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 Blast crisis

B Transformation

C Chronic

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 calcium level of 7.5 mg/dL

C serum protein level 5.8 g/dL

D serum creatinine level 0.5 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 Axillary

B Cervical

C Popliteal

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 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 Ruddy complexion

B Jaundice skin and sclera

C Pale skin and mucous membranes

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 72-year-old patient with a history of cancer

B A 24-year-old female taking oral contraceptives

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

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

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 “The goal of therapy is palliation.”

B “Side effects are rare with therapy.”

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 Adventitous lung sounds

C Hair loss

D Diarrheal stools

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 sodium level of 133 mEq/L

B Hemoglobin of 9.8 g/dl

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 Encourage adequate nutrition.

B Promote safety.

C Increase mobility.

D Provide adequate hydration.

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 Total blood cell count

B Histology of tissue

C Staging of disease

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 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 loosening of the teeth.

B The patient can develop osteonecrosis of the jaw.

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 Decrease intake of antipyretic medications such as acetaminophen

B Decrease alcohol intake

C Decrease fat intake

D Reduce exposure to excessive sunlight

E Smoking cessation

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 Antimicrobial therapy

C Induction therapy

D Standard 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 Allow family members to express feelings.

B Suggest the family go to church more often.

C Suggest support for household maintenance.

D Educate the family about medications and side effects.

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 Evaluate the client’s INR.

B Evaluate the client’s platelet count.

C Ask the client whether they have recently fallen.

D Keep the client on bed rest.

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 acute leukemia there are not many undifferentiated cells.”

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

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 Tissue infarction

B Pulmonary embolus

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 splenomegaly

B peripheral edema

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 Deficiency of erythrocytes

B Deficiency of neutrophils

C Excess of immature erythrocytes

D Excess of immature leukocytes

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 Nausea and vomiting

B Easy bruising

C Diarrhea

D Fatigue from anemia

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 Temperature change

B Aspirin

C Alcohol consumption

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 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 Thrombocytopenia

B Pancytopenia

C Leukopenia

D Anemia

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 Polycythemia vera

D Sickle cell disease

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 Maintain adequate blood pressure control

C Take a daily multivitamin with iron supplement

D Bath in tepid or cool water to control itching

Question #29

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

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

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

C Provide a clear liquid, low-sodium diet.

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

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 polycythemia vera

B sickle cell disease

C aplastic anemia

D pernicious 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 Osteoclasts break down bone cells so pathologic fractures occur.

B Osteolytic activating factor weakens bones producing fractures

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 Risk for falls

C Impaired tissue integrity

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 Non-Hodgkin lymphoma

B Chronic myeloid leukemia

C Hodgkin lymphoma

D Multiple myeloma

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 Pancytopenia

C Thrombocytopenia

D Anemia

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

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

D The dead red blood cells release excess uric acid.

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 Fluid volume excess

C Excessive thirst

D Polyuria

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 Place heating pads on the client’s back.

B Administer pain medication, as ordered.

C Assess renal function.

D Refer the client to a chiropractor.

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 Osteolytic activating factor weakens bones producing fractures.

C Osteoclasts break down bone cells so pathologic fractures occur.

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

B Use contact precautions with this client

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

D Perform a neurologic assessment with vital signs.

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 Debilitating fatigue

B Severe thrombocytopenia

C Gradual muscle paralysis

D Bone pain in the back of the ribs

Question #42

A Magnesium levels

B Iron levels

C Creatinine and blood urea nitrogen (BUN) levels

D Potassium 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 Address issues of negative body image.

D Maintain nutrition.

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 Implement neutropenic precautions.

B Eliminate direct contact with others who are infectious.

C Monitor temperature at least once per shift.

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

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 Leukemia

B Multiple myeloma

C Hemolytic anemia

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 Too many erythrocytes

B A general reduction in neutrophils and basophils

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 do not understand why this happened to me.”

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

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

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

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 Hypernatremia

D Hypermagnesemia

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 Monitoring respiratory status

C Balancing rest and activity

D Preventing bone injury

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 Monitor the client’s temperature every shift.

B Encouarge increased fluid consumption.

C Maintain contact precautions.

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 Creatinine level of 1.0 mg/dL

B Platelet count of 9,000/mm3

C WBC count of 4,200 cells/mcL

D Hematocrit of 38%

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 pulse and blood pressure.

B Assess the client’s skin.

C Check the client’s history.

D Assess the client’s hemoglobin and platelets.

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

B “Side effects are rare with therapy.”

C “Intrathecal chemotherapy is used primarily as preventive 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 “In acute leukemia there are not many undifferentiated cells.”

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

D “Acute leukemia develops slowly.”

Question #57

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

A They produce all blood cells.

B They defend against bacterial infection.

C They produce antibodies against foreign antigens.

D They are active against hypersensitivity reactions.

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 Age and gender

D Menstrual history

Question #59

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

A chronic liver failure.

B acute heart failure.

C hypoxemia.

D pathologic bone fractures

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 Acute respiratory distress syndrome

D Graft-versus-host disease

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 Have the client rest.

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

D Encourage ambulation.

Question #62

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

A Absence of bone pain

B Neutrophil and platelet counts within normal limits

C No evidence of edema

D Vital signs within normal ranges

Question #63

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

A Spherocyte

B Thrombocyte

C Granulocyte

D Lymphocyte

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