hemo test

Mr. Black has generalized lymphadenopathy. His lymph nodes are painless, enlarged, and rubbery in the cervical and supraclavicular areas. His tonsils and adenoids are enlarged as well. Other symptoms he presents with are fever, night sweats, and weight loss. You suspect he has?

Non-Hodgkins Lymphoma

The nurse is reinforcing discharge instructions to a client with cancer of the prostate after a suprapubic prostatectomy. The nurse should reinforce which discharge instructions?

Take the prescribed stool softener everyday Avoid lifting objects heavier than 20 pounds for 6 weeks

You are transferring a patient with newly diagnosed chronic myeloid leukemia to a long term facility. Which information is most important to communicate to the long term charge nurse before transferring the patient?

The patient's chemotherapy has resulted in neutropenia.

A patient has a white blood cell count of 8000/mm3. What concern does the nurse have about this finding?

There is no concern, this is a normal finding.

You are making a room assignment for a newly arrived patient whose lab results indicate pancytopenia. There are no private rooms available. Which patient would be the best roommate for the new patient?

a patient with digoxin toxicity

The nurse is assisting with developing the plan of care for a client experiencing leukopenia as a result of chemotherapy. Which of the following is included in the plan of care?

restrict flowers and plants from the room

A nurse is teaching a patient with sickle cell anemia about what activities to avoid. Which of the following activities that the patient plans to do shows more teaching is needed?

running a marathon

A patient with acute myelogenous leukemia is receiving chemotherapy. Which assessment finding requires the most rapid action?

serum potassium level 7.8

The MD makes a tentative diagnosis of idiopathic thrombocytopenia and notes the client has purpura. When conducting the physical assessment the nurse looks for:

skin hemorrhages

A client with laryngeal cancer has undergone a laryngectomy and is receiving radiation to the head and neck. The nurse should monitor this client for which adverse effect of external radiation? Choose all that apply

stomatitis xerothermia dysgeusia

A client is admitted with hemophilia. Which sports should the nurse recommend for the client? Select all that apply

swimming golf

A patient is being prepared for sealed internal radiation therapy for cervical cancer. Which information when given by the nurse would best help to reduce the patients anxiety concerning this procedure?

the nurse will be available whenever needed

You obtain the following data about a patient admitted with multiple myeloma. Which information has the most immediate implications for the patient's care?

the patient complains of chronic bone patient

When the nurse is caring for a client undergoing internal radiation therapy he/she should keep these three safety principles in mind:

time, distance, and shielding

The client with metastatic breast cancer is receiving Tamoxifen (Novadex). The nurse should specifically monitor which lab value while the client is taking this medication?

Calcium level

Ms. Walker has chronic lymphocytic leukemia. She is closely observed for signs of infection even though her white blood count is elevated because

many of her WBCs are immature

To potentiate the maximum absorption of oral iron supplements, the nurse is most accurate to advise the client to take the tablet with:

orange juice

150 mL of sodium chloride to infuse over 1 1/2 hours. Drip Factor 10gtt/mL.

17 gtts/min

5000 mL of D5 and 1/2 normal saline to infuse over 48 hours. Drip factor 15 gtts/mL.

26

Treatment for a client with polycythemia vera includes the following. Select all that apply.

phlebotomy chemotherapy radiation

What lab alerts the nurse to iron deficiency anemia

Hgb dl

A nurse is caring for a client with an internal radiation implant. When caring for the client the nurse should observe which principle?

Pregnant women are not allowed into the client's room

A 67-year-old who is receiving chemotherapy for lung cancer is admitted to the hospital with thrombocytopenia. Which statement made by the patient when you are obtaining the admission history is of most concern?

"I take one aspirin every morning because of my history of angina"

A patient is admitted in a sickle cell crisis with symptoms of dyspnea and leg pain. The patients wife states "I don't understand why he is hurting so badly". What is the best response by the nurse?

"clumping of the abnormal red blood cells blocks the flow of blood through the capillaries."

Mr. Bradley has a platelet count of 20,000/mm3 after his most recent round of chemotherapy. You will institute which of the following nursing interventions? Choose all that apply

Check his stool for occult blood inspect skin for ecchymosis or petechiae Institute bleeding precautions

The doctor orders Cefactor 2 grams via gastric tube in 2 divided doses. The pharmacy sends cefactor 375 mg/5 mL suspension. The nurse should administer ___ mL per dose.

13

The MD orders bleomycin sulfate 45 units IV bolus. The pharmacy sends reconstituted bleomycin sulfate 30 units/10 mL. The nurse should administer _____ mL IV bolus.

15

Ms. Walker has chronic lymphocytic leukemia and is scheduled for chemotherapy. When initially assessing Ms. Walker the nurse looks for the more common signs and symptoms of leukemia which include:

pallor, weakness, fatigue, and low grade fever.

The nurse is caring for a client with a bleeding disorder. Which of the following medication orders should the nurse question?

Ibuprofen

Treatment of DIC includes all of the following except:

phlebotomy

The doctor orders 450 IU of antihematopoietic factor (Factor VIII IV) everyday. The pharmacy supplies the antihematopoetic factor in 75 IU/5 mL. The nurse should administer ___ mL IV.

30

A patient diagnosed with cancer is taking erythropoietin (Epogen). The blood test that should be checked to evaluate the effectiveness of this medication would be:

Hemoglobin and hematocrit

A lymphoma that usually arises as a painless swelling in a lymph node and is confirmed when that biopsy reveals Reed-Sternberg cells is:

Hodgkin's Disease

All of the following clients assigned to the nurse ring their call bells. Which client needs the most immediate attention?

A client with a blood transfusion infusing who says her chest hurts.

The nursing unit is informed to expect a 30 year old male who is experiencing a sickle cell crisis. During the admission assessment, which one of the following can the nurse attribute to the clients blood disease?

he is jaundice

A client receiving chemotherapy for breast cancer develops myelosuppression (bone marrow depression). What instructions should the nurse include in discharge teaching? Choose all that apply.

Avoid crowded places Avoid activities that may cause bleeding Wash hands frequently Allow rest periods between activities

A nurse is assigned to care for a patient receiving radiation therapy. With which type of therapy is it safe for the nurse to spend time with the patient without concern for radiation exposure?

External radiation

The client with ovarian cancer is being treated with vincristine (Vincasar). The nurse monitors the client, knowing that which adverse effect is specific to this medication?

Extremity numbness

A client is diagnosed with pernicious anemia. What will the nurse discuss with the client regarding the Vitamin B12 he will be prescribed when he is discharged.

He will need to have monthly injections of vitamin B12 for the rest of his life.

Because a corticosteroid therapy has not been effective, the client with aplastic anemia has consented to have a bone marrow transplant. She undergoes total body irradiation. Just prior to and for several weeks following bone marrow transplant. The highest priority when planning nursing care of this client is:

Preventing infection

The client with squamous cell carcinoma of the larynx is receiving bleomycin sulfate by IV. The nurse anticipates that which of the following diagnostic studies will be prescribed?

Pulmonary functions studies Chest x ray

The nurse provides dietary instructions to a client diagnosed with iron-deficiency anemia. The nurse should tell the client to increase intake of which food item?

Red apples

Tamoxifen is prescribed for the client with metastatic breast carcinoma. The nurse understands that the primary action of this medication is to:

Reduces estrogen levels in the body

The nurse is reviewing a clients CBC and notes and erythrocyte count of 2.7 million/mm3, leukocytes 2700/mm3 and platelets 90,000/mm3. The nurse interprets this as indicative of which condition?

Sickle cell anemia

A transfusion of PRBCs has been infusing for 5 minutes when the patient becomes flushed and tachypneic and says, "I'm having chills. Please get me a banket." Which action should you take first?

Stop the transfusion

A client is admitted with acute lymphoblastic leukemia. He's scheduled to have a bone marrow transplant in which he will receive his own harvested bone marrow. What type of transplant does this describe?

autologous transplant

A client undergoing colon cancer treatment has developed thrombocytopenia. The nurse should check the client for which of the following manifestations? Select all that apply

hematuria ecchymosis melena epistaxis

A female client is receiving external beam radiation for squamous cell cancer of the lung. After 2 weeks of treatment her skin area is red and warm to the touch. Your best response would be

do not apply anything and notify the doctor