The nurse analyzes the laboratory values of a child with leukemia who is receiving chemotherapy

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Elementary and Intermediate Algebra

Tussy/Gustafson

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Dosage Calculations

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Leukemia NCLEX questions

In formulating a nursing diagnosis of risk for infection for a client with chronic lymphoid leukemia (CLL), nursing measures should include: (Select all that apply.)"A. Maintaining a clean technique for all invasive procedures.

B. Placing the client in

Correct Answers: B, C, D
Rationale: Chronic lymphoid leukemia (CLL) is characterized by a proliferation and accumulation of small, abnormal mature lymphocytes in bone marrow, peripheral blood, and body tissues. Infections and fever are frequent complicat

The client diagnosed with leukemia has central nervous system involvement. Whichinstructions should the nurse teach?"1.Sleep with the head of the bed elevated to prevent increased intracranial pressure.

2.Take an analgesic medication for pain only when

Correct: 3
1.Sleeping with the head of the bed elevatedmight relieve some intracranial pressure, but it will not prevent intracranial pressure from occurring.2.Analgesic medications for clients with cancer are given on a scheduled basis with a fast-actin

The nurse analyzes the laboratory values of a child with leukemia who is receiving chemotherapy . The nurse notes that the platelet count is 20,000/ul. Based on the laboratry result, which intervention will the nurse document in the plan of care?
1 Mointo

Correct Ans 4 If a child is severely thrombocytopenic and has a platelet count less than 20,000/ul, bleeding precautions need to be initated because of increased risk of bleeding or hemorrhage. Options 1,2,3 are related to the prevention of infection rath

A client with acute leukemia is admitted to the oncology unit. Whichof the following would be most important for the nurse to inquire?"a. ""Have you noticed a change in sleeping habits recently?""

b. ""Have you had a respiratory infection in the last 6

Answer B is correct. The client with leukemia is at risk for infection and has often had recurrent respiratory infections during the previous 6 months. Insomnolence, weight loss, and a decrease in alertness also occur in leukemia, but bleeding tendencies

What nursing diagnosis is seen with acute lymphocytic leukemia and thromocytopenia?"A. potential for injuryB. self-care deficitC. potential for self harm

D. alteration in comfort

Answer: A potential for injury
Low platelet increases risk of bleeding from even minor injuries. Safety measures: shave with an electric razor, use soft tooth brush, avoid SQ or IM meds and invasive procedures (urinary drainage catheter or a nasogastric

When caring for a client with a diagnosis of thrombocytopenia, the nurse should plan to:"a.Discourage the use of stool softenersb.Assess temperature readings every six hoursc.Avoid invasive procedures

d.Encourage the use of a hard, brittle toothbrush

Answer: CRationale:

Thrombocytopenia is a deficiency of platelets, and leaves the patient more prone to hemmorrhage. For this reason, avoiding invasive procedures will limit the risk of hemorrhage. Stool softeners should be encouraged, while hard brittl

Which statement is correct about the rate of cell growth in relation to chemotherapy?"1. Faster growing cells are less susceptible to chemotherapy.2. Nondividing cells are more susceptible to chemotherapy.

3. Faster growing cells are more susceptible t

Answer 3
The faster the cell grows, the more susceptible it is to chemotherapy and radiation therapy. Slow-growing and nondividing cells are less susceptible to chemotherapy. Repeated cycles of chemotherapy are used to destroy nondividing cells as the be

The nurse is caring for a client diagnosed with acute myeloid leukemia. Which assess-ment data warrant immediate intervention?1.T 99, P 102, R 22, and BP 132/68.2.Hyperplasia of the gums.3.Weakness and fatigue.

4.Pain in the left upper quadrant.

Correct: 41.These vital signs are not alarming. The vitalsigns are slightly elevated and indicate moni-toring at intervals, but they do not indicate animmediate need.

2.Hyperplasia of the gums is a symptom of myeloid leukemia, but it is not an emergency

Which medication is contraindicated for a client diagnosed with leukemia?1. Bactrim, a sulfa antibiotic2. Morphine, a narcotic analgesic3. Epogen, a biologic response modifier

4. Gleevec, a genetic blocking agent

Correct: C1. Because of the ineffective or nonexistent WBCs characteristic of leukemia, the body cannot fight infections, and antibiotics are given to treat infections.

2. Leukemic infiltrations into the organs or the CNS cause pain. Morphine is the dru

A 68-year-old woman is diagnosed with thrombocytopenia due to acute lymphocytic leukemia. She is admitted to the hospital for treatment. The nurse should assign the patient:
"A. To a private room so she will not infect other patients and healthcare worke

Correct Answer: BA. To a private room so she will not infect other patients and health care workers � poses little or no threat

B. To a private room so she will not be infected by other patients and health care workers � CORRECT: protects patient from e

A 33-year-old male is being evaluated for possible acute leukemia. Which of the following would the nurse inquire about as a part of the assessment?"a. The client collects stamps as a hobby.b. The client recently lost his job as a postal worker.

c. The

Answer C is correct. Radiation treatment for other types of cancer can result in leukemia. Some hobbies and occupations involving chemicals are linked to leukemia, but not the ones in these answers; therefore, answers A and B are incorrect. Answer D is in

A child with leukemia is complaining of nausea. A nurse suspects that the nausea is related to the chemotherapy regimen. The nurse, concerned about the child's nutritional status, most appropriately would offer which of the following during this episode

Correct: 1.
With nausea, cool and clear liquids are better tolerated. Do not offer foods when the child is nauseated so he doesn't associate if with being sick. Support nutrition with oral supplements and foods high in proteins and calories

The nurse is caring for a 59-year-old woman who had surgery 1 day ago for removal of a suspected malignant abdominal mass. The patient is awaiting the pathology report. She is tearful and says that she is scared to die. The most effective nursing interve

Correct answer: D
Rationale: While the patient is waiting for diagnostic study results, the nurse should be available to actively listen to the patient's concerns and should be skilled in techniques that can engage the patient and the family members or s

Which of the following laboratory values could indicate that a child has leukemia?"1. WBCs 32,000/mm32. Platelets 300,000/mm33. Hemoglobin 15g/dL

4. Blood pH of 7.35

Correct: 1.1. YES! - A normal WBC count is approximately 4.5 mm3 - 11.0 mm3. In leukemia a high WBC count is diagnostic and is usually confirmed by a blood smear.

2-4. None of these indicate leukemia,

A client has developed oral mucositis as a result of radiation to the head and neck. The nurse shouls teach the client to incorporate which of the following measures in his or her daily home care routine?
a) oral hygiene should be performed in the morning

2) D
Oral mucositis (irritation, inflammation, and/or ulceration of the mucosa) commonly occurs in clients receiving radiation to the head and neck. Measures need to be taken to soothe the mucosa as well as provide effective cleansing of the oral cavity.

The nurse and the unlicensed assistive personnel (UAP) are caring for clients in a bone marrow transplantation unit. Which nursing task should the nurse delegate?"A. Take the hourly vital signs on a client receiving blood transfusions.

B. Monitor the in

Correct: A.Explanation:

A. After the first 15 minutes during which the client tolerates the blood transfusion, it is appropriate to ask the UAP to take the vital signs as long as the UAP has been given specific parameters for the vital signs. Any vital

The most common signs and symptoms of leukemia related to bone marrow involvement are which of the following?"A. Petechiae, fever, fatigueB. Headache, papilledema, irritabilityC. Muscle wasting, weight loss, fatigue

D. Decreased intracranial pressure,

Answer A is Correct.
Signs of infiltration of the bone marrow are petechiae from lowered platelet count, fever related to infection from the depressed number of effective leukocytes, and fatigue from the anemia.

A client, diagnosed with chronic lymphocytic leukemia, is admitted to the hospital for treatment of hemolytic anemia. Which of the following measures, if incorporated into the nursing care plan, would best address the patient's needs?
"1. Encourage activ

Correct: D.1. does not meet need for rest2. no info given about WBC or reverse isolation, on reverse isolation if neutrophil count is less than 500/mm33. needed for wound healing and resistance to infection, not best choice

4. primary problem activity

A client diagnosed with leukemia is being admitted for an induction course of chemotherapy. Which laboratory values indicate a diagnosis of leukemia?1. A left shift in the white blood cell count differential.

2. A large number of WBCs that decrease afte

Correct answer is 1.
1. A left shift indicates immature white blood cells are being produced and released into the circulating blood volume. This should be investigated for the malignant process of leukemia.

A pediatric nurse clinician is discussing the pathophysiology related to childhood leukemia with a class of nursing students. Which statement made by a nursing student indicates a lack of understanding of the pathophysiology of this disease? "
1. Normal b

4. Reed-sternberg Cell is found in Hodgkins

Which of the following findings yields a poor prognosis for a pediatric patient with leukemia? "1) Presence of a mediastinal mass2) Late CNS leukemia3) Normal WBC count at diagnosis

4) Disease presents between age 2 and 10

1) Presence of a mediastinal mass indicates a poor prognosis. The rest of the choices refer to diagnosis not prognosis.

The nurse writes a nursing problem of "altered nutrition" for a client diagnosed withleukemia who has received a treatment regimen of chemotherapy and radiation. Which nursing intervention should be implemented?
"1. Administer an antidiarrheal medication

Answer: 21. The nurse should administer an antiemetic prior to meals, not an antidiarrheal medication2. Serum albumin is a measure of the protein content in the blood that is derived form food eaten; albumin monitors nutritional status

3. Assessment of

A 43-year-old African American male is admitted with sickle cell anemia. The nurse plans to assess circulation in the lower extremities every 2 hours. Which of the following outcome criteria would the nurse use? "a. Body temperature of 99�F or less

b. To

Answer D is correct. It is important to assess the extremities for blood vessel occlusion in the client with sickle cell anemia because a change in capillary refill would indicate a change in circulation. Body temperature, motion, and sensation would not

The mother of a 5-year-old child asks the nurse questions regarding the importance of vigilant use of sunscreen. Which information is most important for the nurse to convey to the mother?
"A. Appropriate use of sunscreen decreases the risk of skin cancer

Correct: A.Appropriate use of sunscreen decreases the risk of skin cancer.While all of the answer choices are correct, recommending the use of sunscreen to decrease the incidence of skin cancer is the best response.Nursing Process: Implementation

Cate

A 4 yo is admitted for abdominal pain. She has been pale and excessively tired and is bruising easily. On physical exam, lymphadenopathy and hepatosplenomaegaly are noted. Diagnostic studies are being performed on the child because acute lymphocytic leuke

Correct: 3.
3 leukemia is a malignant increase in the number of leukocytes, usually at an immature stage, in the bone marrow. The confirmatory test is microscopic exam of bone marrow obtained by bone marrow aspirate and biopsy. a lumbar puncture may be d

Nursing considerations related to the administration of chemotherapeutic drugs include which of the following? "A. Anaphylaxis cannot occur, since the drugs are considered toxic to normal cells.
B. Infiltration will not occur unless superficial veins are

Correct: C 3. Chemotherapeutic agents can be extremely damaging to cells. Nurses experienced with the administration of vesicant drugs should beresponsible for giving these drugs and be prepared to treatextravasations if necessary.

1. Anaphylaxis is a

After a client with a potential diagnosis of leukemia is admitted to thehospital, the nurse should assess for which of the following? (Selectall that apply.)" "A. Reports of fatigue and weaknessB. An elevation in the leukocytes

especially neutrophils

Correct: A, CANSWER: Reports of fatigue and weakness Signs of bruising easilyRationale: General manifestations of leukemiaresult from anemia, infection, and bleeding. The client would complain

of fatigue and weakness and show signs of bruising. Leukem

After a client is admitted to the pediatric unit with a diagnosis of acute lymphocytic leukemia, the laboratory test indicates that the client is neutropenic. The nurse should perform which of the following?"
"A. advise the client to rest and avoid exert

Answer: BRationale: Neutropenia is a decreased number ofneutrophil cells in the blood which are responsible for the body'sdefense against infection. Rest and avoid exertion would be related to

erythrocytes and oxygen carrying properties. Monitoring th

The nurse is assessing a client diagnosed with acute myeloid leukemia. Which assessment data support this diagnosis?"1.) Fever and infections.2.) Nausea and vomiting.3.) Excessive energy and high platelet counts.

4.) Cervical lymph node enlargement and

Correct: 1.
1. Fever and infection are hallmark symptoms of leukemia. They occur because the bone marrow is unable to produce WBCs of the number and maturity needed to fight infection (CORRECT). 2. Nausea and vomiting are symptoms related to the treatmen

A bone marrow transplant is being consideredfor treatment of a patient with acute leukemia that has not responded to chemotherapy. In discussing the treatment with the patient, the nurse explains that

"a. hospitalization will be required for several wee

Correct Answer: A
The patient requires strict protective isolation to prevent infection for 2 to 4 weeks after HSCT while waiting for the transplanted marrow to start producing cells. The transplanted cells are infused through an IV line, so the transpla

A bone marrow transplant is being considered for treatment of a patient with acute leukemia that has not responded to chemotherapy. In discussing the treatment with the patient, the nurse explains that
a. hospitalization will be required for several weeks

A
Rationale: The patient requires strict protective isolation to prevent infection for 2 to 4 weeks after HSCT while waiting for the transplanted marrow to start producing cells. The transplanted cells are infused through an IV line, so the transplant is

After the nurse has explained the purpose of and schedule for chemotherapy to a 23-year-old patient who recently received a diagnosis of acute leukemia, the patient asks the nurse to repeat the information. Based on this assessment, which nursing diagnosi

C
Rationale: The patient who has a new cancer diagnosis is likely to have high anxiety, which may impact learning and require that the nurse repeat and reinforce information. The patient's history of a recent diagnosis suggests that infiltration of the le

A hospitalized patient who has received chemotherapy for leukemia develops neutropenia. Which observation by the RN caring for the patient indicates that the nurse should take action?a. The patient's visitors bring in some fresh peaches from home.

b. The

A
Rationale: Fresh, thinned-skin peaches are not permitted in a neutropenic diet because of the risk of bacteria being present. The patient should ambulate in the room rather than the hospital hallway to avoid exposure to other patients or visitors. Becau

Which action by a nursing assistant (NA) when caring for a patient who is pancytopenic indicates a need for the nurse to intervene?a. The NA assists the patient to use dental floss after eating.

b. The NA makes an oral rinse using 1 teaspoon of salt in a

A
Rationale: Use of dental floss is avoided in patients with pancytopenia because of the risk for infection and bleeding. The other actions are appropriate for oral care of a pancytopenic patient.

Which information noted by the nurse reviewing the laboratory results of a patient who is receiving chemotherapy is most important to report to the health care provider?a. Hemoglobin of 10 g/Lb. WBC count of 1700/�lc. Platelets of 65,000/�l

d. Serum cr

B
Rationale: Neutropenia places the patient at risk for severe infection and is an indication that the chemotherapy dose may need to be lower or that white blood cell (WBC) growth factors such as filgrastim (Neupogen) are needed. The other laboratory data

A chemotherapeutic agent known to cause alopecia is prescribed for a patient. To maintain the patient's self-esteem, the nurse plans toa. suggest that the patient limit social contacts until regrowth of the hair occurs.

b. encourage the patient to purcha

B
Rationale: The patient is taught to anticipate hair loss and to be prepared with wigs, scarves, or hats. Limiting social contacts is not appropriate at a time when the patient is likely to need a good social support system. The damage occurs at the hair

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