Management Of Clients With Leukemia And Lymphoma

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Question 1
Free
Multiple Choice

The nurse explains that acute leukemia is caused by

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A

accumulation of immature blast cells.

B

excessively rapid mitosis of leukemic cells.

C

proliferation of neutrophils.

D

undifferentiated blast cells entering bone marrow.

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Question 2
Free
Multiple Choice

The nurse reviewing a hematology report recognizes pancytopenia, which is when

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A

cellular components of the blood are reduced.

B

platelets are immature and dividing rapidly.

C

red cells have become polymorphic.

D

white cells are poorly undifferentiated.

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Question 3
Free
Multiple Choice

The nurse reviewing a hematology report of a client with chronic leukemia brings to the attention of the physician a change that may indicate a blast crisis may be occurring, which is

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A

a drastic decrease in monocytes.

B

a hemoglobin drop to 9 g/dl.

C

myeloid cell precursors >20%.

D

thrombocytic proliferation.

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Question 4
Free
Multiple Choice

The nurse preparing a client with acute leukemia for the induction phase of chemotherapy explains that the objective of this phase is to

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A

decrease the number of monocytes.

B

induce complete remission.

C

reduce long bone pain and splenomegaly.

D

"shock" the marrow into producing normal cells.

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Question 5
Free
Multiple Choice

When the nurse records a platelet count of 20,000/mm³, the most appropriate nursing action is to

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A

encourage iron-rich foods.

B

increase fluid intake.

C

institute bleeding precautions.

D

place the client in protective isolation.

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Question 6
Multiple Choice

The nurse caring for a client who had a bone marrow transplant this morning should observe the client for manifestations of

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A
graft-versus-host disease.
B
hemorrhage.
C
pulmonary complications.
D
Sjögren's syndrome.
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Question 7
Multiple Choice

After a bone marrow transplant, a client develops GVHD and is readmitted to the hospital. The nurse intervenes to prevent which potential complication of treatment for GVHD?

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A
Anorexia
B
Bleeding
C
Hypoglycemia
D
Infection
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Question 8
Multiple Choice

A client with stage I GVHD following a bone marrow transplant is very depressed because he has developed this complication. The nurse should base interactions with this client on the fact that stage I GVHD

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A
is likely to prevent successful engraftment.
B
may prevent leukemic relapse.
C
is treatable with steroids.
D
is usually fatal very quickly.
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Question 9
Multiple Choice

A client with Hodgkin's disease is staged at III?. The nurse plans care knowing this means there

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A
are nodes on both sides of the diaphragm with para-aorta involvement.
B
are nodes on both sides of the diaphragm with portal involvement.
C
is involvement of a single lymphoid structure.
D
might be a single node on one side of the diaphragm.
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Question 10
Multiple Choice

A client has been receiving MOPP (mechlorethamine, vincristine [Oncovin], procarbazine, prednisone) therapy for treatment of Hodgkin's disease. The treatment has changed to a protocol of ABVD (doxorubicin [Adriamycin], bleomycin, vinblastine, and dacarbazine). When the client asks the nurse for clarification about the change in protocol, the nurse's response will include that ABVD

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A
can frequently produce a remission after only 1 cycle.
B
negates the need for radiation therapy.
C
prevents hypercalcemia.
D
reduces the risk of leukemia.
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Question 11
Multiple Choice

A client with Hodgkin's lymphoma has relapsed after completing chemotherapy. The nurse plans care for this client understanding the probable treatment will be

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A
BMT or stem cell transplantation.
B
immunosuppressants.
C
more chemotherapy.
D
systemic steroids.
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Question 12
Multiple Choice

A client with leukemia has the nursing diagnosis Imbalanced Nutrition: Less Than Body Requirements. Which food offered by the nurse would the client be least likely to want?

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A
A sandwich
B
Cold applesauce
C
Hot soup
D
Vanilla milkshake
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Question 13
Multiple Choice

A nurse is educating high school students about avoiding risk factors for different diseases. When a teenager laughs off a recent infection with mononucleosis as a silly "kissing disease," the nurse cautions him that mononucleosis is a risk factor for

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A
acute lymphoblastic leukemia.
B
chronic lymphocytic leukemia.
C
Hodgkin's disease.
D
severe bone marrow depression.
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Question 14
Multiple Choice

A client with acute leukemia has an extremely high white count and is going to receive chemotherapy. The nurse should anticipate administering which agents to this client? (Select all that apply.)

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A
Allopurinol (Zyloprim)
B
Increased IV fluids
C
Rasburicase (Elitek)
D
Urine acidifiers
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Question 15
Multiple Choice

A client with acute leukemia develops a neutrophil count of 450/mm³. The nurse should (Select all that apply)

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A
allow no plants or live flowers in the room.
B
allow no visitors at this time.
C
ensure strict adherence to hand-washing protocol.
D
place the client on protective isolation.
E
restrict the client's access to raw fruits and vegetables.
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Question 16
Multiple Choice

A client contemplating chemotherapy for acute leukemia tells the nurse that s/he is concerned about the effects of chemotherapy on sexuality. Appropriate interventions by the nurse include (Select all that apply)

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A
describing the physical changes that may occur with chemotherapy affecting sexuality.
B
explaining that because of fatigue or other causes, libido may be decreased during chemotherapy.
C
informing the client and partner that you will call a social worker who can address their concerns.
D
informing the client about some reproductive alternatives such as sperm banking and egg harvesting.
E
offering information on alternative sexual positioning and techniques the client can try.
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