ch 11 patho
A student makes the statement to a colleague, "Blood plasma is essentially just a carrier for the formed cells like red blood cells and white blood cells." What would be the most accurate response to this statement?
"Actually, plasma plays a significant role in nutrient and waste transport."
The nurse is reviewing the client's laboratory report. Select the report that represents a normal value for leukocytes.
6500 cells/mL (6.5 ×109/L)
In which individuals would a clinician most suspect multiple myeloma as a diagnosis?
A 40-year-old man who has had 3 broken bones over the past 6 months and whose serum calcium and creatinine levels are elevated.
In which client would a clinician most suspect multiple myeloma as a diagnosis?
A 40-year-old man who has had three broken bones over the past 6 months and whose serum calcium and creatinine levels are elevated.
The nurse is caring for a client with chronic myelogenous leukemia (CML) and notes that the client has splenomegaly and an increased basophil count as well as night sweats, bone pain, and a low grade fever. The nurse interprets the symptoms as indicating that the client is in which phase of the clinical course of CML?
Accelerated
Which type of lymphocyte is involved with humoral-mediated immunity?
B lymphocytes
Which type of white blood cells are related to the connective tissue mast cells and respond in allergic and hypersensitivity reactions?
Basophils
A client's laboratory report shows the presence of the Philadelphia chromosome. Which diagnosis should the nurse suspect the client has developed?
Chronic myelogenous leukemia (CML)
The nurse working on a cancer unit is assessing clients for neutropenia. Which client has the greatest risk?
Client receiving IV chemotherapy
A nurse working in an emergency department is assigned to triage the following clients. Which client should the nurse evaluate first?
Client who has chemotherapy-induced neutropenia (decrease in neutrophil levels) and a temperature of 101.2°F (38.4°C)
A nurse is caring for a newborn that has developed a low platelet count. What could be the cause?
Decreased thrombopoietin (TPO)
A nurse is evaluating laboratory results of a client diagnosed with a parasitic infection. The tests reveal a large group of cells that are membrane-bound with granules in their cytoplasm that are aiding in the destruction of the parasite. Which cell is the nurse evaluating?
Eosinophil
A client presented to the emergency department with symptoms of fever, abdominal pain and diarrhea following a vacation out of the country. A helminthic parasite infection is suspected. Which lab result should the nurse evaluate?
Eosinophils
A client being treated for polymyalgia rheumatica (PMR) comes to the clinic for a follow-up visit. The current erythrocyte sedimentation rate (ESR) rate has decreased from 60 mm/hour to 30 mm/hour and the client is afebrile, denies any headaches, and reports a decrease in joint pain and fatigue. Based on these findings, the nurse anticipates which change to the treatment plan?
Gradually decrease the current dosage of prednisone and repeat ESR in 2 weeks
A client reports a general deterioration in his health over the past several weeks. Which assessment and laboratory findings would be most closely associated with acute leukemia?
High blast cell counts and fever
Which assessment and laboratory findings would be most closely associated with acute leukemia?
High blast cell counts and fever
A client arrives reporting fevers, chills, and night sweats. Upon assessment, the health care provider palpates an enlarged supraclavicular lymph node and suspects the client may have developed which disease?
Hodgkin lymphoma (HL)
A client is admitted to the emergency department with a diagnosis of polycythemia. The nurse plans to assess for symptoms related to which problem?
Increased blood viscosity
A 44-year-old hospitalized client with a diagnosis of end-stage acquired immunodeficiency syndrome (AIDS) has been placed on neutropenic precautions that limit his interaction with visitors, staff, and other clients. What is the underlying rationale for these precautions?
Insufficient levels of neutrophils make him particularly susceptible to infections.
The nurse conducting a community education program on mononucleosis determines the participants are understanding the information when they make which statement? Select all that apply.
It is caused by the Epstein-Barr virus. It is a self-limiting disorder.
Which type of macrophages are found in the liver?
Kupffer cells
A nurse educator is explaining to a group of students the differences between leukemias and lymphomas. With respect to classification of these diseases, which explanation is most accurate?
Leukemia arises from precursors in marrow, and lymphomas originate in peripheral lymphoid structures
An adult female, newly diagnosed with possible leukemia, arrives for a bone marrow biopsy. The admission laboratory work includes: red blood cell count (RBC): 3.4 ×106/µL (3.4 ×1012/L); white blood cell count (WBC): 2,500/µL (2.5 ×109/L); platelet count of 80 ×103/µL (80 ×109/L); all below normal values. What assessment is the highest priority for this client?
Monitoring for any type of bleeding
A 30 year-old male's blood work and biopsies indicate that he has proliferating osteoclasts that are producing large amounts of IgG. What is the man's most likely diagnosis?
Multiple myeloma
A student nurse is taking microbiology and reviewing various types of cells. From which cell type are granulocytes derived?
Myeloid stem cells
A client is admitted to the hospital with an elevated temperature and flank pain. When reviewing the complete blood count (CBC), which level is the most important for the nurse to communicate to the health care provider?
Neutrophils 85%
Which statement accurately describes a component of the hematopoietic system?
Neutrophils are the most prevalent white blood cell
A nurse is reviewing a client's complete blood count (CBC) which indicates thrombocytopenia. Based on this result, which action should the nurse include in the plan of care?
Place the client on bleeding precautions
A client's history and physical documents the presence of an indolent lymphoma. The nurse plans care for which type of lymphoma?
Slow-growing
The nurse planning care for a client with acute lymphoblastic leukemia (ALL) should include the use of:
Soft bristle toothbrush
A client with severe anemia asks, "What happens if my bone marrow cannot produce sufficient numbers of red blood cells due to my bleeding?" Which response(s) by the nurse correctly identifies the organs that can resume hematopoiesis? Select all that apply.
Spleen Liver
Chronic lymphocytic leukemia (CLL) commonly causes hypogammaglobulinemia. This makes clients with CLL more susceptible to infection. What is the most common infectious organism that attacks clients with CLL?
Staphylococcus aureus
A client diagnosed with pancytopenia due to aplastic anemia is scheduled for which treatment that can correct bone marrow deficiencies?
Stem cell transplant
What is the reason why bed rest and analgesics are expected treatments for infectious mononucleosis?
To relieve fever, headache, and sore throat
A nurse is reviewing laboratory data for an older adult client. Which laboratory value should the nurse be most concerned about?
White blood cell (WBC) count 3500/mL
A nurse is reviewing the laboratory data for a hospitalized client. The nurse would be most concerned about which finding?
White blood cell (WBC) count of 2800/µL (2.80 x 109/L)
A high school teenager comes to the emergency room with symptoms that include the abrupt onset of severe pharyngitis and a high fever. The teenager reports that in the previous 4 days he has "just not felt well." The nurse anticipates orders to include which of the following?
White blood cell count
The nurse is reviewing the complete blood count (CBC) and white blood cell (WBC) differential of a client admitted with lower right abdominal pain. Which laboratory results are the most important for the nurse to communicate to the health care provider?
White blood cells (WBCs) 18,500/µL (18.50 x 109/L)
A client has been experiencing anemia and thrombocytopenia. Subsequent diagnostic testing has revealed the presence of immature granulocyte types and the Philadelphia chromosome. This client is likely to experience
a prolonged chronic phase of leukemia
A nurse on an oncology floor is treating a client who is anemic following chemotherapy. The drugs being administered are designed to increase the number of red blood cells in circulation. These drugs are likely agonists of
cytokines
