Management of Patients with Hematologic Neoplasms (Chapter 34)

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

a 72-year-old patient with a history of cancer

The clinic nurse is caring for a client diagnosed with leukopenia. What does the nurse know this client has?

a general reduction in all white blood cells

Which of the following is the only curative treatment for chronic myeloid leukemia (CML)?

allogenic stem cell transplant

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.

bone pain in the back of the ribs

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 with leukemia has developed a cough and increased fatigue. What is the primary nursing intervention?

evaluate the client for potential infection

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

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?

excess of immature blast cells

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

When assessing a female client with a disorder of the hematopoietic or the lymphatic system, which assessment is most essential?

health history, such as bleeding, fatigue, or fainting

A client has been diagnosed with polycythemia vera. It is most important for the nurse to teach the client about

maintaining adequate blood pressure control

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

What assessment findingbest indicates that the client has recovered from induction therapy?

neutrophil and platelet counts within normal limits

The nurse is caring for a client with multiple myeloma. Why would it be important to assess this client for fractures?

osteoclasts break down bone cells so pathologic fractures occur

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

pancytopenia

A nurse is assessing a client with multiple myeloma. The nurse should keep in mind that clients with multiple myeloma are at risk for:

pathologic bone fractures

Which nursing intervention is most appropriate for a client with multiple myeloma?

preventing bone injury

The nurse is assisting the client with multiple myeloma to ambulate. What is the most important nursing diagnosis to help prevent fractures in this client?

safety

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 nurse is aware that chronic lymphocytic leukemia (CLL), a common malignancy in those older than 60, has an early stage and a late stage. The nurse assesses a patient for late stage CLL by looking for:

thrombocytopenia

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

they produce all blood cells

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.)

exposure to water of any temperature; temperature change; alcohol consumption

The nurse is teaching a client about the development of leukemia. What statement should be included in the teaching plan?

"chronic leukemia develops slowly."

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)

Which nursing intervention should be incorporated into the plan of care to manage the delayed clotting process in a client with leukemia?

apply prolonged pressure to needle sits or other sources of external bleeding

A client presents with peripheral neuropathy and hypothesia of the feet. What is the best nursing intervention?

assess for signs of injury

A client with AML has pale mucous membranes and bruises on the legs. What is the primary nursing intervention?

assess the client's hemoglobin and platelets

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

hypercalcemia

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

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?

infection

Which term refers to a form of white blood cell involved in immune response?

lymphocyte

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

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?

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

A client with multiple myeloma is complaining about pain. What instructions will the nurse give the client to help to reduce pain during activity?

do not lift more than 10 pounds