythemia vera. Which skin assessment data will the nurse identify as a normal finding for this patient? a) Pale skin and mucous membranes b) Bronze skin tone c) Ruddy complexion d) Jaundice skin and sclera

c) Ruddy complexion

The nurse is caring for a patient who will begin taking long-term biphosphonate therapy. Why is it important for the nurse to encourage the patient to receive a thorough evaluation of dentition, including panoramic dental x-rays? a) The patient is at risk for tooth decay b) The patient will develop gingival hyperplasia c) The patient can develop osteonecrosis of the jaw d) The patient can develop loosening of the teeth

c) The patient can develop osteonecrosis of the jaw

Which patient assessed by the nurse is at greatest risk for the development of myelodysplastic syndromes (MDSs)? a) A 24 year old female taking oral contraceptives b) A 40 year old patient with a history of hypertension c) A 52 year old patient with acute kidney injury d) A 72 year old patient with a history of cancer

d) A 72 year old patient with a history of cancer

A patient with acute myeloid leukemia (AML) has a neutrophil count that persists at less than 100/mm^3. Which will the nurse cautiously monitor this patient for? a) Abdominal cramps b) Hypotension c) Seizure activity d) Infection

d) Infection

A patient with polycythemia vera has a high RBC count and is at risk for the development of thrombosis. Which treatment is important to reduce blood viscosity and to deplete the patient's iron stores? a) Blood transfusions b) Radiation c) Chelation therapy d) Phlebotomy

d) Phlebotomy

The nurse is performing an assessment for a patient with acute myeloid leukemia (AML) and observes multiple areas of ecchymosis and petechiae. Which laboratory study will the nurse be most concerned about? a) WBC count of 4200 cells/mcL b) Hematocrit of 38% c) Platelet count of 9000/mm^3 d) Creatinine level of 1.0 mg/dL

c) Platelet count of 9000/mm^3

The nurse is administering packed RBC transfusions for a patient with MDS. The patient has had several transfusions and is likely to receive several more. Which is a priority for the nurse to monitor related to the transfusions? a) Creatinine and blood urea nitrogen (BUN) levels b) Iron levels c) Magnesium levels d) Potassium levels

b) Iron levels

The nurse is caring for a patient with acute myeloid leukemia (AML) with high uric acid levels. Which medication administered by the nurse will prevent crystallization of uric acid and stone formation? a) Allopurinol b) Filgrastim c) Hydroxyurea d) Asparaginase

a) Allopurinol

The nurse is caring for a patient with chronic myeloid leukemia (CML) taking imatinib mesylate. In which phase of the leukemia is this medication most useful to induce remission? a) Chronic b) Transformation c) Accelerated d) Blast crisis

a) Chronic

A patient with acute myeloid leukemia (AML) is having aggressive chemotherapy to attempt to achieve remission and is aware that hospitalization will be necessary for several weeks. Which type of therapy will the nurse educate the patient about? a) Induction therapy b) Supportive therapy c) Antimicrobial therapy d) Standard therapy

a) Induction therapy

A patient is taking hydroxyurea for the treatment of primary myelofibrosis. While the patient is taking this medication, which laboratory studies will the nurse monitor to determine effectiveness? a) Leukocyte and platelet count b) BUN and creatinine levels c) Asparate aminotransferase (AST) and alanine transaminase (ALT) levels d) Hemoglobin and hematocrit

a) Leukocyte and platelet count

The nurse is caring for a patient with Hodgkin lymphoma in the hospital and preparing discharge planning education. Because this patient is at risk for the development of a second malignancy, which education is beneficial for the nurse to discuss to reduce the risk factors? (select all that apply) a) Reduce exposure to excessive sunlight b) Smoking cessation c) Decrease alcohol intake d) Decrease intake of antipyretic medications such as acetaminophen e) Decrease fat intake

a) Reduce exposure to excessive sunlight b) Smoking cessation c) Decrease alcohol intake

A patient with polycythemia vera reports severe itching. Which triggers does the nurse know can cause this symptom? (select all that apply) a) Temperature change b) Allergic reaction to the RBC increase c) Alcohol consumption d) Exposure to water of any temperature e) Aspirin

a) Temperature change c) Alcohol consumption d) Exposure to water of any temperature

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

b) Graft - versus- host disease