EX1 CH30- Dysrhythmias

A patient is diagnosed with coagulopathy and receives a prescription for warfarin therapy. The nurse provides dietary education. Which statement made by the patient indicates that the teaching was effective?

"I need to have a consistent amount of vitamin K in my diet."

The nurse instructs a patient with thrombocytopenia about safety measures. Which statement made by the patient indicates the need for further instruction?

"I will take aspirin if I have a headache."

A patient with neutropenia asks how the prescribed protective (reverse) isolation helps prevent the spread of organisms. What primary explanation should the nurse give?

"It is designed to minimize the spread of germs to you from sources outside your environment."

A student nurse asks the nurse about the difference between lymphoma and leukemia. What explanation should the nurse give?

"With lymphoma, there are fewer circulating abnormal cells."

The nurse provides education to a patient with leukemia that is receiving chemotherapy. What is appropriate for the nurse to include in the teaching?

"You can feel free to communicate your problems to me; don't think that you are isolated."

A patient with thrombocytopenia is being discharged from the hospital. What should the nurse include in the education? Select all that apply.

-"Avoid blowing your nose forcefully. Instead, gently pat it with a tissue." -"Notify your health care provider if you have black, tarry bowel movements." -"Notify your health care provider if you have difficulty speaking or sudden weakness in the arm or leg."

The nurse expects to observe which manifestations in a patient who experienced an acute blood loss of 2000 mL? Select all that apply.

-Air hunger -Clammy skin -Decreased central venous pressure

Positron emission tomography (PET) with computed tomography (CT) scan reveals the presence of mediastinal lymphadenopathy in a patient diagnosed with Hodgkin's disease. The nurse recalls that these procedures can also identify what other abnormalities? Select all that apply.

-Brain infiltration -Liver and spleen infiltration -Abnormal lymph node enlargement

A patient reports weight loss, fever, drenching night sweats, and painless lymph node enlargement. The nurse recognizes that the symptoms may be indicative of which diseases? Select all that apply.

-Burkitt's lymphoma -Peripheral T-cell lymphoma

The nurse recognizes that the events associated with the development of disseminated intravascular coagulation (DIC) occur in what order?

-Circulation of fibrin degradation products -Fibrinolysis in the microcirculation -Circulation of fibrin degradation products -Thrombolytic occlusion of microcirculation of all organs

A patient who is at risk for disseminated intravascular coagulation (DIC) experiences shortness of breath and increased heart rate. The nurse expects what other symptoms that indicate thrombotic manifestations? Select all that apply.

-Cyanosis -Abdominal pain

Five days after the initiation of heparin therapy, a patient's platelet count falls to 50,000/µL. The nurse identifies that which measures are appropriate to reduce the risk of bleeding? Select all that apply.

-Discontinuing heparin -Administering protamine sulfate -Administering a direct thrombin inhibitor

A patient experiences a decreased neutrophil count (neutropenia). To prevent complications, which interventions should the nurse include in the patient's discharge teaching? Select all that apply.

-Encourage the patient to wash hands frequently -Advise the patient to notify the health care provider if a fever develops. -Advise the patient to brush the teeth four times a day with a soft toothbrush.

The nurse concludes that a patient with gingival bleeding and petechiae on the skin is experiencing thrombotic thrombocytopenic purpura (TTP). Which assessment findings support the nurse's conclusion? Select all that apply.

-Increased reticulocytes -Decreased hemoglobin

When teaching a patient about treatment for iron deficiency, the nurse provides a list of foods that provide nutritional support for hemoglobin synthesis. Which foods should the nurse include on the list? Select all that apply.

-Legumes -Dried fruits -Dark green leafy vegetables

After reviewing the diagnostic reports of a patient, the nurse suspects that a patient is experiencing acute lymphocytic leukemia (ALL) based on which findings? Select all that apply.

-Presence of lymphocytes in cerebrospinal fluid -Presence of hypercellular bone marrow with lymphoblasts

A patient with initial symptoms of immune thrombocytopenic purpura (ITP) receives corticosteroid therapy. The nurse recalls that the medication will produce which results? Select all that apply.

-Reduce capillary leakage -Depress antibody formation

The nurse monitors a patient with multiple myeloma for resulting bone degeneration. What clinical manifestations may be indicative of this complication? Select all that apply.

-Seizures -Anorexia -Confusion

A nurse mentor provides teaching to a group of nursing students about the cardiac manifestations of severe anemia. Which compensatory cardiac changes should the nurse include? Select all that apply.

-Tachycardia -Heart failure -Intermittent claudication

A patient reports bleeding from the nose and abnormally heavy bleeding during menstruation. The nurse recognizes that which drugs would benefit the patient? Select all that apply.

-Tranexamic acid -Epsilon-aminocaproic acid

The nurse assesses a patient who has severe anemia and expects to find which manifestations? Select all that apply.

-Vertigo -Dyspnea at rest -Jaundice and pruritus -Glossitis and smooth tongue

A patient is diagnosed with heparin-induced thrombocytopenia. The nurse anticipates that which therapies will be prescribed, to maintain anticoagulation? Select all that apply.

-Warfarin -Plasmapheresis -Protamine sulfate

The nurse provides care for a patient experiencing thrombocytopenia. It is likely that platelets administration will be prescribed when what occurs? Select all that apply.

-When the platelet count in the patient is 8,000/µL -When there is anticipated bleeding before a procedure

The nurse will begin a patient's transfusion of packed red blood cells at 1030. The nurse should plan to stay in the patient's room until what time?

1045

A patient is scheduled to receive two units of packed red blood cells. The prescription was written at 1000. The nurse picks the transfusion up from the laboratory at 1130 and recognizes that it must be initiated no later than what time?

1200

When preparing to administer a unit of packed red blood cells, the nurse should inform the patient of the nurse's plan to stay at the bedside for how many minutes after the transfusion begins?

15

The nurse prepares to administer a unit of fresh frozen plasma to a patient and notes that it contains what quantity?

250 mL

Which patient is most likely to experience anemia related to an increased destruction of red blood cells?

A 23-year-old African American man who has a diagnosis of sickle cell disease

A nurse assesses four patients and identifies that which patient is most likely to experience thrombotic thrombocytopenic purpura (TTP)?

A 35-year old female adult

A patient experiences thrombocytopenia due to consumption of certain herbs. The nurse suspects that which mechanism of thrombocytopenia occurred?

Accelerated platelet destruction

The nurse expects that a patient will experience central nervous system manifestations with which type of leukemia?

Acute lymphocytic leukemia (ALL)

The nurse recalls that which leukemia is most commonly seen in children?

Acute lymphocytic leukemia (ALL)

The nurse recognizes that which type of leukemia is characterized by the proliferation of immature small lymphocytes in the bone marrow?

Acute lymphocytic leukemia (ALL)

The nurse recalls that which type of leukemia accounts for 80% of acute leukemia in adults?

Acute myelogenous leukemia (AML)

The treatment plan for a patient with chronic lymphocytic leukemia (CLL) includes a drug that acts by binding to CD52, a panlymphocyte antigen present on both T and B cells. The nurse anticipates that what drug will be prescribed?

Alemtuzumab

A patient is scheduled to receive a transfusion of two units of packed red blood cells. The nurse would ask which health team member to assist in checking the unit before administration?

Another registered nurse (RN)

The nurse obtains a unit of packed red blood cells to administer to a patient. It is appropriate for the nurse to ask which member of the health care team to assist in checking the unit before initiating the transfusion?

Another registered nurse (RN)

Which nursing intervention would be helpful to a patient with hemophilia who experiences severe joint bleeding?

Applying direct pressure with ice at the joint

A patient with anemia experiences fatigue when performing activities of daily living. Which nursing intervention is appropriate to include in the patient's plan of care?

Assist the patient in prioritizing activities

An adult patient is diagnosed with acute myelogenous leukemia (AML). The nurse explains to the patient that collaborative care will focus on what?

Attaining remission

Which cells are involved in the origin of Burkitt's lymphoma?

B-cell blasts in the lymph nodes

A patient is in the early stage of Hodgkin's lymphoma. What chemotherapeutic agent does the oncology nurse anticipate administering?

Bleomycin

A patient is admitted to the emergency room after an anaphylactic reaction. The nurse identifies that which assessment finding may indicate the development of disseminated intravascular coagulation (DIC)?

Blood oozing from venipuncture sites

It is suspected that a patient is experiencing tumor lysis. The nurse should prepare the patient for what diagnostic study?

Blood test

Which diagnostic test can detect destruction of circulating platelets as the cause of thrombocytopenia?

Bone marrow analysis

A patient is diagnosed with thrombocytopenia. The nurse reviews the patient's laboratory results and notes a decrease in the number of megakaryocytes. Which laboratory test provided this information?

Bone marrow examination

The oncology nurse is administering a chemotherapeutic agent to a patient with relapsed Hodgkin's lymphoma. Which medication administered will most likely have the best outcome for this patient?

Brentuximab vedotin

A patient with a platelet count of 52,000/mm3 is diagnosed with thrombocytopenia. The nurse expects what clinical manifestations?

Bruising and petechiae

The nurse recalls that which disease originates from B-cell blasts present in the lymph nodes?

Burkitt's lymphoma

The nurse recalls that which system of the body is most commonly affected by leukemia?

Central nervous system

A patient with leukemia is undergoing maintenance therapy. The nurse recalls what information about this course of treatment?

Chemotherapy is given every three to four weeks for a prolonged period

The nurse recognizes that which treatment option is appropriate for a patient diagnosed with chronic lymphocytic leukemia (CLL)?

Colony-stimulating factors

The nurse recalls that which blood product is prepared from fresh frozen plasma and is available in 10 to 20 mL/bag?

Cryoprecipitate

The nurse provides information to a group of student nurses about disseminated intravascular coagulation (DIC). What is appropriate for the nurse to include related to the etiology and pathophysiology of the disorder?

DIC is a secondary disease of clotting and hemorrhage.

The nurse provides care for a patient with immune thrombocytopenic purpura (ITP) that has a platelet count of 90,000/mcL of blood. What could be the reason for this condition in the patient?

Decreased production of platelets

Which type of lymphoma originates from lymph nodes, usually in the neck or abdomen?

Diffuse large B-cell lymphoma

The nurse provides teaching to a patient who receives a prescription for an iron supplement. What should the nurse include in the education?

Dilute the liquid iron and ingest it through a straw

A patient with leukemia is hospitalized. Which piece of information obtained by the nurse during the patient's admission process should be documented under the subjective data section?

Exposure to chemical toxins

A patient with metastatic cancer experiences a hemoglobin level of 8.7 g/dL and a hematocrit of 26%. The nurse identifies that treatment strategies should be focused on management of what symptom?

Fatigue

The oncology nurse is caring for a patient with marginal zone B-cell lymphoma. The nurse expects that what combination of chemotherapy will be prescribed?

Fludarabine, cyclophosphamide, mitoxantrone, rituximab (FCMR)

A patient that is receiving treatment for thalassemia show evidence of hemolysis. The nurse anticipates a prescription for which supplementation?

Folic acid

The nurse recalls that which condition results in anemia due to synthesis of defective DNA in the body?

Folic acid deficiency

The oncology nurse is administering chemotherapy to a group of patients with non- Hodgkin's lymphoma. A patient with which type of lymphoma will most likely have the best outcome with indolent therapy?

Follicular lymphoma

A patient is scheduled to receive cobalamin (vitamin B 12) 1,000 mcg by mouth (PO). The pharmacy issues 250-mcg tablets. How many tablets should the nurse give to the patient?

Four tablets

A patient with disseminated intravascular coagulation (DIC) is bleeding due to a deficiency of clotting factors. The nurse anticipates that which type of blood product will be prescribed?

Fresh frozen plasma

The nurse recognizes that which drug is directly myelosuppressive and may cause patient thrombocytopenia?

Ganciclovir

A patient receives a new prescription for a transfusion of two units of packed red blood cells (PRBCs). The nurse should take which action to ensure patient safety?

Have a second registered nurse check the identifying information on the unit of blood against the identification bracelet and blood-bank identification bracelet.

Which statement is true regarding hemophilia?

Hemophilia can be treated by replacement therapy

A patient experiences thrombocytopenia. The nurse should monitor the patient for which major complication?

Hemorrhage

A patient with disseminated intravascular coagulation (DIC) takes one oral anticoagulant daily and experiences prolonged bleeding episodes. The nurse suspects a chronic type of DIC and anticipates that which therapy will be prescribed?

Heparin

The nurse assesses a patient with disseminated intravascular coagulation (DIC) and determines that the patient does not evidence signs of life-threatening hemorrhage. The nurse anticipates a prescription for which therapy when the benefit outweighs the risk?

Heparin

The nurse reviews the medical record of a patient with acute myelogenous leukemia (AML) and expects what finding?

Hypercellular bone marrow with myeloblasts

The nurse reviews documentation of assessment findings of a patient with severe anemia. The nurse should question which assessment finding?

Hyperpigmentation

The diagnostic findings of a patient with chronic myelogenous leukemia indicate the presence of the Philadelphia chromosome. The patient's plan of care includes a drug that targets the genes responsible for the origin of the Philadelphia chromosome. The nurse expects that what medication will be prescribed?

Imatinib

The nurse recalls that the etiology of disseminated intravascular coagulation (DIC) disorder is what?

Imbalance in the coagulation system

The nurse is caring for a patient with a viral infection and recognizes that the patient is at risk for which type of thrombocytopenia?

Immune thrombocytopenic purpura (ITP)

The nurse cares for a patient with polycythemia vera and expects what assessment finding?

Increased hemoglobin

While caring for a patient with disseminated intravascular coagulation (DIC), which nursing diagnosis is the highest priority?

Ineffective peripheral tissue perfusion

A patient is diagnosed with chronic lymphocytic leukemia (CLL). The nurse expects what diagnostic finding?

Infiltration of lymphocytes into the bone marrow, spleen, and liver

The nurse reviews a patient's pre-op prescription which states: "Infuse one unit of fresh frozen plasma (FFP) before arrival to the operating room." To complete this prescription safely, the nurse should take which action?

Infuse the FFP as rapidly as the patient will tolerate

The nurse is preparing to administer two units of blood to a patient. The nurse should take which action to prevent an adverse effect during this procedure?

Infuse the blood slowly for the first 15 minutes of the transfusion

Which body system should the nurse assess to determine the signs of external bleeding in a patient with disseminated intravascular coagulation (DIC)?

Integumentary

Which process does the nurse recognize as occurring in stage IV of Hodgkin's non-Hodgkin's lymphomas?

Involvement outside of the diaphragm

The nurse recalls that which condition may cause patient anemia due to decreased hemoglobin synthesis?

Iron deficiency

The nurse identifies that which sign of microvascular thrombosis observed in a patient with disseminated intravascular coagulation (DIC) is associated with the integumentary system?

Ischemic tissue necrosis

A patient with non-Hodgkin's lymphoma asked the nurse why a lumbar puncture has been prescribed. What rationale should the nurse give?

It helps rule out central nervous system involvement.

The nurse recalls what information about the Philadelphia chromosome's role in leukemia?

It interferes with normal cell cycle events

The white blood cell count of a patient with leukemia is 120,000 cells/µL. The nurse identifies that which emergency treatment would be most beneficial for the patient?

Leukapheresis

When a patient experiences a group of malignant disorders that affects the blood and blood-forming tissues of the bone marrow, lymph system, and spleen, the nurse identifies that what diagnosis will be made

Leukemia

A patient with respiratory distress experiences a white blood cell count of more than 100,000 cells/µL. Immediate treatment has been prescribed. The nurse suspects that the patient is experiencing what condition?

Leukostasis

The nurse is caring for a patient admitted for treatment of sickle cell disease (SCD). The nurse recalls that with repeated episodes of sickling, there is gradual involvement of all body systems and organs, especially which one?

Lungs

Which non-Hodgkin's lymphoma is included in the classification of T-cell and NK-cell lymphomas?

Lymphoblastic lymphoma

A patient is suspected to have non-Hodgkin's disease. The nurse anticipates a prescription for what diagnostic test to rule out central nervous system (CNS) disease?

Magnetic resonance imaging (MRI)

A patient that has sickle cell disease has developed cellulitis above the left ankle. What is the nurse's priority for this patient?

Maintain oxygenation

A patient has a hemoglobin level of 11 g/dL. The nurse determines that the patient has what level of severity of anemia?

Mild anemia

A patient who has been receiving chemotherapy now has severe neutropenia. Which assessment finding requires immediate action by the nurse?

Oral temperature is 100.5° F (36.7° F).

The nurse presents information to a group of nursing students about treatment for disseminated intravascular coagulation (DIC) and should include what information?

Oxygenation helps in stabilizing the patient with DIC

A patient is diagnosed with non-Hodgkin's lymphoma. The nurse expects what clinical manifestation?

Painless lymph node enlargement

A patient with leukemia is being seen for a follow-up visit, following a course of treatment. The patient no longer experiences symptoms, and the peripheral blood smear is normal. There is still evidence of disease in the bone marrow. The nurse identifies that the patient is in which stage of disease control?

Partial remission

The nurse provides discharge teaching to a patient with chronic anemia. What should the nurse include in the education?

Participate in a nutrition education session

The nurse reviews the laboratory reports of four patients and anticipates that which patient will receive α-interferon therapy?

Patient D

To determine the presence of external bleeding, the nurse should assess which patient clinical parameter?

Petechiae

Which strategy is most important for a nurse to include when planning care for a patient who has leukopenia?

Placing the patient in a private room

The nurse should question which therapy that is listed on a treatment plan for a patient who has thrombotic thrombocytopenic purpura (TTP)?

Platelet transfusion

The nurse is reviewing the lab reports of several patients. Which report is consistent with a diagnosis of thrombocytopenia?

Platelets 20,000/µL

The nurse recalls that the role of folic acid in erythropoiesis is what?

Promotes RBC maturation

The nurse assesses a patient with pernicious anemia and expects to find what classic sign of this condition?

Red, beefy tongue

The nurse assesses enlarged retroperitoneal nodes in a patient with Hodgkin's lymphoma. The nurse should monitor the patient for which complication?

Renal dysfunction

A patient with non-Hodgkin's lymphoma (NHL) develops tumor lysis syndrome. For which complication should the nurse monitor?

Renal failure

The nurse cares for a patient with hemophilia that experiences bleeding in a knee joint. What should be included in the initial plan of treatment?

Resting the patient's knee to prevent hemarthroses

A patient with acute myelogenous leukemia (AML) has completed the prescribed cycles of cytotoxic chemotherapy, and documentation indicates that the patient is in partial remission. How should the nurse interpret this documentation?

Symptoms are absent, and there is a normal peripheral blood smear, but there is evidence of the disease in the bone marrow.

The student nurse creates a list of risk factors that predispose a patient to chronic disseminated intravascular coagulation (DIC). What is appropriate to be included on the list?

Systemic lupus erythematosus (SLE)

The nurse reviews the history of an older patient and notes increased fatigue, headache, pale skin, and glossitis. The nurse suspects the patient has microcytic, hypochromic anemia and should provide what teaching?

Take the iron with orange juice one hour before meals

Imatinib is prescribed as treatment for leukemia. What is its mechanism of action?

Targets BCR-ABL protein

After receiving chemotherapy treatments for leukemia, a patient is declared to be in partial remission. Which statement does the nurse identify as being true about partial remission?

There is a lack of symptoms and a normal peripheral blood smear, but evidence of the disease is still present in bone marrow.

The nurse recognizes that which disorder is the most common cause of mortality in patients with polycythemia vera?

Thrombosis

Which syndrome is caused by the deficiency of plasma enzyme ADAMTS13?

Thrombotic thrombocytopenic purpura (TTP)

The nurse cares for a patient that is newly diagnosed with disseminated intravascular coagulation (DIC). What is the primary goal of the plan of care?

Treat the causative problem

The patient is being treated for non-Hodgkin's lymphoma (NHL). The nurse identifies that the most important teaching that should be provided to the patient is related to what topic?

Treatment type and expected side effects

A patient is treated with chemotherapy for Burkitt's non-Hodgkin's lymphoma (NHL). The nurse should monitor the patient for what complication?

Tumor lysis syndrome

A patient has been diagnosed with stage 1A Hodgkin's lymphoma. The nurse identifies that which chemotherapy regimen will most likely be prescribed?

Two to four cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD)

The nurse recognizes that patients with von Willebrand disease are at risk for prolonged bleeding times for what reason?

Variable factor VIII deficiencies and platelet dysfunction

An initial emergency plan of care for a patient with leukemia includes leukapheresis and hydroxyurea. The nurse concludes that the treatments were prescribed based on which laboratory parameter?

WBC count of 120,000 cells/µL

A patient that receives baby aspirin therapy has developed thrombocytopenia. The nurse recognizes that normal platelet function will be restored when what occurs?

When new platelets are formed

The nurse provides education to a group of student nurses about the staging system of Hodgkin's and non-Hodgkin's lymphomas. Which statement made by a student nurse indicates the need for further teaching?

"In stage II, there is an involvement of two or more lymph nodes on both sides of the diaphragm."

The registered nurse teaches a group of student nurses about the etiology and pathophysiology of disseminated intravascular coagulation (DIC). Which statement made by a student nurse indicates the need for further teaching?

"It results from the surplus production of clotting factors."

Which instruction should the nurse give to a patient who is newly diagnosed with acquired immunodeficiency syndrome (AIDS)?

"It's important for you to avoid eating any uncooked meat."

A patient that reports recent weight loss, fever, and night sweats is diagnosed with chronic lymphocytic leukemia. The nurse expects what dianostic findings? Select all that apply.

-Hepatomegaly -Platelet count 50,000/mcL -White blood cell count 110,000/mcL

A patient is diagnosed with Hodgkin's lymphoma that involves the bone and the liver. The nurse expects what diagnostic findings? Select all that apply.

-Hypercalcemia -Hypoalbuminuria

The nurse concludes that a patient has von Willebrand disease based on a decreased von Willebrand coagulation protein (vWF) and which other laboratory parameters? Select all that apply.

-Increased bleeding time -Increased partial thromboplastin time

The nurse suspects that a patient has polycythemia vera based on which findings in the patient's laboratory reports? Select all that apply.

-Increased cobalamin levels -Increased hemoglobin levels -Increased red blood cell levels -Increased white blood cell levels

The nurse recalls that the events that lead to heparin-induced thrombocytopenia occur in what order?

-Platelet factor 4 (PF4) binds to heparin -Complex binds to heparin -Complex binds to platelet surface -Positive feedback loop is created. -Antibodies are created against the complex -Antibodies are prematurely removed from circulation

The nurse recognizes that which condition is depicted in the figure?

Acute hemarthrosis

A patient with leukemia reports nausea, vomiting, and lethargy. The diagnostic findings indicate meningitis. The nurse suspects that what diagnosis will be made?

Acute lymphocytic leukemia (ALL)

The assessment findings of a patient include a decreased RBC and platelet counts and the presence of hypercellular bone marrow with lymphoblasts. The patient reports nausea, vomiting, and lethargy. The nurse expects the patient to be diagnosed with which type of leukemia?

Acute lymphocytic leukemia (ALL)

The nurse provides teaching to a group of nursing students about Hodgkin's lymphoma and includes information that the disease most commonly starts in the lymph nodes in what locations?

Cervical

The nurse notes that the diagnostic studies of a leukemia patient indicate normal bone marrow and peripheral blood, and the physical examination does not show any evidence of disease. Which term is used to refer to this patient's condition?

Complete remission

A patient is suspected to have leukemia. The nurse anticipates a prescription for which diagnostic test that detects leukemic cells outside of the blood and bone marrow?

Computed tomography (CT) scan

The nurse recognizes that which medication may benefit a patient with immune thrombocytopenic purpura (ITP) by increasing the platelet production?

Eltrombopag

The nurse assesses a patient and identifies signs of hemorrhage based on what changes in the mucous membranes?

Epistaxis

The nurse recalls that which therapy is appropriate to be prescribed for both indolent and aggressive non-Hodgkin's lymphoma (NHL)?

Hematopoietic stem cell transplant (HSCT)

The nurse reviews a patient's medical record and notes assessment findings which include fatigue, arthralgia, abdominal pain, weight loss, an enlarged liver, and a total body iron level of 70 g. The nurse suspects which condition?

Hemochromatosis

A patient with cancer experiences weight loss, weakness, fever, tachycardia, and a hemoglobin of 7.4 mg/dL. What complication does the nurse suspect may be occurring?

Hodgkin's lymphoma

A patient with primary polycythemia is admitted to the health care facility every two months for phlebotomy. Which intervention should the nurse perform when caring for the patient?

Initiate active or passive leg exercises.

The nurse provides information about non-Hodgkin's lymphoma to a group of nursing students. What is appropriate to be included in the education about the disease?

It is a group of malignant neoplasms

Which disease process has chromosomal translocations as its contributing factor?

Non-Hodgkin's lymphoma

The nurse reviews a patient's medical record and suspects heparin-induced thrombocytopenia (HIT). Which finding supports the nurse's conclusion?

Patient has a platelet count of 100,000/µL

The nurse creates a plan of care for a patient with polycythemia vera and will include which intervention?

Perform phlebotomy at the bedside

A patient with thrombocytopenia experiences a nosebleed. What is the priority nursing intervention?

Position the patient's head upwards and apply pressure to nostrils

The nurse recognizes that which diagnostic study is helpful in determining the clinical stage of Hodgkin's lymphoma?

Positron emission tomography (PET) with CT scan

The nurse provides education regarding daily activities to a patient with thrombocytopenia. Which patient activity indicates understanding of the teaching?

Shaving using an electric razor

The nurse recognizes that which assessment finding is related to cognitive-perceptual health patterns in a patient with leukemia?

Sore throat

A patient with Hodgkin's lymphoma experiences sensory and motor impairment of the lower limbs. What does the nurse suspect to be the cause of this condition?

Spinal cord compression

The nurse provides education to a patient with thrombocytopenia about precautions to be taken at home. The nurse identifies that further teaching is needed when the patient performs which action?

Uses an alcohol based mouthwash twice a day

A patient with anemia receives a new prescription for oral iron supplements. What should the nurse include in the medication education related to improving the absorption of the supplement?

"Take it one hour before breakfast, with orange juice."

The nurse suspects heparin-induced thrombocytopenia (HIT) in a patient who is receiving heparin therapy. Which nursing interventions would be beneficial for this patient? Select all that apply.

-Administering argatroban -Performing plasmapheresis -Discontinuing heparin therapy

The nurse recalls that which tests are considered primary methods for diagnosing leukemias? Select all that apply.

-Bone marrow examination -Peripheral blood evaluation

When caring for a patient with leukemia, the nurse expects what assessment finding that occurs due to thrombocytopenia?

Bruising

A patient receives a prescription for ferrous gluconate. The nurse should provide education related to what potential side effect?

Constipation

The nurse reviews the laboratory test results for a patient with upper gastrointestinal bleeding and notes that the hemoglobin level is 8.7 g/dL and the hematocrit is 26%. The nurse should place highest priority on initiating interventions that will reduce which symptom?

Dizziness

The nurse provides education about thrombotic thrombocytopenic purpura (TTP) to a group of nursing students and should include what information?

It is associated with hemolytic-uremic syndrome

A patient with leukemia asks the nurse, "What causes the reddish-purplish colored spots on my skin?" The nurse should explain that the spots are due to what condition?

Low platelet count

A patient reports the type B symptoms of night sweats, fever, and weight loss. The nurse suspects that the patient is experiencing what disease process?

Non-Hodgkin's lymphoma

The nurse reviews the laboratory reports of patients suspected of having a hematologic disorder. The nurse identifies that the findings of which patient are indicative of acute disseminated intravascular coagulation (DIC)?

Patient 1

The nurse assesses four patients and identifies that which patient is at the highest risk for sickle cell anemia?

Patient A

A patient completed a course of treatment for Hodgkin's lymphoma. The nurse anticipates that which diagnostic study will be performed to differentiate the residual tumor from fibrotic masses?

Positron emission tomography (PET)

The nurse assesses the vital signs of a patient with lymphoma and notes a blood pressure of 80/60 mm Hg and an irregular cardiac rhythm. Which medication does the nurse suspect is causing the condition?

Rituximab

A patient with cancer experiences fever, drenching night sweats, and weight loss. The laboratory reports show intrathoracic involvement. The nurse should monitor the patient for which complication?

Superior vena cava syndrome

A patient is receiving low-grade chemotherapy. Based on this treatment plan, the nurse suspects that the patient has what type of lymphoma?

Zone B-cell lymphoma

A patient experiences anemia secondary to acute blood loss following trauma. The patient asks the nurse about treatment that will be needed following discharge. How should the nurse respond?

"Once the blood loss is controlled and blood volume is replaced, the anemia generally corrects itself, so no long-term treatment is needed."

Which instruction is beneficial for the nurse to provide to a patient diagnosed with pernicious anemia?

"Undergo frequent gastrointestinal cancer screenings."

The nurse is caring for a patient with severe anemia and expects which compensatory respiratory changes? Select all that apply.

-Orthopnea -Tachypnea -Dyspnea at rest

A patient with factor VIII deficiency experiences joint bleeding. Which nursing interventions to include in the patient's plan of care? Select all that apply.

-Pack the joint in ice -Provide analgesics such as acetaminophen -Encourage the patient to perform range-of-motion exercises when bleeding is stopped

A nurse is providing care for a patient with hemophilia who has developed bleeding in a knee joint. Which self-care strategies are appropriate to be included in the rehabilitative plan of care? Select all that apply.

-Packing the joint with ice -Resting during an acute episode -Avoiding weight bearing until swelling subsides

A patient with peptic ulcer disease reports presence of blood in stools. The laboratory results reveal a hemoglobin level of 10 g/dL and a total iron level of 40 mcg/dL. The nurse expects what clinical manifestations? Select all that apply.

-Pallor -Cheilitis -Paresthesias

The nurse recognizes that the events associated with disseminated intravascular coagulation (DIC) that lead to multiple organ dysfunction syndrome (MODS) occur in what order?

-Release of tissue factor at the site of injury -Abundant production of intravascular thrombin -Conversion of fibrinogen to fibrin -Deposition of platelets in capillaries and arterioles

A patient is admitted to the emergency department in a state of shock with acute blood loss. The nurse reviews the patient's plan of care and should perform the interventions in what order?

-Replace blood volume -identify source of -Administer packed red blood cells (RBCs) -Provide supplemental iron

A patient with hemophilia experiences a knee that is bleeding following a fall. The nurse should perform the interventions that are listed on the plan of care in which order?

-Rest the knee and pack in ice -Administer specific coagulation factor -Administer prescribed analgesic -Encourage mobilization as soon as bleeding ceases.

A patient's assessment findings include epistaxis, gingival bleeding, a deficiency of ADAMTS13, platelet count of 90,000/µL, hemoglobin of 9.8 g/dL, and lactate dehydrogenase of 300 U/L. The peripheral smear shows spherocytes, fragmented cells, and pronounced reticulocytes. The nurse recognizes that which options are appropriate to include in the patient's treatment plan? Select all that apply.

-Rituximab -Plasmapheresis -Splenectomy if refractory to plasma exchange or immunosuppression

When preparing to administer a prescribed blood transfusion, the nurse should select which intravenous (IV) solution to prime the blood tubing?

0.9% Sodium chloride

To prepare for a patient's transfusion of packed red blood cells, the nurse should select which intravenous solution to use for the procedure?

0.9% normal saline

A patient is hospitalized with suspected Hodgkin's lymphoma. The nurse expects what assessment finding?

Enlarged lymph nodes

The nurse cares for a patient with iron-deficiency anemia. Which nursing diagnostic statement associated with the condition is the highest priority?

Impaired gas exchange

The nurse recognizes that desmopressin acetate needs to be given to a patient in repeated doses for what reason?

It is relatively short-lived

The nurse provides teaching to a group of nursing students about leukostasis and should include what information about the process?

It is the thickening of blood and blocking of circulatory pathways by leukemic WBCs.

A patient is diagnosed with non-Hodgkin's lymphoma (NHL). The nurse anticipates that what test will be performed to diagnose the cell type and pattern?

Lymph node excisional biopsy

The diagnostic findings of a patient with leukemia indicate the presence of the Philadelphia chromosome and excessive lymphoblasts in the bone marrow and cerebrospinal fluid. The patient reports frequent episodes of fever, nausea, vomiting, and lethargy. The nurse anticipates a prescription for which medication that will be administered intrathecally?

Methotrexate

A patient takes immunosuppressive medication for the treatment of psoriatic arthritis. The nurse identifies that the patient is at risk for what complication related to this treatment regimen?

Non-Hodgkin's lymphoma

The nurse assesses hepatomegaly and neurologic symptoms in a patient with central nervous disease. The nurse recalls that the symptoms are characteristic of which disease?

Non-Hodgkin's lymphoma (NHL)

The nurse reviews the blood test reports of four patients and determines that which patient is most likely to have an increased heart rate?

Patient B

The nurse is caring for a patient with suspected mediastinal lymphadenopathy. The nurse anticipates that which diagnostic test will be performed?

Positron emission tomography (PET)

What should the nurse consider to be the highest priority when caring for a patient with thrombocytopenia?

Protecting the patient from injury

A patient with von Willebrand disease receives a prescription for laboratory studies. The nurse anticipates that which result will be normal??

Prothrombin time

The nurse reviews a patient's history and identifies that what finding is the likely cause of the patient's thrombocytopenia?

Quinine

Assessment findings of a patient with Hodgkin's lymphoma include involvement of the lymph nodes above and below the diaphragm. The patient reports fever, night sweats, and weight loss. The nurse identifies that the patient is in what clinical stage of the disease?

Stage IIIB

A competent patient is hospitalized with suspected internal bleeding. The patient states, "I am a Jehovah's Witness and do not want to receive any blood products if they are needed." Shortly after admission, the patient becomes unconscious. It is determined that the patient needs packed red blood cells (pRBCs). What is the nurse's most appropriate action?

Withhold the blood products.

The nurse is teaching a group of nursing students about disseminated intravascular coagulation (DIC). Which statement made by a student indicates the need for further teaching?

"The blood is clotting during DIC."

A patient is suspected of having disseminated intravenous coagulation (DIC). Which questions should the nurse ask to determine the presence of bleeding? Select all that apply.

-"Do you get frequent headaches?" -"Have you noticed changes in vision or dizziness? -"Have you noticed changes in your urine or stools? -"Are you experiencing breathing that is faster than normal?

The nurse provides discharge teaching to a patient with sickle cell disease (SCD). Which statements made by the patient indicates understanding of the teaching? Select all that apply.-

-"I should avoid high altitudes." -"I should start screening for retinopathy at age 10."

A patient is diagnosed with acute disseminated intravascular coagulation (DIC). In addition to reduced plasminogen levels, the nurse expects that which other laboratory levels will also be decreased? Select all that apply.

-Antithrombin III (AT III) levels -Fibrinogen and platelet levels -Protein C and protein S levels

A patient with cancer who is receiving methotrexate therapy has developed anemia. The nurse recognizes that which therapies may benefit this patient? Select all that apply.

-Epoetin alfa -Oral folic acid

A patient's laboratory findings show an elevated hemoglobin and RBC count with microcytosis, as well as an elevated WBC count with basophilia. The nurse should provide what interventions? Select all that apply.

-Evaluating fluid intake and output -Assessing the patient's nutritional status -Initiating active and passive leg exercises

Which parameters should the nurse assess while monitoring a patient for the development of disseminated intravascular coagulation (DIC)? Select all that apply.

-Fibrinogen levels -Partial thromboplastin time (PTT)

The nurse prepares to administer rituximab to a patient. The nurse recognizes that the medication is appropriate for what disorders? Select all that apply

-Follicular lymphoma -Mantle cell lymphoma -Peripheral T-cell lymphoma

A patient is prescribed oral iron for the treatment of anemia. The nurse should instruct the patient about what side effects? Select all that apply.

-Heartburn -Black stools -Constipation

The nurse presents information about hemophilia to a group of nursing students. What should the nurse include? Select all that apply.

-Hemophilia B is transmitted by female carriers -Von Willebrand disease is seen in both genders. -Hemophilia A is displayed almost exclusively in men

A patient with chronic disseminated intravascular coagulation (DIC) experiences episodes of bleeding. Which interventions are appropriate to be included in the patient's plan of care? Select all that apply.

-Instructing the patient to report oozing of blood from the gums -Instructing the patient to use a soft toothbrush to clean the teeth -Instructing the patient to observe stools and urine for the presence of blood

The nurse identifies that a patient with what condition may be at high risk for developing chronic or subacute disseminated intravascular coagulation (DIC) disorder?

Malignant disorder

The nurse suspects that a patient is experiencing microcytic, hypochromic anemia after noting which blood test results?

Mean corpuscular volume of 70 fL and mean corpuscular hemoglobin of 20 pg

A patient with leukemia, who is undergoing induction therapy, shows absence of any symptoms of the disease. The peripheral blood smear of the patient is normal, but the bone marrow shows evidence of the disease. The nurse recognizes that which term will be used to refer to the patient's condition?

Partial remission

A patient with acute lymphocytic leukemia (ALL) asks for clarification about the disease. The nursing response should be based on which understanding of the disease?

ALL is malignant in nature and characterized by a proliferation of immature white blood cells

The nurse recognizes that which event that occurs during disseminated intravascular coagulation (DIC) may predispose a patient to hemorrhage?

Accumulation of fibrin split products (FSPs)

A patient is undergoing aggressive chemotherapy treatment, during which the patient becomes critically ill. The nurse recognizes that the findings indicate that the patient is in which stage of chemotherapy?

Induction therapy

The nurse recalls that which type of deficiency causes hemophilia B in a patient?

Christmas factor deficiency

The diagnostic findings of a patient indicate accumulation of small, mature-appearing lymphocytes in the bone marrow. The nurse identifies that the patient is most likely experiencing what disorder?

Chronic lymphocytic leukemia (CLL)

Which term is used to indicate the solid masses that result from collection of leukemic cells?

Chloromas

A patient's laboratory report reveals a hemoglobin (Hgb) level of 11 g/dL. The nurse expects to observe which clinical manifestation?

Palpitations

The nurse suspects a patient may have von Willebrand disease. Which assessment finding supports the nurse's suspicion?

Prolonged bleeding after a minor tooth extraction

The nurse provides education to a group of nursing students about hematopoietic stem cell transplantation (HSCT) therapy as treatment for acute lymphocytic leukemia (ALL). What is appropriate for the nurse to include in the education?

HSCT involves eradication of patient's hematopoietic stem cells.

Initial treatment for a patient with refractory lymphoma has been unsuccessful. The nurse anticipates that which type of therapy will be prescribed next, to treat the aggressive lymphoma?

Hematopoietic stem cell transplantation (HSCT

A patient is in a limited stage of cutaneous T-cell lymphoma. Which treatment administered by the oncology nurse would be most beneficial for this patient?

Topical chemotherapy

A patient experiences a minor bleeding episode during a dental procedure. The nurse recognizes that which therapy will be beneficial?

Desmopressin acetate

Recalling that myelodysplastic syndrome (MDS) arises from the pluripotent hematopoietic stem cell in the bone marrow, that nurse expects what laboratory results? Select all that apply.

-A deficiency of granulocytes -Inefficiently functioning platelets

The nurse provides education to a patient with hemophilia about safety measures. Which statements made by the patient indicates an understanding of the teaching? Select all that apply.

-"I should wear a Medic Alert tag wherever I go." -"I should wear gloves while doing household chores." -"I should immediately consult my health care provider after severe injury."

The nurse provides education to a patient with a low platelet count about precautions to be taken. Which statements made by the patient indicates effective learning? Select all that apply.

-"I will floss gently using thin tape floss." -"I will apply firm pressure to the nostrils and bridge of the nose if a nosebleed occurs."

The nurse cares for a patient that presents with chest discomfort with cough and dyspnea. Assessment findings indicate Hodgkin's lymphoma with mediastinal node involvement. Which chemotherapy regimens are appropriate to be included in the patient's plan of care? Select all that apply.

-ABVD (Doxorubicin [Adriamycin], bleomycin, vinblastine, and dacarbazine) -BEACOPP (Bleomycin, etoposide, doxorubicin [Adriamycin], cyclophosphamide, vincristine [Oncovin], procarbazine, and prednisone)

The nurse teaches home care measures to a patient diagnosed with hemophilia and should include which instructions? Select all that apply.

-Avoid contact sports -Perform oral hygiene daily -Wear gloves while doing household chores

After an upper endoscopy with biopsy, a patient is diagnosed with Helicobacter pylori gastric lymphoma. What type of therapy does the nurse expect to find on the patient's treatment plan of care?

Antibiotic therapy

The nurse creates a plan of care for a patient with disseminated intravascular coagulation (DIC) and should include what nursing diagnosis that is related to the disease process and therapy?

Anxiety

Which drug used to treat acute promyelocytic leukemia acts by causing DNA fragmentation and cell death?

Arsenic trioxide

An obstetric patient who had a placental abruption is experiencing acute hemorrhage due to disseminated intravascular coagulation (DIC). Which action is the highest priority for the nurse?

Assessing the patient for signs and symptoms of hypovolemic shock

Before beginning a transfusion of red blood cells (RBCs), which nursing action is the highest priority to avoid an error during the procedure?

Check the identifying information on the unit of blood against the patient's identification (ID) bracelet

A patient is diagnosed with ineffective peripheral tissue perfusion and acute pain. The patient's history includes chronic disseminated intravascular coagulation (DIC). The nurse should monitor the patient for what assessment finding that is associated with DIC?

Cyanosis of the extremities

The nurse recognizes that which assessment finding in a patient with disseminated intravascular coagulation (DIC) is a thrombotic manifestation?

Decreased urinary output

When caring for patients with disseminated intravascular coagulation (DIC), the nurse recognizes that what associated condition may require treatment with fresh frozen plasma?

Deficiency in clotting factors

The nurse recalls that which product results from the breakdown of fibrin?

D-dimer

A patient that is hospitalized with multiple traumatic injuries is at risk for disseminated intravascular coagulation (DIC). The nurse notes the presence of blood in the urine and feces. The nurse expects to find what abnormal laboratory result?

Decreased protein C and S

A patient with multiple traumatic injuries receives an intravenous (IV) injection. Following the injection, the nurse assesses continuous bleeding from the IV site, extensive bruising in the areas of injury, ecchymosis in areas where there is no trauma, and petechiae. The nurse suspects that the patient has what disorder?

Disseminated intravascular coagulation (DIC)

The diagnostic reports of a patient with severe bleeding reveal elevated prothrombin time (PT) and activated partial thromboplastin time (aPTT). The nurse suspects that the patient is experiencing which condition?

Disseminated intravascular coagulation (DIC)

The patient is scheduled for a dose of cobalamin (vitamin B12) 1000 mg intramuscularly (IM). The medication is available 1000 mg/2 mL. Which site would best for the nurse to use to administer this injection?

Dorsogluteal

The nurse creates patient teaching information related to heparin therapy. The nurse recalls that heparin should never be given to a patient with a history of what?

Heparin-induced thrombocytopenia (HIT)

A patient receives a prescription for rituximab. Prior to administering the medication, the nurse should check the patient's history for which condition?

Hepatitis

The nurse reviews a patient's diagnostic results which reveal the presence of Reed-Sternberg cells. The nurse recalls that the cells are indicative of what condition?

Hodgkin's lymphoma

The nurse that is caring for a group of patients identifies that the patient with what condition is at the greatest risk for the development of Hodgkin's lymphoma?

Human immunodeficiency virus (HIV) infection

A patient who is in acute sickle cell crisis cries and reports a pain level of "10" on a 1 to 10 scale. The nurse identifies that which type of medication is most appropriate for the patient?

Hydromorphone (Dilaudid) via patient-controlled analgesia (PCA)

The student nurse lists the obstetric conditions that may predispose a pregnant patient to acute disseminated intravascular coagulation (DIC). Which condition is life-threatening and assumed to be a type of severe preeclampsia?

HELLP syndrome

While taking undiluted liquid iron that was prescribed, a patient asks the nurse why it must be drunk through a straw. How should the nurse respond?

It prevents staining of the teeth

A patient with mild hemophilia receives a prescription for desmopressin acetate, an analog of vasopressin. The nurse recognizes that it is appropriate to administer the medication based on what effect it has on the clotting mechanisms?

It stimulates an increase in factor VIII

A patient is diagnosed with acute lymphocytic leukemia (ALL). The nurse identifies that which assessment finding is associated with the diagnosis?

Leukemic meningitis

The nurse reviews a treatment plan of a patient with leukemia that is receiving chemotherapy. The plan includes low doses of chemotherapy every three or four weeks. Which stage of chemotherapy does this indicate?

Maintenance therapy

The nurse is caring for a patient with leukemia. The nurse recalls that which condition may occur due to infiltration of leukemic cells in the patient's body systems?

Meningeal irritation

The nurse reviews the diagnostic results of a patient that received treatment for leukemia. All of the patient's molecular studies are negative for residual leukemia. The nurse recognizes that the patient is experiencing what condition?

Molecular remission

A patient's assessment findings include hypercalcemia, polyuria, and pain in the pelvis, spine, and ribs with movement. The nurse suspects which hematologic problem?

Multiple myeloma

The nurse is assessing skin manifestations in four patients who have thrombocytopenia. Which patient has developed ecchymosis?

Patient C

The nurse is reviewing the blood test reports of four patients. Which patient is most likely to experience hemophilia?

Patient D

A patient diagnosed with advanced-stage lymphoma reports fever, night sweats, and weight loss. The nurse recognizes that which medication may be beneficial?

Prednisone

The nurse recalls that which diagnostic finding is a hallmark of chronic myelogenous leukemia (CML)?

Presence of Philadelphia chromosome

A patient is scheduled for a hematopoietic stem cell transplant (HSCT) and receives preoperative combination chemotherapy. What is the nursing priority?

Prevent patient infection

The nurse reviews a patient's medical record and notes the presence of Epstein-Barr (EBV) virus and painless lymph node enlargement in the cervical chain. The nurse expects a prescription for what medication?

Rituximab

Which drug that is used for patients with thrombotic thrombocytopenic purpura (TPP) has the ability to decrease the level of inhibitory ADAMTS13 IgG antibodies?

Rituximab

The nurse recalls that which condition is characterized by the presence of a high percentage of Hgb S in the erythrocytes?

Sickle cell disease

Which finding supports the nurse's conclusion that a patient has pernicious anemia?

Smooth, beefy-red tongue

Several minutes after the start of a transfusion of packed red blood cells, the patient reports itching. Hives begin to develop on the patient's chest and abdomen. Which immediate action should the nurse take?

Stop the transfusion immediately

A patient has received instructions about the use of liquid iron supplements. During a follow-up visit, the nurse determines that the patient still has iron-deficiency anemia even after receiving complete treatment. Which action could be responsible for this condition?

Taking iron supplements along with meals

A patient's laboratory reports show a low mean corpuscular volume (MCV) and a high reticulocyte count. The nurse suspects which condition?

Thalassemia

The nurse recalls that the standard of care for pain includes what component?

That competent and compassionate care is provided to all patients

A patient with hemophilia experiences difficult episodes of epistaxis and menorrhagia. Which drug does the nurse expect to be prescribed?

Tranexamic acid