Chapter 34 Quiz

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Question #1

The nurse is caring for a client with chronic myeloid leukemia (CML) who is taking imatinib mesylate. In what phase of the leukemia does the nurse understand that this medication is most useful to induce remission?

A Transformation

B Chronic

C Blast crisis

D Accelerated

Question #2

The nurse is teaching a client who is undergoing diagnostic tests for multiple myeloma. What clinical findings support the client’s diagnosis of multiple myeloma?

A serum albumin level of 2.0 g/dL

B serum creatinine level 0.5 mg/dL

C serum protein level 5.8 g/dL

D serum calcium level of 7.5 mg/dL

Question #3

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?

A Cervical

B Axillary

C Inguinal

D Popliteal

Question #4

A patient with polycythemia vera has a high red blood cell (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 Phlebotomy

D Chelation therapy

Question #5

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 Jaundice skin and sclera

C Ruddy complexion

D Bronze skin tone

Question #6

The nurse is administering packed red blood cell (RBC) transfusions for a patient with myelodysplastic syndrome (MDS). 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 Potassium levels

B Magnesium levels

C Creatinine and blood urea nitrogen (BUN) levels

D Iron levels

Question #7

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

A A 52-year-old patient with acute kidney injury

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

C A 24-year-old female taking oral contraceptives

D A 40-year-old patient with a history of hypertension

Question #8

The nurse is teaching a client with acute lymphocytic leukemia (ALL) about therapy. What statement should be included in the plan of care?

A “Side effects are rare with therapy.”

B “Intrathecal chemotherapy is used primarily as preventive therapy.”

C “The goal of therapy is palliation.”

D “Treatment is simple and consists of single-drug therapy.”

Question #9

A client is receiving radiation therapy for lesions in the abdomen from non–Hodgkin’s lymphoma. Because of the effects of the radiation treatments, what will the nurse assess for?

A Diarrheal stools

B Hair loss

C Adventitous lung sounds

D Laryngeal edema

Question #10

A client with multiple myeloma presents to the emergency department and reports excessive thirst and constipation. Family members report that the client has been confused for the last day. Which laboratory value is most likely responsible for this client’s symptoms?

A Serum calcium level 13.8 mg/dl

B Serum sodium level of 133 mEq/L

C Hemoglobin of 9.8 g/dl

D Platelet count 300,000/mm3

Question #11

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

A Encourage adequate nutrition.

B Promote safety.

C Provide adequate hydration.

D Increase mobility.

Question #12

A client is newly diagnosed with Hodgkin lymphoma. The nurse understands that the client’s treatment will be based on what concept?

A Staging of disease

B Total blood cell count

C Histology of tissue

D Involvement of lymph nodes

Question #13

The nurse cares for a client with acute myeloid leukemia with severe bone pain. What pathophysiological concept does the nurse understand is the reason for the client’s pain?

A Abnormal blood cells deposit in small vessels.

B Bone marrow expands.

C Lymph nodes expand.

D Abnormal blood cells crystalize.

Question #14

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 will develop gingival hyperplasia.

B The patient is at risk for tooth decay.

C The patient can develop loosening of the teeth.

D The patient can develop osteonecrosis of the jaw.

Question #15

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 factors? (Select all that apply.),,

A Reduce exposure to excessive sunlight

B Smoking cessation

C Decrease fat intake

D Decrease intake of antipyretic medications such as acetaminophen

E Decrease alcohol intake

Question #16

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 Standard therapy

B Antimicrobial therapy

C Induction therapy

D Supportive therapy

Question #17

The nurse is interacting with a family that has been caring for a client with cancer for several months. What are the best interventions to assist in relieving caregiver stress in this family? Select all that apply.,,

A Educate the family about medications and side effects.

B Suggest the family go to church more often.

C Suggest the prescription of antianxiety medications.

D Suggest support for household maintenance.

E Allow family members to express feelings.

Question #18

A client who is being treated for AML has bruises on both legs. What is the nurse’s mostappropriate action?

A Ask the client whether they have recently fallen.

B Keep the client on bed rest.

C Evaluate the client’s platelet count.

D Evaluate the client’s INR.

Question #19

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

A “Acute leukemia develops slowly.”

B “In chronic leukemia, the majority of leukocytes are mature.”

C “In acute leukemia there are not many undifferentiated cells.”

D “Chronic leukemia develops slowly.”

Question #20

A client diagnosed with polycythemia vera has come into the clinic because he has developed a nighttime cough, fatigue, and shortness of breath. What complication would you suspect in this client?

A Pulmonary embolus

B Tissue infarction

C Stroke

D Congestive heart failure

Question #21

The nurse is assessing a client admitted with a deep vein thrombosis with an elevated red blood cell count. The admitting diagnosis is polycythemia vera. What is the hallmark clinical sign of PV?

A weight gain

B splenomegaly

C pale body color

D peripheral edema

Question #22

A nurse prepares a client for a bone marrow biopsy who is suspected of having acute myeloid leukemia. What results from the bone marrow biopsy does the nurse expect?

A Deficiency of erythrocytes

B Excess of immature leukocytes

C Deficiency of neutrophils

D Excess of immature erythrocytes

Question #23

A client is suspected of having leukemia and is having a series of laboratory and diagnostic studies performed. What does the nurse recognize as the hallmark signs of leukemia? Select all that apply.,,

A Frequent infections

B Easy bruising

C Nausea and vomiting

D Fatigue from anemia

E Diarrhea

Question #24

A client with polycythemia vera reports severe itching. What triggers does the nurse know can cause this distressing symptom? Select all that apply.,,

A Alcohol consumption

B Aspirin

C Temperature change

D Exposure to water of any temperature

E Allergic reaction to the red blood cell increase

Question #25

Which statement indicates the client understands teaching about induction therapy for leukemia?

A “I will start slowly with medication treatment.”

B I will be in the hospital for several weeks.”

C “I will need to come every week for treatment.”

D “I know I can never be cured.”

Question #26

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

A Pancytopenia

B Anemia

C Thrombocytopenia

D Leukopenia

Question #27

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?

A Pernicious anemia

B Aplastic anemia

C Sickle cell disease

D Polycythemia vera

Question #28

A client has been diagnosed with polycythemia vera. What is the best instruction for the nurse to give to this client?

A Drink alcohol to decrease blood viscosity

B Take a daily multivitamin with iron supplement

C Bath in tepid or cool water to control itching

D Maintain adequate blood pressure control

Question #29

Which precautions should a nurse include in the care plan for a client with leukemia and neutropenia?

A Put on a mask, gown, and gloves when entering the client’s room.

B Eliminate fresh fruits and vegetables, avoid using enemas, and practice frequent hand washing.

C Provide a clear liquid, low-sodium diet.

D Have the client use a soft toothbrush and electric razor, avoid using enemas, and watch for signs of bleeding.

Question #30

The nurse is discussing disorders of the hematopoietic system when a client asked about erythrocytosis. What disease will the nurse mention with a primary characteristic of erythrocytosis?

A pernicious anemia

B aplastic anemia

C sickle cell disease

D polycythemia vera

Question #31

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

A Osteolytic activating factor weakens bones producing fractures

B Osteoclasts break down bone cells so pathologic fractures occur.

C Osteopathic tumors destroy bone causing fractures.

D Osteosarcomas form producing pathologic fractures.

Question #32

A client with multiple myeloma reports severe paresthesia in the feet. When planning care for the client, which priority nursing diagnosis will the nurse choose?

A Acute pain

B Sensory-perception disturbance

C Risk for falls

D Impaired tissue integrity

Question #33

The nurse cares for an older adult client with unprovoked back pain and increased serum protein. Which hematologic neoplasm does the nurse suspect the client has?

A Multiple myeloma

B Chronic myeloid leukemia

C Non-Hodgkin lymphoma

D Hodgkin lymphoma

Question #34

A client with acute myeloid leukemia has a fever. What pathophysiological process does the nurse recognize is the cause of the client’s fever?

A Anemia

B Pancytopenia

C Neutropenia

D Thrombocytopenia

Question #35

A client with polycythemia vera reports gouty arthritis symptoms in the toes and fingers. What is the nurse’s best understanding of thepathophysiological reason for this symptom?

A Excess red blood cells cause vascular injury in the joints.

B Excess red blood cells produce extracellular toxins that build up.

C The dead red blood cells release excess uric acid.

D The dead red blood cells occlude the small vessels in the joints.

Question #36

A nurse cares for a client with multiple myeloma who reports severe back pain that worsens throughout the day. What additional clinical symptoms will the nurse associate with the pathophysiology of the client’s disease?

A Diarrhea

B Polyuria

C Excessive thirst

D Fluid volume excess

Question #37

The nurse is caring for a client 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?

A Hydroxyurea

B Allopurinol

C Asparaginase

D Filgrastim

Question #38

A client who is undergoing chemotherapy for AML reports pain in the low back. What is the nurse’s first action?

A Place heating pads on the client’s back.

B Refer the client to a chiropractor.

C Administer pain medication, as ordered.

D Assess renal function.

Question #39

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

A Osteopathic tumors destroy bone causing fractures.

B Osteoclasts break down bone cells so pathologic fractures occur.

C Osteolytic activating factor weakens bones producing fractures.

D Osteosarcomas form producing pathologic fractures.

Question #40

The hospitalized client is experiencing gastrointestinal bleeding with a platelets at 9,000/mm³. The client is receiving prednisone and azathioprine. What action will the nurse take?

A Request a prescription of diphenoxylate and atropine for loose stools.

B Perform a neurologic assessment with vital signs.

C Use contact precautions with this client

D Teach the client to vigorously floss the teeth to prevent infections.

Question #41

The nurse suspects that a client has multiple myeloma based on the client’s major presenting symptom and the analysis of laboratory results. What classic symptom for multiple myeloma does the nurse assess for?

A Bone pain in the back of the ribs

B Debilitating fatigue

C Severe thrombocytopenia

D Gradual muscle paralysis

Question #42

A Creatinine and blood urea nitrogen (BUN) levels

B Potassium levels

C Iron levels

D Magnesium levels

Question #43

A client has completed induction therapy and has diarrhea and severe mucositis. What is the appropriate nursing goal?

A Maintain nutrition.

B Address issues of negative body image.

C Place the client in reverse isolation.

D Administer pain medication.

Question #44

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

A Apply prolonged pressure to needle sites or other sources of external bleeding.

B Eliminate direct contact with others who are infectious.

C Monitor temperature at least once per shift.

D Implement neutropenic precautions.

Question #45

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?

A Polycythemia vera

B Leukemia

C Multiple myeloma

D Hemolytic anemia

Question #46

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

A A decrease in granulocytes

B A general reduction in neutrophils and basophils

C A general reduction in all white blood cells

D Too many erythrocytes

Question #47

A client with leukemia is being discharged from the hospital to hospice care. Which statement by the client indicates the client is not appropriately dealing with spiritual distress?

A “I have resources within myself that I can depend on.”

B I know I am going to die. I want to say good–bye to my family.”

C “I do not understand why this happened to me.”

D “I am going to call my clergy to pray with me.”

Question #48

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

A Hypermagnesemia

B Hypernatremia

C Hyperkalemia

D Hypercalcemia

Question #49

A nurse is caring for a client with multiple myeloma. Which nursing intervention is most appropriate for this client?

A Restricting fluid intake

B Preventing bone injury

C Monitoring respiratory status

D Balancing rest and activity

Question #50

The nurse recognizes the clinical assessment of a patient with acute myeloid leukemia (AML) includes observing for signs of infection early. What nursing action will most likely help prevent infection?

A Maintain contact precautions.

B Practice vigilant handwashing.

C Encouarge increased fluid consumption.

D Monitor the client’s temperature every shift.

Question #51

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?

A Creatinine level of 1.0 mg/dL

B WBC count of 4,200 cells/mcL

C Hematocrit of 38%

D Platelet count of 9,000/mm3

Question #52

The nurse is assessing several clients. Which client does the nurse determine is most likely to have Hodgkin lymphoma?

A The client with enlarged lymph nodes in the neck.

B The client with a painful sore throat.

C The client with painful lymph nodes under the arm.

D The client with painful lymph nodes in the groin.

Question #53

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

A Assess the client’s hemoglobin and platelets.

B Assess the client’s pulse and blood pressure.

C Check the client’s history.

D Assess the client’s skin.

Question #54

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

A Assess for signs of injury.

B Elevate the client’s legs.

C Encourage ambulation.

D Keep the feet cool.

Question #55

The nurse is teaching a client with acute lymphocytic leukemia (ALL) about therapy. What statement should be included in the plan of care?

A “Treatment is simple and consists of single-drug therapy.”

B “Intrathecal chemotherapy is used primarily as preventive therapy.”

C “The goal of therapy is palliation.”

D “Side effects are rare with therapy.”

Question #56

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

A “Chronic leukemia develops slowly.”

B “In acute leukemia there are not many undifferentiated cells.”

C “Acute leukemia develops slowly.”

D In chronic leukemia, the majority of leukocytes are mature.”

Question #57

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

A They produce antibodies against foreign antigens.

B They are active against hypersensitivity reactions.

C They defend against bacterial infection.

D They produce all blood cells.

Question #58

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

A Age and gender

B Health history, such as bleeding, fatigue, or fainting

C Menstrual history

D Lifestyle assessments, such as exercise routines

Question #59

A nurse is assessing a client with multiple myeloma. Due to this condition, what will this client be at risk for?

A hypoxemia.

B pathologic bone fractures

C acute heart failure.

D chronic liver failure.

Question #60

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?

A Bone marrow depression

B Remission

C Graft-versus-host disease

D Acute respiratory distress syndrome

Question #61

A client with suspected multiple myeloma is reporting back pain. What is the priority nursing action?

A Have the client lie on a hard surface.

B Encourage ambulation.

C Send the client for a spinal x-ray study.

D Have the client rest.

Question #62

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

A Vital signs within normal ranges

B No evidence of edema

C Absence of bone pain

D Neutrophil and platelet counts within normal limits

Question #63

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

A Lymphocyte

B Granulocyte

C Spherocyte

D Thrombocyte

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