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 Accelerated

B Blast crisis

C Chronic

D Transformation

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 protein level 5.8 g/dL

C serum creatinine level 0.5 mg/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 Popliteal

B Cervical

C Axillary

D Inguinal

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 Phlebotomy

B Radiation

C Chelation therapy

D Blood transfusions

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 Bronze skin tone

B Ruddy complexion

C Pale skin and mucous membranes

D Jaundice skin and sclera

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 Creatinine and blood urea nitrogen (BUN) levels

C Magnesium 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 40-year-old patient with a history of hypertension

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

D A 24-year-old female taking oral contraceptives

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 “The goal of therapy is palliation.”

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

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 Laryngeal edema

B Diarrheal stools

C Adventitous lung sounds

D Hair loss

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 Hemoglobin of 9.8 g/dl

B Serum sodium level of 133 mEq/L

C Serum calcium level 13.8 mg/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 Promote safety.

B Provide adequate hydration.

C Increase mobility.

D Encourage adequate nutrition.

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 Involvement of lymph nodes

D Histology of tissue

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 crystalize.

B Lymph nodes expand.

C Bone marrow expands.

D Abnormal blood cells deposit in small vessels.

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 can develop osteonecrosis of the jaw.

B The patient can develop loosening of the teeth.

C The patient is at risk for tooth decay.

D The patient will develop gingival hyperplasia.

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 Smoking cessation

B Decrease alcohol intake

C Decrease fat intake

D Reduce exposure to excessive sunlight

E Decrease intake of antipyretic medications such as acetaminophen

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 Supportive therapy

B Standard therapy

C Antimicrobial therapy

D Induction 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 Suggest the family go to church more often.

B Allow family members to express feelings.

C Educate the family about medications and side effects.

D Suggest support for household maintenance.

E Suggest the prescription of antianxiety medications.

Question #18

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

A Keep the client on bed rest.

B Evaluate the client’s platelet count.

C Ask the client whether they have recently fallen.

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 Congestive heart failure

D Stroke

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 peripheral edema

B splenomegaly

C pale body color

D weight gain

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 Excess of immature erythrocytes

B Excess of immature leukocytes

C Deficiency of neutrophils

D Deficiency of 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 Easy bruising

B Fatigue from anemia

C Nausea and vomiting

D Diarrhea

E Frequent infections

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 Exposure to water of any temperature

C Aspirin

D Temperature change

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 know I can never be cured.”

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

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

D “I will start slowly with medication treatment.”

Question #26

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

A Anemia

B Pancytopenia

C Leukopenia

D Thrombocytopenia

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 Sickle cell disease

B Polycythemia vera

C Aplastic anemia

D Pernicious anemia

Question #28

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

A Take a daily multivitamin with iron supplement

B Bath in tepid or cool water to control itching

C Drink alcohol to decrease blood viscosity

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 Provide a clear liquid, low-sodium diet.

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

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

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

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 sickle cell disease

B polycythemia vera

C pernicious anemia

D aplastic anemia

Question #31

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 #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 Risk for falls

B Impaired tissue integrity

C Acute pain

D Sensory-perception disturbance

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 Hodgkin lymphoma

B Multiple myeloma

C Chronic myeloid leukemia

D Non-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 Neutropenia

B Anemia

C Pancytopenia

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 Polyuria

B Diarrhea

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 Allopurinol

B Filgrastim

C Asparaginase

D Hydroxyurea

Question #38

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

A Refer the client to a chiropractor.

B Place heating pads on the client’s back.

C Assess renal function.

D Administer pain medication, as ordered.

Question #39

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 Osteosarcomas form producing pathologic fractures.

D Osteopathic tumors destroy bone causing 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 Perform a neurologic assessment with vital signs.

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

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

D Use contact precautions with this client

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 Gradual muscle paralysis

B Bone pain in the back of the ribs

C Severe thrombocytopenia

D Debilitating fatigue

Question #42

A Potassium levels

B Iron levels

C Creatinine and blood urea nitrogen (BUN) 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 Administer pain medication.

B Place the client in reverse isolation.

C Maintain nutrition.

D Address issues of negative body image.

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 Eliminate direct contact with others who are infectious.

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

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 Multiple myeloma

B Hemolytic anemia

C Leukemia

D Polycythemia vera

Question #46

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

A A general reduction in neutrophils and basophils

B Too many erythrocytes

C A decrease in granulocytes

D A general reduction in all white blood cells

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

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

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

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

Question #48

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

A Hypercalcemia

B Hyperkalemia

C Hypermagnesemia

D Hypernatremia

Question #49

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

A Balancing rest and activity

B Preventing bone injury

C Monitoring respiratory status

D Restricting fluid intake

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 Encouarge increased fluid consumption.

B Maintain contact precautions.

C Monitor the client’s temperature every shift.

D Practice vigilant handwashing.

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 Platelet count of 9,000/mm3

B Creatinine level of 1.0 mg/dL

C Hematocrit of 38%

D WBC count of 4,200 cells/mcL

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 painful lymph nodes under the arm.

B The client with painful lymph nodes in the groin.

C The client with a painful sore throat.

D The client with enlarged lymph nodes in the neck.

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 pulse and blood pressure.

B Assess the client’s hemoglobin and platelets.

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 Encourage ambulation.

B Assess for signs of injury.

C Elevate the client’s legs.

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 “Side effects are rare with therapy.”

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

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

D “The goal of therapy is palliation.”

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 “Acute leukemia develops slowly.”

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

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

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 Lifestyle assessments, such as exercise routines

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

C Menstrual history

D Age and gender

Question #59

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

A pathologic bone fractures

B hypoxemia.

C chronic liver failure.

D acute heart 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 Acute respiratory distress syndrome

B Graft-versus-host disease

C Bone marrow depression

D Remission

Question #61

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

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

B Have the client lie on a hard surface.

C Encourage ambulation.

D Have the client rest.

Question #62

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

A No evidence of edema

B Absence of bone pain

C Neutrophil and platelet counts within normal limits

D Vital signs within normal ranges

Question #63

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

A Lymphocyte

B Spherocyte

C Thrombocyte

D Granulocyte

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