CH 34 Management of Patients With Hematologic Neoplasms - ML5

A client has been diagnosed with multiple myeloma. Which of the following laboratory values should the nurse expect to find in a client with multiple myeloma? Decreased calcium level Decreased serum protein Increased urinary protein Polycythemia vera

Increased urinary protein

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? Multiple myeloma Leukemia Polycythemia vera Hemolytic anemia

Multiple myeloma

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 Non-Hodgkin lymphoma Multiple myeloma Chronic myeloid leukemia

Multiple myeloma

A client with suspected multiple myeloma is reporting back pain. What is the priority nursing action? Encourage ambulation. Send the client for a spinal x-ray study. Have the client rest. Have the client lie on a hard surface.

Send the client for a spinal x-ray study.

Which statement best describes the function of stem cells in the bone marrow? They are active against hypersensitivity reactions. They produce antibodies against foreign antigens. They produce all blood cells. They defend against bacterial infection.

They produce all blood cells.

Acute myeloid leukemia (AML) results from a defect in the hematopoietic stem cell that differentiates into which of the following myeloid cells? Erythrocytes Platelets Granulocytes Islet cells Monocytes

Erythrocytes Platelets Granulocytes Monocytes

The nurse meets with the family of a patient who had been diagnosed with stage I Hodgkin's lymphoma. She tells the family that the course of treatment will include: Chemotherapy with vincristine. A combination of chemotherapy and radiation. Radiotherapy to the specific node over a space of 2 to 4 months. A drug regimen of nitrogen mustard, vincristine, and a steroid.

Radiotherapy to the specific node over a space of 2 to 4 months.

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 anticipate the need for airway management. reduce deficits in the blood oxygen concentration. detect compromised ventilation. increase lung expansion.

increase lung expansion.

A client is suspected of having leukemia and is having a series of laboratory and diagnostic studies performed. What does the nurse recognize as the hallmark signs of leukemia? Select all that apply. Diarrhea Nausea and vomiting Frequent infections Fatigue from anemia Easy bruising

Frequent infections Fatigue from anemia Easy bruising

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 Menstrual history Health history, such as bleeding, fatigue, or fainting Age and gender

Health history, such as bleeding, fatigue, or fainting

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 Induction therapy Standard therapy

Induction therapy

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

Pancytopenia

The nurse is caring for a patient 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? Allopurinol (Zyloprim) Filgrastim (Neupogen) Hydroxyurea (Myleran) Asparaginase (Elspar)

Allopurinol (Zyloprim)

Which nursing intervention should be incorporated into the plan of care to manage the delayed clotting process in a client with leukemia? Implement neutropenic precautions. Apply prolonged pressure to needle sites or other sources of external bleeding. Eliminate direct contact with others who are infectious. Monitor temperature at least once per shift.

Apply prolonged pressure to needle sites or other sources of external bleeding.

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

Lymphocyte

The nurse is teaching a client about the development of leukemia. What statement should be included in the teaching plan? "In acute leukemia there are not many undifferentiated cells." "In chronic leukemia, the majority of leukocytes are mature." "Chronic leukemia develops slowly." "Acute leukemia develops slowly."

"Chronic leukemia develops slowly."

The nurse is teaching a client with acute lymphocytic leukemia (ALL) about therapy. What statement should be included in the plan of care? "Treatment is simple and consists of single-drug therapy." "Intrathecal chemotherapy is used primarily as preventive therapy." "The goal of therapy is palliation." "Side effects are rare with therapy."

"Intrathecal chemotherapy is used primarily as preventive therapy."

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

A general reduction in all white blood cells

Which of the following is the only curative treatment for chronic myeloid leukemia (CML)? Allogeneic stem cell transplant Cytarabine Idarubicin Imatinib

Allogeneic stem cell transplant

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

Assess for signs of injury.

A client who is undergoing chemotherapy for AML reports pain in the low back. What is the nurse's first action? Administer pain medication, as ordered. Assess renal function. Place heating pads on the client's back. Refer the client to a chiropractor.

Assess renal function.

A client with AML has pale mucous membranes and bruises on the legs. What is the primary nursing intervention? Check the client's history. Assess the client's pulse and blood pressure. Assess the client's hemoglobin and platelets. Assess the client's skin.

Assess the client's hemoglobin and platelets.

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

Do not lift more than 10 pounds

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. Educate the family about medications and side effects. Suggest the family go to church more often. Suggest the prescription of antianxiety medications. Allow family members to express feelings. Suggest support for household maintenance.

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

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

Hypercalcemia

A nurse reviews the laboratory results of a client with polycythemia vera. Which findings will the nurse find? Select all that apply. Increased erythropoietin Decreased leukocytes Decreased platelets Increased hemoglobin Decreased erythropoietin

Increased hemoglobin Decreased erythropoietin

A patient with acute myeloid leukemia (AML) has a neutrophil count that persists at less than 100/mm3. What should the nurse cautiously monitor this patient for? Hypotension Abdominal cramps Infection Seizure activity

Infection

A client with acute myeloid leukemia has a fever. What pathophysiological process does the nurse recognize is the cause of the client's fever? Anemia Pancytopenia Neutropenia Thrombocytopenia

Neutropenia

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

Neutrophil and platelet counts within normal limits

The hospitalized client is experiencing gastrointestinal bleeding. Laboratory test results show that the client's platelets are 9000/mm³. The client is receiving prednisone and azathioprine (Imuran). The nurse Teaches the client to vigorously floss the teeth to prevent infections Uses contact precautions with this client Performs a neurologic assessment with vital signs Requests a prescription of diphenoxylate/atropine (Lomotil) for loose stools

Performs a neurologic assessment with vital signs

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? WBC count of 4,200 cells/mcL Creatinine level of 1.0 mg/dL Platelet count of 9,000/mm3 Hematocrit of 38%

Platelet count of 9,000/mm3

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

Preventing bone injury

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 Acute pain Sensory-perception disturbance

Risk for falls

A client with polycythemia vera presents to the primary care clinic for an annual physical. Which health care provider prescriptions does the nurse recognize as preventive measures to prevent thrombosis in the client? Select all that apply. Statin therapy Nitrate therapy Iron therapy Beta blocker therapy Anti-dysrhythmia therapy

Statin therapy, Beta blocker therapy

The nurse is assessing several clients. Which client does the nurse determine is most likely to have Hodgkin lymphoma? The client with a painful sore throat. The client with enlarged lymph nodes in the neck. The client with painful lymph nodes under the arm. The client with painful lymph nodes in the groin.

The client with enlarged lymph nodes in the neck.

What is the rationale for the classification of leukemia? Which bone marrow it arises from, red, or yellow Which bone marrow stem cell line is dysfunctional Whether it attacks younger or older people Whether it is acute or chronic

Which bone marrow stem cell line is dysfunctional

The nurse practitioner suspects that a patient has multiple myeloma based on his major presenting symptom and the analysis of his laboratory results. Select the classic symptom for this disease. Gradual muscle paralysis Severe thrombocytopenia Debilitating fatigue Bone pain in the back of the ribs

Bone pain in the back of the ribs

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

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? Bone marrow depression Acute respiratory distress syndrome Remission Graft-versus-host disease

Graft-versus-host disease

A client has been diagnosed with polycythemia vera. It is most important for the nurse to teach the client about Drinking alcohol to decrease blood viscosity Taking a daily multivitamin with iron supplement Maintaining adequate blood pressure control Bathing in tepid or cool water to control itching

Maintaining adequate blood pressure control

A patient is scheduled for a test to help confirm the diagnosis of acute myeloid leukemia (AML). Which of the following is the result that the nurse knows is consistent with the diagnosis? Erythrocyte count of 5.8 m/?L Neutrophil reading of 60% Platelet count of 300,000/mm3 Excess of immature blast cells

Excess of immature blast cells