prepU ch 30

The nurse is assisting the client with multiple myeloma to ambulate. What is the most important nursing intervention to help prevent fractures in the client? Promote safety. Encourage adequate nutrition. Provide adequate hydration. Increase mobility.

Promote safety

A client with polycythemia vera has a basophil count of greater than 2. Which assessment finding will the nurse expect to assess in this client? Early satiety Dizziness Ruddy complexion Pruritis

Pruritis

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? Elevated platelet count Increased basophils Reed-Sternberg cells Misshaped red blood cells

Reed-Sternberg cells

An elderly client is hospitalized for induction of chemotherapy to treat leukemia. The client reports fatigue to the nurse. What nursing intervention would best address the client's fatigue? Have the client maintain complete bedrest. Talk to the family about not visiting so the client can obtain rest. Provide sedentary activities only, such as watching television. Assist the client to sit in a chair for meals.

Assist the client to sit in a chair for meals.

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

Osteoclasts break down bone cells so pathologic fractures occur.

The nurse is assessing a patent with polycythemia vera. What skin assessment data would the nurse determine is a normal finding for this patient? Bronze skin tone Jaundice skin and sclera Ruddy complexion Pale skin and mucous membranes

Ruddy complexion

A client with multiple myeloma presents to the emergency department and reports excessive thirst and constipation. Family members report that the client has been confused for the last day. Which laboratory value is most likely responsible for this client's symptoms?

Serum calcium level 13.8 mg/dl

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? weight gain pale body color peripheral edema splenomegaly

splenomegaly

Which statement indicates the client understands teaching about induction therapy for leukemia? "I will be in the hospital for several weeks." "I know I can never be cured." "I will need to come every week for treatment." "I will start slowly with medication treatment."

"I will be in the hospital for several weeks."

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

"Intrathecal chemotherapy is used primarily as preventive therapy."

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

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. Place heating pads on the client's back. Assess renal function. 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? Assess the client's pulse and blood pressure. Assess the client's hemoglobin and platelets.

Assess the client's hemoglobin and platelets.

What interventions are most appropriate for the nurse to include in the plan of care for a client at risk for infection? Select all that apply. Auscultate lung sounds every shift and as needed. Provide oral hygiene once daily. Encourage the client to take deep breaths every 4 hours while awake. Place fresh flowers on a shelf on the opposite wall from the client. Assess skin and mucus membranes every shift.

Auscultate lung sounds every shift and as needed. Encourage the client to take deep breaths every 4 hours while awake. Assess skin and mucus membranes every shift.

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

Maintain nutrition.

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 Remission Bone marrow depression Acute respiratory distress syndrome

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

Health history, such as bleeding, fatigue, or fainting

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 Hemolytic anemia Leukemia Polycythemia vera

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? Chronic myeloid leukemia Non-Hodgkin lymphoma Multiple myeloma Hodgkin lymphoma

Multiple myeloma

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

Neutropenia

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

Neutrophil and platelet counts within normal limits

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? Popliteal Inguinal Axillary Cervical

Cervical

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

"Chronic leukemia develops slowly."

The nurse is teaching the client about consolidation. What statement should be included in the teaching plan? "Consolidation of the lungs is an expected effect of induction therapy." "Consolidation therapy is administered to reduce the chance of leukemia recurrence." "Consolidation occurs as a side effect of chemotherapy." "Consolidation is the term used when a client does not tolerate chemotherapy."

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

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? Alkaline phosphatase level Bone marrow analysis Complete blood count Clotting factors

Bone marrow analysis

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

Decreased erythropoietin Increased hemoglobin

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. Keep the client on bed rest. Ask the client whether they have recently fallen. Evaluate the client's INR.

Evaluate the client's platelet count.

A client is being evaluated for a diagnosis of chronic myeloid leukemia (CML). What diagnostic indicator will the nurse assess? Increased number of blast cells An enlarged liver A leukocyte count >100,000/mm3 Lymphadenopathy

A leukocyte count >100,000/mm3

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? Allopurinol Hydroxyurea Asparaginase Filgrastim

Allopurinol

The nurse is caring for a client receiving treatment for non-Hodgkin lymphoma (NHL). Which assessment findings indicate to the nurse that the client is developing multifocal leukoencephalopathy? Select all that apply. Altered vision Change in speech Peripheral neuropathy Change in motor coordination Facial nerve paralysis

Altered vision Change in speech Change in motor coordination

The nurse suspects that a client has multiple myeloma based on the client's major presenting symptom and the analysis of laboratory results. What classic symptom for multiple myeloma does the nurse assess for? Debilitating fatigue Gradual muscle paralysis Severe thrombocytopenia Bone pain in the back of the ribs

Bone pain in the back of the ribs

The nurse suspects that a client has multiple myeloma based on the client's major presenting symptom and the analysis of laboratory results. What classic symptom for multiple myeloma does the nurse assess for? Debilitating fatigue Gradual muscle paralysis Bone pain in the back of the ribs Severe thrombocytopenia

Bone pain in the back of the ribs

A client is receiving radiation therapy for lesions in the abdomen from non-Hodgkin's lymphoma. Because of the effects of the radiation treatments, what will the nurse assess for? Diarrheal stools Laryngeal edema Adventitious lung sounds Hair loss

Diarrheal stools

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

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

Which precautions should a nurse include in the care plan for a client with leukemia and neutropenia? Provide a clear liquid, low-sodium diet. Eliminate fresh fruits and vegetables, avoid using enemas, and practice frequent hand washing. Put on a mask, gown, and gloves when entering the client's room. Have the client use a soft toothbrush and electric razor, avoid using enemas, and watch for signs of bleeding.

Eliminate fresh fruits and vegetables, avoid using enemas, and practice frequent hand washing.

A nurse prepares a client for a bone marrow biopsy who is suspected of having acute myeloid leukemia. What results from the bone marrow biopsy does the nurse expect? Deficiency of neutrophils Excess of immature leukocytes Deficiency of erythrocytes Excess of immature erythrocytes

Excess of immature leukocytes

A nurse cares for a client with multiple myeloma who reports severe back pain that worsens throughout the day. What additional clinical symptoms will the nurse associate with the pathophysiology of the client's disease? Diarrhea Excessive thirst Fluid volume excess Polyuria

Excessive thirst

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

Hypercalcemia

A nurse plans care for a client with multiple myeloma. Using the CRAB acronym for symptoms associated with this disease, which clinical features does the nurse expect to find upon assessment of the client? Select all that apply. Hypercalcemia Bone lesions Anemia Renal insufficiency Acidosis

Hypercalcemia Bone lesions Anemia Renal insufficiency

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. Low socioeconomic status Living alone Taking medication independent of meals Lower self-report of functional status Not participating in a clinical trial

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

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

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

Iron levels

A nurse caring for a client with myeloma prepares to administer dexamethasone to the client. What is the nurse's best understanding of how this medication is an effective treatment option for this client? It decreases tumor necrosis factor. It kills affected cells. It kills affected bone marrow. It decreases immune response.

It kills affected cells.

A client with acute myeloid leukemia (AML) is scheduled to begin induction therapy. Which treatments will the nurse expect to be prescribed to prevent life-threatening effects of this therapy? Select all that apply. Packed red blood cells Granulocytic growth factors Hematopoietic stem cell transplant Platelets Antibiotics

Packed red blood cells Granulocytic growth factors Platelets Antibiotics

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

Pancytopenia

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

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 Calcified bones Pathologic fractures

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? Teach the client to vigorously floss the teeth to prevent infections. Use contact precautions with this client. Request a prescription of diphenoxylate and atropine for loose stools. Perform a neurologic assessment with vital signs.

Perform a neurologic assessment with vital signs.

A client is diagnosed with low risk asymptomatic polycythemia vera. For which treatment will the nurse prepare teaching for this client? Hydroxyurea Interferon-alfa Ruxolitinib Phlebotomy

Phlebotomy

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

Platelet count of 9,000/mm3

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

The nurse recognizes the clinical assessment of a patient with acute myeloid leukemia (AML) includes observing for signs of infection early. What nursing action will most likely help prevent infection? Practice vigilant handwashing. Monitor the client's temperature every shift. Encourage increased fluid consumption. Maintain contact precautions.

Practice vigilant handwashing.

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 Preventing bone injury Balancing rest and activity

Preventing bone injury

The nurse is reviewing the long-term treatment plan with a client diagnosed with Hodgkin lymphoma. Which recommendations will the nurse provide to reduce the client's risk of developing secondary malignancies? Select all that apply. Reduce intake of alcohol. Restrict use of tobacco. Avoid foods high in carbohydrates. Limit the intake of citrus fruits. Avoid excessive sunlight.

Reduce intake of alcohol. Restrict use of tobacco. Avoid excessive sunlight.

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? Sensory-perception disturbance Impaired tissue integrity Acute pain Risk for falls

Risk for falls

A client is newly diagnosed with Hodgkin lymphoma. The nurse understands that the client's treatment will be based on what concept? Histology of tissue Involvement of lymph nodes Staging of disease Total blood cell count

Staging of disease

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

The client with enlarged lymph nodes in the neck.

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. The dead red blood cells occlude the small vessels in the joints. Excess red blood cells produce extracellular toxins that build up. Excess red blood cells cause vascular injury in the joints.

The dead red blood cells release excess uric acid.

The nurse in the oncology clinic is caring for a 42-year-old female client receiving chemotherapy with fludarabine for acute myeloid leukemia who has developed petechiae, epistaxis, and ecchymosis. The nurse anticipates that the client has developed ---- deep vein thrombosis, infection, hemorrhage, hyperkalemia. and that the laboratory results will reveal ---- leukocytosis, thrombocytopenia, electrolyte imbalances, abnormal renal function tests.

hemorrhage thrombocytopenia

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

increase lung expansion.

The nurse is teaching a client diagnosed with Hodgkin's lymphoma about metastasis. What type of cancer is the most likely to appear as a secondary malignancy in clients with Hodgkin's lymphoma disease? breast bone colon lung

lung