Question 1

A nurse is caring for a client with chronic myeloid leukemia (CML)who is neutropenic.Which interventions will the nurse implement to ensure this client's safety? Select all that apply.
A)Teach the client to maintain good personal hygiene.
B)Encourage the client to eat a diet low in protein.
C)Administer granulocyte colony-stimulating factor (G-CSF)as ordered.
D)Administer neutrophil colony-stimulating factor (N-CSF)as ordered.
E)Administer a prophylactic gram-negative antibiotic.

Accepted Answer

A)A client who is neutropenic has a decrease in the level of white blood cells (WBCs)and is susceptible to infection and/or disease. To ensure the safety of the client with neutropenia, the nurse will teach the client to maintain good personal hygiene, administer granulocyte colony-stimulating factor (G-CSF)as ordered, and administer a broad-spectrum antibiotic as ordered. The client should be taught to eat a diet high in protein, not low in protein.
B)A client who is neutropenic has a decrease in the level of white blood cells (WBCs)and is susceptible to infection and/or disease. To ensure the safety of the client with neutropenia, the nurse will teach the client to maintain good personal hygiene, administer granulocyte colony-stimulating factor (G-CSF)as ordered, and administer a broad-spectrum antibiotic as ordered. The client should be taught to eat a diet high in protein, not low in protein.
C)A client who is neutropenic has a decrease in the level of white blood cells (WBCs)and is susceptible to infection and/or disease. To ensure the safety of the client with neutropenia, the nurse will teach the client to maintain good personal hygiene, administer granulocyte colony-stimulating factor (G-CSF)as ordered, and administer a broad-spectrum antibiotic as ordered. The client should be taught to eat a diet high in protein, not low in protein.
D)A client who is neutropenic has a decrease in the level of white blood cells (WBCs)and is susceptible to infection and/or disease. To ensure the safety of the client with neutropenia, the nurse will teach the client to maintain good personal hygiene, administer granulocyte colony-stimulating factor (G-CSF)as ordered, and administer a broad-spectrum antibiotic as ordered. The client should be taught to eat a diet high in protein, not low in protein.
E)A client who is neutropenic has a decrease in the level of white blood cells (WBCs)and is susceptible to infection and/or disease. To ensure the safety of the client with neutropenia, the nurse will teach the client to maintain good personal hygiene, administer granulocyte colony-stimulating factor (G-CSF)as ordered, and administer a broad-spectrum antibiotic as ordered. The client should be taught to eat a diet high in protein, not low in protein.

Question 2

A client who presents with complaints of easily bruising,bleeding gums,and petechiae may be suffering from what complication of leukemia?
A)Thrombocytopenia
B)Anemia
C)Hepatomegaly
D)Neutropenia

Accepted Answer

Thrombocytopenia is a common complication of leukemia where the patient has a low platelet count, leading to easy bruising, bleeding gums, and petechiae. Anemia, hepatomegaly, and neutropenia may also occur in leukemia, but they do not typically present with these specific symptoms.

Question 3

A nurse is planning care for a client with leukemia.The nurse chooses "Risk for Bleeding" as the nursing diagnosis.Which interventions support this nursing diagnosis? Select all that apply.
A)Educate client to not strain during bowel movements.
B)Use nonelectric razor when providing grooming for client.
C)Limit parenteral injections.
D)Apply pressure to arterial puncture sites for 5 minutes.
E)Encourage client to deep breathe and huff cough frequently.

Accepted Answer

A)The client at risk for bleeding has specific interventions to which the nurse should adhere. The nurse should educate the client to not strain during bowel movements and to use an electric razor to avoid bleeding. The nurse should also limit the use of parenteral injections and apply 15 to 20 minutes of pressure to any arterial puncture sites. The nurse should discourage the client from forceful coughing to prevent further bleeding.
B)The client at risk for bleeding has specific interventions to which the nurse should adhere. The nurse should educate the client to not strain during bowel movements and to use an electric razor to avoid bleeding. The nurse should also limit the use of parenteral injections and apply 15 to 20 minutes of pressure to any arterial puncture sites. The nurse should discourage the client from forceful coughing to prevent further bleeding.
C)The client at risk for bleeding has specific interventions to which the nurse should adhere. The nurse should educate the client to not strain during bowel movements and to use an electric razor to avoid bleeding. The nurse should also limit the use of parenteral injections and apply 15 to 20 minutes of pressure to any arterial puncture sites. The nurse should discourage the client from forceful coughing to prevent further bleeding.
D)The client at risk for bleeding has specific interventions to which the nurse should adhere. The nurse should educate the client to not strain during bowel movements and to use an electric razor to avoid bleeding. The nurse should also limit the use of parenteral injections and apply 15 to 20 minutes of pressure to any arterial puncture sites. The nurse should discourage the client from forceful coughing to prevent further bleeding.
E)The client at risk for bleeding has specific interventions to which the nurse should adhere. The nurse should educate the client to not strain during bowel movements and to use an electric razor to avoid bleeding. The nurse should also limit the use of parenteral injections and apply 15 to 20 minutes of pressure to any arterial puncture sites. The nurse should discourage the client from forceful coughing to prevent further bleeding.

Question 4

The nurse is teaching a class at a local community center about decreasing risk factors for cancer.Which risk factors should the nurse include in the teaching regarding leukemia? Select all that apply.
A)Smoking
B)Diets low in fat
C)Exposure to infectious agents
D)Bloom syndrome
E)Decreased exercise

Accepted Answer

A)A higher incidence of leukemia is associated with chromosomal defects such as Bloom syndrome, exposure to infectious agents, and cigarette smoking. Low-fat diets are not a risk factor for leukemia, and neither is lack of exercise.
B)A higher incidence of leukemia associated with chromosomal defects such as Bloom syndrome, exposure to infectious agents, and chemical agents used to treat previous cancer, such as alkylating agents. Low-fat diets are not a risk factor for leukemia, and neither is lack of exercise.
C)A higher incidence of leukemia is associated with chromosomal defects such as Bloom syndrome, exposure to infectious agents, and cigarette smoking. Low-fat diets are not a risk factor for leukemia, and neither is lack of exercise.
D)A higher incidence of leukemia is associated with chromosomal defects such as Bloom syndrome, exposure to infectious agents, and cigarette smoking. Low-fat diets are not a risk factor for leukemia, and neither is lack of exercise.
E)A higher incidence of leukemia is associated with chromosomal defects such as Bloom syndrome, exposure to infectious agents, and cigarette smoking. Low-fat diets are not a risk factor for leukemia, and neither is lack of exercise.

Question 5

The nurse is planning care for a client with acute myeloid leukemia (AML).Which diagnoses are priorities for this client to minimize the risk of complications associated with AML? Select all that apply.
A)Risk for Infection
B)Ineffective Thermoregulation
C)Imbalanced Nutrition,Less than Body Requirements
D)Fluid Volume Excess
E)Risk for Bleeding

Accepted Answer

AML is a type of cancer that affects the blood and bone marrow, leading to an increased risk of infection and bleeding. Therefore, the priorities for this client are to minimize the risk of infection (A) and bleeding (E) by implementing appropriate infection control measures and monitoring for signs of bleeding. The other options, such as thermoregulation (B), nutrition (C), and fluid balance (D), may also be important but are not as high of a priority as infection and bleeding prevention.

Question 6

Which type of lung cancer typically spreads by local invasion?
A)Small-cell carcinoma
B)Adenocarcinoma
C)Squamous cell carcinoma
D)Large-cell carcinoma

Accepted Answer

Squamous cell carcinoma typically spreads by local invasion. It is the second most common type of lung cancer and is found in the cells that line the airways. It tends to grow near the surface of the lung and can spread to nearby tissues and organs.

Question 7

A nurse working in the pediatric intensive care unit (PICU)is caring for a child with leukemia.What is the most common type of leukemia in children?
A)Chronic lymphocytic leukemia
B)Acute lymphocytic (lymphoblastic)leukemia
C)Acute myeloid (myeloblastic)leukemia
D)Chronic myeloid (myelogenous)leukemia.

Accepted Answer

Acute lymphocytic leukemia (or lymphoblastic leukemia) is the most common type of leukemia in children, accounting for approximately 75% of all pediatric leukemia cases. Chronic lymphocytic leukemia is extremely rare in children, and acute myeloid and chronic myeloid leukemias are less common than acute lymphocytic leukemia in pediatric patients.

Question 8

Which individuals are more likely to develop lung cancer without a history of smoking?
A)An individual under age 50
B)An individual with a genetic abnormality on chromosome 6
C)An individual over age 50
D)An individual with a genetic abnormality on chromosome 8

Accepted Answer

Individuals with a genetic abnormality on chromosome 6 are more likely to develop lung cancer even without a history of smoking. Other risk factors for non-smokers include exposure to radon, air pollution, and secondhand smoke. Age is not a determining factor in non-smokers developing lung cancer. There is no significant correlation between lung cancer and genetic abnormalities on chromosome 8.

Question 9

A client is receiving chemotherapy for acute lymphocytic leukemia.While providing care for this client,which clinical manifestations would indicate tumor lysis syndrome? Select all that apply.
A)Thrombocytopenia
B)Cardiac arrhythmia
C)Respiratory distress
D)Changes in urine output
E)Upper-extremity edema

Accepted Answer

A)Tumor lysis causes a metabolic emergency. The release of intracellular contents into the circulation cause hyperkalemia, hyperuricemia, and hyperphosphatemia, which may lead to cardiac arrhythmias, renal failure, and even death. Thrombocytopenia occurs with a hematological emergency. Space-occupying lesions can cause respiratory distress and upper-extremity edema.
B)Tumor lysis causes a metabolic emergency. The release of intracellular contents into the circulation cause hyperkalemia, hyperuricemia, and hyperphosphatemia, which may lead to cardiac arrhythmias, renal failure, and even death. Thrombocytopenia occurs with a hematological emergency. Space-occupying lesions can cause respiratory distress and upper-extremity edema.
C)Tumor lysis causes a metabolic emergency. The release of intracellular contents into the circulation cause hyperkalemia, hyperuricemia, and hyperphosphatemia, which may lead to cardiac arrhythmias, renal failure, and even death. Thrombocytopenia occurs with a hematological emergency. Space-occupying lesions can cause respiratory distress and upper-extremity edema.
D)Tumor lysis causes a metabolic emergency. The release of intracellular contents into the circulation cause hyperkalemia, hyperuricemia, and hyperphosphatemia, which may lead to cardiac arrhythmias, renal failure, and even death. Thrombocytopenia occurs with a hematological emergency. Space-occupying lesions can cause respiratory distress and upper-extremity edema.
E)Tumor lysis causes a metabolic emergency. The release of intracellular contents into the circulation cause hyperkalemia, hyperuricemia, and hyperphosphatemia, which may lead to cardiac arrhythmias, renal failure, and even death. Thrombocytopenia occurs with a hematological emergency. Space-occupying lesions can cause respiratory distress and upper-extremity edema.

Question 10

The nurse is caring for a client in a community clinic who wishes to quit smoking.The client asks the nurse,"If I quit smoking,will my risk of lung cancer be the same as a nonsmoker?" Which is the best response by the nurse?
A)"No one knows for sure what the risk is for someone who quits smoking."
B)"Your risk of lung cancer will be equal to that of a nonsmoker."
C)"Your risk of lung cancer will decline if you quit,but it will remain higher than a nonsmoker's."
D)"Your risk of lung cancer will never drop because the damage has already been done."

Accepted Answer

Quitting smoking will decrease the risk of lung cancer, but it may not be equal to that of a nonsmoker as the damage done to the lungs and other organs may not be fully reversible. However, continuing to smoke will definitely increase the risk of lung cancer. It is important to encourage the client to quit smoking for overall health improvement, but it is also important to provide accurate information.

Question 11

The nurse is assessing several children with polyps in the colon and rectum.Which child is at highest risk of developing colorectal cancer in adulthood?
A)A 4-year-old with isolated juvenile polyps
B)A 6-month-old with diffuse juvenile polyposis of infancy
C)A 12-year-old with juvenile polyposis coli
D)A 7-year-old with adenomatous polyps

Accepted Answer

Juvenile polyposis coli is a rare autosomal dominant disease that is caused by a mutation in the SMAD4 or BMPR1A genes. Individuals with juvenile polyposis coli have a high risk of developing colorectal cancer, with the risk increasing with age. Isolated juvenile polyps are uncommon and usually do not develop into cancer. Diffuse juvenile polyposis of infancy is a severe form of the disease, but only a small percentage of affected individuals develop cancer. Adenomatous polyps are generally not considered a risk factor for colorectal cancer in childhood.

Question 12

A young school-age boy is admitted with newly diagnosed acute lymphocytic leukemia.The multidisciplinary team is meeting to plan care for this child and family.Which statement by the parents should receive priority in the nursing planning process?
A)"His brother is upset about the amount of time we are away from home."
B)"Can we plan a trip out of town sometime this summer?"
C)"We are afraid that he will dislodge his central line at school."
D)"How are we going to pay for his treatment?"

Accepted Answer

The priority statement from the parents is their fear that the child will dislodge his central line while at school. This is important to address as dislodging the line can cause significant complications for the child. The nursing team should focus on educating the child and school staff on how to safely manage the central line. The other statements are also important and should be addressed, but they are not an immediate priority.

Question 13

The nurse is assisting the healthcare provider with a bone marrow aspiration and biopsy on a client who has leukemia.The client also has thrombocytopenia.Upon completing the test,which intervention is a priority for the nurse?
A)Dispose of the equipment used,and clean the area properly.
B)Label and refrigerate the specimen obtained by the physician.
C)Hold pressure on the wound for approximately 5 minutes.
D)Make certain the client understands the purpose of the test.

Accepted Answer

The priority intervention for a client with thrombocytopenia after a bone marrow aspiration and biopsy is to hold pressure on the wound for approximately 5 minutes to minimize the risk of bleeding. Disposing of equipment and cleaning the area, labeling and refrigerating the specimen, and educating the client are important interventions but are not the priority in this situation.

Question 14

The nurse is caring for a client who is undergoing diagnostic tests to rule out lung cancer.The client asks the nurse why a computed tomography (CT)scan was ordered.What is the best response by the nurse?
A)"The doctor prefers this test."
B)"To rule out the possibility that your problems are caused by pneumonia."
C)"It is more specific in diagnosing your condition."
D)"Why are you concerned about this test?"

Accepted Answer

A CT scan is more specific in diagnosing lung cancer compared to other imaging tests such as X-rays, and can also provide information on the size, location, and spread of the tumor.

Question 15

The nurse is caring for a client with leukemia who is experiencing neutropenia as a result of chemotherapy.Which action should the nurse include in the plan of care for this client?
A)Replace hand hygiene with gloves.
B)Restrict visitors with communicable illnesses.
C)Restrict fluid intake.
D)Insert an indwelling urinary catheter to prevent skin breakdown.

Accepted Answer

Neutropenia, or low levels of neutrophils (a type of white blood cell), can make the client more susceptible to infections. Restricting visitors with communicable illnesses can help prevent the client from being exposed to infectious diseases. The other options are not related to preventing infections in a neutropenic client. Hand hygiene should still be practiced, but gloves should not replace it. Restricting fluid intake and inserting an indwelling urinary catheter are not indicated for preventing infections in a neutropenic client.

Question 16

The nurse is assessing an older adult client recently diagnosed with colorectal cancer.What information is important for the nurse to ask for when completing the geriatric assessment?
A)The names,addresses,and birthdates of all of the client's children
B)The client's food diary for the past month
C)A complete list of all medications and supplements the client is currently taking
D)Whether the client has ever had a gastrointestinal disorder that caused diarrhea

Accepted Answer

A complete list of medications and supplements is important to assess for potential drug interactions and contraindications with chemotherapy and other cancer treatments. The other options, while potentially important in assessing the overall health and well-being of the client, are not directly relevant to the diagnosis and treatment of colorectal cancer.

Question 17

An adult client reports to the nurse an inability to tolerate usual exercise and the feeling of fatigue.The client states that these symptoms have been gradual over time.Which physical assessment findings,along with the client's verbal complaints,would indicate chronic lymphocytic leukemia (CLL)? Select all that apply.
A)Joint pain
B)Pallor
C)Splenomegaly
D)Abnormal bleeding
E)Edema

Accepted Answer

A)The symptoms for CLL are insidious and occur over time, affecting older adults. The client may exhibit splenomegaly, pallor, edema, and lymphadenopathy. Bone and joint pain with abnormal bleeding are characteristics of acute myeloid leukemia (AML), which also occurs in older clients.
B)The symptoms for CLL are insidious and occur over time, affecting older adults. The client may exhibit splenomegaly, pallor, edema, and lymphadenopathy. Bone and joint pain with abnormal bleeding are characteristics of acute myeloid leukemia (AML), which also occurs in older clients.
C)The symptoms for CLL are insidious and occur over time, affecting older adults. The client may exhibit splenomegaly, pallor, edema, and lymphadenopathy. Bone and joint pain with abnormal bleeding are characteristics of acute myeloid leukemia (AML), which also occurs in older clients.
D)The symptoms for CLL are insidious and occur over time, affecting older adults. The client may exhibit splenomegaly, pallor, edema, and lymphadenopathy. Bone and joint pain with abnormal bleeding are characteristics of acute myeloid leukemia (AML), which also occurs in older clients.
E)The symptoms for CLL are insidious and occur over time, affecting older adults. The client may exhibit splenomegaly, pallor, edema, and lymphadenopathy. Bone and joint pain with abnormal bleeding are characteristics of acute myeloid leukemia (AML), which also occurs in older clients.

Question 18

A nurse is caring for a client recovering from a wedge resection of the left lung for a tumor.What would be appropriate goals for the nursing diagnosis of ineffective airway clearance? Select all that apply.
A)Minimize accumulation of fluid.
B)Participation in care by the client
C)Maintain a patent airway.
D)Maintain current weight.
E)Express feelings and concerns.

Accepted Answer

A) All of the outcomes for this client are viable, but appropriate outcomes for the diagnosis of ineffective airway clearance are maintaining a patent airway and minimizing the accumulation of fluid.
B) All of the outcomes for this client are viable, but appropriate outcomes for the diagnosis of ineffective airway clearance are maintaining a patent airway and minimizing the accumulation of fluid.
C) All of the outcomes for this client are viable, but appropriate outcomes for the diagnosis of ineffective airway clearance are maintaining a patent airway and minimizing the accumulation of fluid.
D) All of the outcomes for this client are viable, but appropriate outcomes for the diagnosis of ineffective airway clearance are maintaining a patent airway and minimizing the accumulation of fluid.
E) All of the outcomes for this client are viable, but appropriate outcomes for the diagnosis of ineffective airway clearance are maintaining a patent airway and minimizing the accumulation of fluid.

Question 19

A pediatric nurse is caring for a child with acute lymphoblastic leukemia (ALL).When providing education to the child's parents regarding this disease,which topics should the nurse include? Select all that apply.
A)ALL is characterized by abnormal proliferation of all bone marrow elements.
B)This form of leukemia is the most common type among children and adolescents.
C)Most cases of ALL result from the malignant transformation of B cells.
D)Malignant lymphocytes are able to effectively maintain immunity.
E)The onset of ALL is usually gradual.

Accepted Answer

The nurse should include information that ALL is the most common type of leukemia among children and that most cases result from the malignant transformation of B cells. Option A is incorrect because ALL is characterized by abnormal proliferation of lymphoid progenitor cells, not all bone marrow elements. Option D is incorrect because malignant lymphocytes are not able to maintain immunity effectively. Option E is also incorrect because the onset of ALL is usually rapid, not gradual.

Question 20

The nurse is planning care to address ineffective airway clearance for a client with lung cancer.Which interventions should the nurse include in the client's plan of care? Select all that apply.
A)Suction the airway as needed.
B)Help the client turn,cough,and deep breathe as needed.
C)Provide chest percussion as ordered.
D)Educate the client about smoking cessation.
E)Administer pneumococcal vaccine.

Accepted Answer

Suctioning the airway, helping the client turn, cough, and deep breathe, and providing chest percussion are all interventions that can directly address ineffective airway clearance in a client with lung cancer. Educating the client about smoking cessation and administering the pneumococcal vaccine may be important interventions for the client's overall health, but they are not specifically related to managing ineffective airway clearance.

Quiz 2: Cellular Regulation

A nurse is caring for a client with chronic myeloid leukemia (CML) who is neutropenic.Which interventions will the nurse implement to ensure this client's safety? Select all that apply.

A client who presents with complaints of easily bruising,bleeding gums,and petechiae may be suffering from what complication of leukemia?

A nurse is planning care for a client with leukemia.The nurse chooses "Risk for Bleeding" as the nursing diagnosis.Which interventions support this nursing diagnosis? Select all that apply.

The nurse is teaching a class at a local community center about decreasing risk factors for cancer.Which risk factors should the nurse include in the teaching regarding leukemia? Select all that apply.

The nurse is planning care for a client with acute myeloid leukemia (AML) .Which diagnoses are priorities for this client to minimize the risk of complications associated with AML? Select all that apply.

Which type of lung cancer typically spreads by local invasion?

A nurse working in the pediatric intensive care unit (PICU) is caring for a child with leukemia.What is the most common type of leukemia in children?

Which individuals are more likely to develop lung cancer without a history of smoking?

A client is receiving chemotherapy for acute lymphocytic leukemia.While providing care for this client,which clinical manifestations would indicate tumor lysis syndrome? Select all that apply.

The nurse is caring for a client in a community clinic who wishes to quit smoking.The client asks the nurse,"If I quit smoking,will my risk of lung cancer be the same as a nonsmoker?" Which is the best response by the nurse?

The nurse is assessing several children with polyps in the colon and rectum.Which child is at highest risk of developing colorectal cancer in adulthood?

A young school-age boy is admitted with newly diagnosed acute lymphocytic leukemia.The multidisciplinary team is meeting to plan care for this child and family.Which statement by the parents should receive priority in the nursing planning process?

The nurse is assisting the healthcare provider with a bone marrow aspiration and biopsy on a client who has leukemia.The client also has thrombocytopenia.Upon completing the test,which intervention is a priority for the nurse?

The nurse is caring for a client who is undergoing diagnostic tests to rule out lung cancer.The client asks the nurse why a computed tomography (CT) scan was ordered.What is the best response by the nurse?

The nurse is caring for a client with leukemia who is experiencing neutropenia as a result of chemotherapy.Which action should the nurse include in the plan of care for this client?

The nurse is assessing an older adult client recently diagnosed with colorectal cancer.What information is important for the nurse to ask for when completing the geriatric assessment?

A nurse is caring for a client recovering from a wedge resection of the left lung for a tumor.What would be appropriate goals for the nursing diagnosis of ineffective airway clearance? Select all that apply.

A pediatric nurse is caring for a child with acute lymphoblastic leukemia (ALL) .When providing education to the child's parents regarding this disease,which topics should the nurse include? Select all that apply.

The nurse is planning care to address ineffective airway clearance for a client with lung cancer.Which interventions should the nurse include in the client's plan of care? Select all that apply.