Exam #2 (CH 34 - Patients W/ Hematologic Neoplasms)

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c. Ruddy complexion

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

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

13. The nurse is caring for a patient with Hodgkin lymphoma in the hospital and preparing discharge planning education. Knowing that this patient is at risk for the development of a second malignancy, what education would be beneficial to reduce the risk factor (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. Leukocyte and platelet count

14. 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? a. Leukocyte and platelet count b. BUN and creatinine levels c. Aspartate aminotransferase (AST) & alanine transaminase (ALT) levels d. Hemoglobin and hematocrit

c. The patient can develop osteonecrosis of the jaw.

15. The nurse is caring for a patient who will begin taking long-term biphosphate 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. Platelet count of 9,000/mm3

3. The nurse is performing an assessment on a patient with AML and observes multiple areas of ecchymosis and petechiae. What laboratory study should the nurse be concerned about? a. WBC count of 4,200 cells/mcL b. Hematocrit of 38% c. Platelet count of 9,000/mm3 d. Creatinine level of 1.0 mg/dL

a. Induction therapy

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? a. Induction therapy b. Supportive therapy c. Antimicrobial therapy d. Standard therapy

d. Phlebotomy

11. A patient with polycythemia vera has a high RBC count and is at risk for the development of thrombosis. What 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

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

12. A patient with polycythemia vera is complaining of severe itching. What triggers does the nurse know can cause this distressing 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

b. Graft-versus-host disease

2. A patient with AML is having HSCT with radiation therapy. With which complication does the nurse know that the donor's lymphocytes recognize the patient's body 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

d. Infection

4. A patient with AML has a neutrophil count that persists at less than 100/mm3. What should the nurse cautiously monitor this patient for? a. Abdominal cramps b. Hypotension c. Seizure activity d. Infection

a. Allopurinol (Zyloprim)

5. The nurse is caring for a patient with AML with high uric acid levels. What medication does the nurse anticipate administering that will prevent crystallization of uric acid and stone formation? a. Allopurinol (Zyloprim) b. Filgrastim (Neupogen) c. Hydroxyurea (Myleran) d. Asparaginase (Elspar)

a. Chronic

6. The nurse is caring for a patient with CML who is taking imatinib mesylate (Gleevec). In what phase of the leukemia does the nurse understand that this medication is most useful to induce remission? a. Chronic b. Transformation c. Accelerated d. Blast crisis

b. Take antacids if needed for (GI) upset 2 hours after taking Gleevec

7. The nurse is educating a patient taking imatinib mesylate (Gleevec) for treatment of leukemia. What should the nurse be sure to include when educating the patient on the best way to take the medication to optimize absorption? a. Take the medication with a source of vitamin C to enhance absorption. b. Take antacids if needed for (GI) upset 2 hours after taking Gleevec. c. Take the medication w/ food to enhance absorption. d. Take the medication w/ acetaminophen to prevent decreased absorption and GI upset.

d. A 72-year-old patient with a history of cancer

8. Which patient assessed by the nurse is most likely to develop MDS? 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

b. Iron levels

9. The nurse is administering packed RBC transfusions for a patient with MD). 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? a. Creatinine and blood urea nitrogen (BUN) levels b. Iron levels c. Magnesium levels d. Potassium levels


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