Adult Health Exam 6 PrepU 30, 31, 32

A client with Hodgkin lymphoma is receiving information from the oncology nurse. The client asks the nurse why it is necessary to stop drinking and smoking and stay out of the sun. Which response by the nurse would be best?

"It's important to reduce other factors that increase the risk of second cancers."

Following an extensive diagnostic workup, a client has been diagnosed with myelodysplastic syndrome (MDS). Which assessment question most directly addresses the potential etiology of this client's health problem?

"Were you ever exposed to toxic chemicals in any of the jobs that you held?"

Which client is not a candidate to be a blood donor according to the American Red Cross?

26-year-old female with hemoglobin 11.0 g/dL 30 Clients must meet a number of criteria to be eligible as blood donors, including the following: body weight at least 50 kg; pulse rate regular between 50 and 100 bpm; systolic BP 90-100 to 180 mm Hg and diastolic 50 to 100 mm Hg; hemoglobin level at least 12.5 g/dL. There is no upper age limit to donation.

A client with sickle cell crisis is admitted to the hospital in severe pain. While caring for the client during the crisis, which is the priority nursing intervention?

Administering and evaluating the effectiveness of opioid analgesics 31

The nurse identifies the process of red blood cell (RBC) production and determines the kidneys sense a low level of oxygen in circulating blood. Which physiologic response is initiated?

An increase in the production of erythropoietin 30

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.

Aspirin Anagrelide Hydroxyurea Interferon-Alfa

After receiving a diagnosis of acute lymphocytic leukemia, a client is visibly distraught, stating, "I have no idea where to go from here." How should the nurse prepare to meet this client's psychosocial needs?

Assess the client's specific needs for education and support 32

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.

Avoid excessive sunlight Restrict use of tobacco Reduce intake of alcohol

The clinical nurse educator is presenting health promotion education to a client who will be treated for non-Hodgkin lymphoma on an outpatient basis. The nurse should recommend which of the following actions?

Avoiding highly crowded public places

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

A client donated two units of blood to be used for transfusion during spinal fusion surgery. The client received one unit of autologous blood during the procedure but the second unit is not needed during the procedure. The nurse knows which action will come after the procedure is completed?

Discard the additional unit 30

A thin client is prescribed iron dextran intramuscularly. What is most important action taken by the nurse when administering this medication?

Employs the Z-track technique 31

A client with chronic kidney disease has chronic anemia. What pharmacologic alternative to blood transfusion may be used for this client?

Erythropoietin 30

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

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?

Induction therapy

Through the process of hematopoiesis, stem cells differentiate into either myeloid or lymphoid stem cells. Into what do myeloid stem cells further differentiate? Select all that apply.

Leukocytes Platelets erythrocytes 30

A nurse is caring for a client admitted with pernicious anemia. Which set of findings should the nurse expect when assessing the client?

Pallor, tachycardia, sore tongue 31

A 16-year-old girl has been brought to her primary care provider by her mother due to the daughter's recent malaise and lethargy. Which of the following assessments should the clinician perform in an effort to confirm or rule out infectious mononucleosis?

Palpating the patient's lymph nodes

A client has been diagnosed with a lymphoid stem cell defect. This client has the potential for a problem involving which of the following?

Plasma Cells 30

While hospitalized, a client accidentally injures his finger and begins to bleed. What substance does the nurse recognize as naturally rushing to the site of injury before any other action takes place?

Platelets 30

The nurse is assisting with preparation for a client about to undergo a Schilling test. Which of the following actions by the nurse is correct?

Prepare to collect urine from the client for 24 to 48 hours. 30 A Schilling test is used to diagnose pernicious anemia, macrocytic anemia, and malabsorption syndromes. When this test is prescribed, radioactive vitamin B12 is given orally, followed in 1 hour by an injection of nonradioactive B12. All urine is collected for 24 to 48 hours after the client receives the nonradioactive B12.

A client with a diagnosis of acute myeloid leukemia (AML) is being treated with induction therapy. What nursing action should be prioritized in the client's care plan?

Protective isolation and vigilant use of standard precautions

A young adult is preparing to begin treatment for non-Hodgkin lymphoma (NHL), a disease that has disseminated widely. What is the most likely treatment regimen for this patient that the nurse will help prepare?

Radiation and Chemotherapy

The nurse is reviewing the chart of a client with lymphoma. Which of the following findings would best indicate to the nurse that the client has Hodgkin's disease as opposed to non-Hodgkin's lymphoma?

Reed-Sternberg cells are found diagnostically

Which of the following in a client's history would the nurse be likely to identify as risk factors for secondary lymphedema? Select all that apply.

Repeated Phlebitis Burns Masectomy

A client at the health care facility is diagnosed with Hodgkin's disease that has extended to the liver. What stage should the nurse use to describe the progress of the disease?

Stage IV

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

A 60-year-old client with chronic myeloid leukemia (CML) will be treated in the home setting, and the nurse is preparing appropriate health education. Which topic should the nurse emphasize?

The importance of adhering to the prescribed drug regimen

Which statement best describes the function of stem cells in the bone marrow?

They produce all blood cells

Which patient assessed by the nurse is most likely to develop myelodysplastic syndrome (MDS)?

a 72 year old patient with a history of cancer

Which of the following medications would be least likely to be used in an older adult with Hodgkin's disease?

doxorubicin In addition, doxorubicin is not tolerated due to its toxic effects on the kidneys. 32

A client is in the early stages of Hodgkin's disease. When palpating the client's lymph nodes, the nurse is most likely to find that the lymph nodes are:

enlarged and painless

A client with Hodgkin's disease is receiving chemotherapy with the regimen called "MOPP." For which of the following drugs does the "M" stand?

mechlorethamine (Mustargen)

A 70-year-old client has recently been diagnosed with lymphoma and asks what may have contributed to this illness. Which of the following statements from the nurse would be most accurate?

"Lymphoma incidence increases with age because of cumulative exposures to carcinogens and a decline in immune functioning."

A client is recovering from infectious mononucleosis and asks the nurse when he or she will finally be rid of the disease. How should the nurse most accurately respond?

"You are now immune to mono, but the virus will remain in your body for the rest of your life." 32

A nurse is caring for a client who will undergo total knee replacement and will have an autologous transfusion. Which statement will the nurse include when teaching the client about the transfusion?

"You typically donate blood 4 to 6 weeks before the surgery." 30

You are caring for a client with Hodgkin's disease who has developed associated respiratory problems. Which of the following interventions by the nurse are appropriate? Select all that apply. Keep the neck in midline. Place the client in a semi-Fowler's position. Assess respiratory status each shift and as needed. Administer oxygen per physician's orders if blood saturation is consistently less than 80%. Place an endotracheal tube, laryngoscope, and bag-valve mask at the bedside for intubation.

-Keep the neck in midline -Assess respiratory Status each shift as needed -Place an endotracheal tube, laryngoscope, and bag-valve mask at the bedside for intubation. 32

A client who is undergoing chemotherapy for AML reports pain in the low back. What is the nurse's first action?

Assess renal function

A woman who is in her third trimester of pregnancy has been experiencing an exacerbation of iron-deficiency anemia in recent weeks. When providing the client with nutritional guidelines and meal suggestions, what foods would be most likely to increase the woman's iron stores?

Beef liver accompanied by orange juice 31

A client is diagnosed with primary myelofibrosis. Which assessment findings will the nurse expect to assess in this client? Select all that apply.

Bone Pain Weight Loss Early Satiety Abdominal discomfort

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?

Bone marrow analysis

A night nurse is reviewing the next day's medication administration record (MAR) of a hospital client who has hemophilia. The nurse notes that the MAR specifies both oral and subcutaneous options for the administration of a PRN antiemetic. What is the nurse's best action?

Contact the prescriber to have the SQ option discontinued 31

A 66-year-old man underwent a successful partial gastrectomy for the treatment of stomach cancer 3 years ago. The man had a scheduled follow-up appointment with his primary caregiver and had blood work completed. The results of the man's blood work indicated anemia. The nurse who is contributing to the patient's care should recognize that this patient's anemia may be attributable to what factor?

Decreased vitamin B12 absorption 30

A nurse is caring for a patient who has had a bone marrow aspiration with biopsy. What complication should the nurse be aware of and monitor the patient for?

Hemorrhage

A client with Hodgkin's disease is hospitalized and experiencing respiratory distress. In which position should the nurse place the client?

High Folwer's

A client is scheduled for surgery to remove an abdominal mass. The nurse knows that which reason hemodilution would be contraindicated as a method to provide blood to the client during the surgery?

History of Renal disease 30

A client is recovering from infectious mononucleosis. For which of the following conditions is the nurse aware that the client may also be at increased future risk?

Hodgkin's lympohoma

A nurse at a long-term care facility is amending the care plan of a resident who has just been diagnosed with essential thrombocythemia (ET). The nurse should anticipate the administration of which medication?

Hydroxyurea

A client has been diagnosed with infectious mononucleosis. He asks the nurse how he contracted the illness. Which of the following would the nurse accurately identify as possible causes of the client's condition? Select all that apply.

Kissing Sharing cigarettes Being coughed or sneezed on

The nurse is preparing a patient for a bone marrow aspiration and biopsy from the site of the posterior superior iliac crest. What position will the nurse place the patient in?

Lateral position with one leg flexed 30

A patient is taking hydroxyurea for the treatment of primary myelofibrosis. While the patient is taking this medication, what will the nurse monitor to determine effectiveness?

Leukocyte and Platelet Count 32

A nurse is helping to prepare a client with lymphedema for a procedure in which an intravenous dye and radiography will be used to detect lymph node involvement and reveal the degree and extent of blockage in the lymph system. What procedure will the client be undergoing?

Lymphangiography

A client in critical condition arrives to the ED needing an immediate blood transfusion, but there isn't time to perform a type and crossmatch. Which blood type can be safely transfused until lab results are obtained?

O, RH negative 30

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

A nurse is planning the care of client who has been diagnosed with essential thrombocythemia (ET). Which nursing diagnosis should the nurse prioritize when choosing interventions?

Risk for ineffective tissue perfusion

A client is newly diagnosed with Hodgkin lymphoma. The nurse understands that the client's treatment will be based on what concept?

Staging of disease

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 Beta Blocker Therapy

Laboratory and diagnostic test results have returned for a client with suspected lymphangitis. Which of the following would be most likely for the nurse to review in the results?

Stroptococcus

The health care provider believes that the client has a deficiency in the leukocyte responsible for cell-mediated immunity. What should the nurse check the WBC count for?

T lymphocytes 30

A client with polycythemia vera reports severe itching. What triggers does the nurse know can cause this distressing symptom? Select all that apply.

Temperature changes Alcohol Consumption Exposure to water of any temperature

When reviewing a client's chart, the nurse notes that the client's tonsils are listed as grade 3. How does the nurse interpret this finding?

The client's tonsils are touching the uvula 30

Which cells have the major function of transporting O2 to and removing CO2 from tissues?

erythrocytes 30

Which cell types are produced from pluripotential stem cells?

erythrocytes platelets lymphocytes

The nurse is caring for a patient with a hematologic disorder. The patient asks the nurse where the body forms blood cells. Where should the nurse tell the patient that blood cells are formed?

in the bone marrow 30

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

Parents of a teenager with primary lymphedema are asking for information about their child's condition. Which of the following statements would the nurse accurately share with the parents? Select all that apply.

*Primary lymphedema is usually congenitally acquired *Manifestations usually do not appear until adolescence or early adulthood *Primary lymphedema affects women more often than men