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Management of Patients with non-malignant Hematologic disorders

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Which nursing intervention is most appropriate for a client with MM
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Preventing bone injury
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An elderly client is hospitalized for induction of chemotherapy to treat leukemia. The client reports fatigue to the nurse. What nursing intervention would best address the client’s fatigue
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Assist the client to sit in a chair for meals
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A client with leukemia is being discharged from the hospital to hospice care. Which statement by the client indicates the client has not achieved the goal for the nursing diagnosis Spiritual distress
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I do not understand why this happened to me
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The oncology advanced practice nurse is assessing a client with leukemia. How would the oncology APN assess for enlargement and tenderness over the liver and spleen?
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By palpating the abdomen
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Which of the following is only curative treatment for chronic myeloid leukemia (CML)
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Allogeneic steam cell transplant
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When assessing a female client with a disorder of the hematopoietic or the lymphatic system, which assessment is most essential
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Health history, such as bleeding, fatigue or fainting
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Which statement best describes the function of stem cells in the bone marrow
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Produce all blood cells
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For a client with Hodgkin lymphoma, who is at a risk for ineffective airway clearance and impaired gas exchange, the nurse places the client in a high Fowler’s position to
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Increase lung expansion
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Which statement indicates the client understands teaching about induction therapy for leukemia
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I will be in the hospital for several weeks
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A client who is undergoing chemotherapy for AML reports pain in the low back. What is the nurse’s first action
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Assess renal function
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A client presents with peripheral neuropathy and hypothesis of the feet. What is the best nursing intervention
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Assess for signs of injury
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A client with MM is complaint about pain. What interventions will the nurse give the client. To help reduce pain during activity
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Do not lift more than 10 pounds
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The nurse is assessing several clients. Which client does the nurse determine is most likely to have Hodgkin lymphoma?
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The client with enlarged lymph nodes in the neck
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A patient with acute myeloid leukemia has a neutrophil count that persists at less than 100 mm3. What should the nurse cautiously monitor this patient for
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Infection
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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 al that apply
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Reduce exposure to excessive sunlight Smoking cessation Decrease alcohol intake
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Clinical assessment of a patient with AML includes observing for signs of infection, the major cause of earth for AML . The nurse should assess for indicators of
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Splenomegaly
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The nurse is aware the CLL, a common malignancy in those older than 60, has an early stage and a late stage. The nurse assesses a patient for late stage CLL by looking for
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Thrombocytopenia
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The nurse practitioner suspects that a patient has MM based on his major presenting symptom and the analysis of his laboratory results. Select the classic symptom for this disease
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Bone pain in the back of the ribs
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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
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Excess of immature leukocytes
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A client has been diagnosed with polycythemia Vera. It is most important for the nurse to teach the client about
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Maintaining adequate blood pressure control
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A client is receiving radiation therapy for lesions in the abdomen from non-Hodgkin;s lymphoma. Because of the effects of the radiation treatments, the nurse now assesses for
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Diarrheal stools
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A 40 year old client has multiple myeloma. Prior to starting treatment with thalidomide (thalomid) it is most important for the nurse to
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Contract with the client regarding birth control methods
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The clinic nurse is caring for a client diagnosed with leukopenia. What does the nurse know this client has
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A general education in all white blood cells
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The nurse is assisting the client with MM to ambulated. What is the most important nursing diagnosis to help prevent fractures in this client
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Safety
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What is the rationale for the classification of leukemia
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Which bone marrow stem cell is dysfunctional
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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 characteristics of erythrocytosis
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Polycythemia vera
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Which nursing intervention should be incorporated into the plan of care to manage the delayed clotting process in a client with leukemia
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Apply prolonged pressure to needle sites or other sources of eternal bleeding
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A client is receiving chemotherapy for acute myeloid leukemia and has poor nutritional intake. The first action of the nurse is to
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Ask “are you experiencing nausea”
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The hospitalized client is experiencing gastrointestinal bleeding. Laboratory test results show that the client platelets are 9000mm3. The client is prednisone and azathioprine (imuran) the nurse
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Performs a neurological assessment with vital signs
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Which of the following are complications related to polycythemia vera? Select all that apply
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CVA MI Ulcers Hematuria
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A 48 year old female recently diagnosed with leukemia presents with increased immature lymphocytes, decreased granulocytes and normal erythrocytes. The client most likely has which type of leukemia
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Chronic lymphatic leukemia
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A client was admitted to the hospital with a pathological 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?
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Multiple myeloma
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Which term is used to refer to a primitive cell that is capable of self-replication and differentiation
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Stem cell
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A client has completed induction therapy and has diarrhea and severe mucositis. What is the appropriate nursing goal?
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Maintain nutrition
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What assessment finding best indicates that the client has recovered from induction therapy?
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Neutrophil and platelet counts within normal limits
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The nurse is teaching a client with acute lymphocytic leukemia about therapy. What statement should be included in the plan of care
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Intrathecal chemotherapy is used primarily as preventive therapy
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A patient with acute myeloid leukemia 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?
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Graft versus host disease
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The nurse is performing an assessment on a patient with acute myeloid leukemia (AML) and observes multiple areas of ecchymosis and petechiae. What lab study should the nurse be concerned about?
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Platelet count of 9000mm3
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A nurse assesses a patient who has been diagnosed with DIC. Which of the following indicators are consistent with this diagnosis? Select all that apply
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Cyanosis in the extremities Dyspnea and hypoxia Increased blood area use nitrogen (BUN) and creatinine
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A nurse prepares teaching for a group of clients with chronic myeloid leukemia (CML). When planning the teaching on a medication adherence, which factors associated with lower oral therapy adherence will the nurse keep in mind? Select all that apply
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Living alone Low socioeconomic status Not participating in a clinical trial Taking medication independent of meals
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A nurse reviews the lab results of a client with PV. Which findings will the nurse find. Select all that apply
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Decreased erythropoietin Increased hemoglobin
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A client with PV presents to the primary care clinic for an annual physical. Which health care provider prescriptions does the nurse recognize as preventive measures to prevent thrombosis in the client. Select all that apply
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Statin therapy Beta blocker therapy
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A nurse is caring for an asymptomatic client with acute myelogenous leukemia. The client has a total WBC count of 0, a platelet count of 3,000mm2 and a hemoglobin level of 9mg/dL. He has a single lumen central venous catheter in place and physician has ordered the nurse to administer imipenem cilastatin (Primaxin) 500 mg every 8 hours, transfuse 1 unit packed RBC, give amphotericin B (Fungizone) 40 mg IV over 4 hours and transfuse 2 pheresis units of platelets. In what order should the nurse infuse these medications and blood products?
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Platelets, imipenem cilastatin, amphotericin B, packed RBCs
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When assessing a female client with a disorder of the hematopoietic or the lymphatic system, which assessment is most essential
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Health history, such as bleeding, fatigue or fainting
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Which statement best describes the function of stem cells in the bone marrow
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Produce all blood cells
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For a client with Hodgkin lymphoma, who is at risk for ineffective airway clearance and impaired gas exchange, the nurse places the client in a high Fowler’s position to
answer

Increase lung expansion
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Which statement indicates the client has understands teachings about induction therapy for leukemia
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I will be in the hospital for several weeks
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A client with leukemia has developed a cough and increased fatigue. What is the primary nursing intervention
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Evaluate the client for potential infection
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The nurse is assessing several clients. Which client does the nurse determine is most likely to have Hodgkin lymphoma
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The client with enlarged lymph nodes in the neck
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A patient with acute myeloid leukemia (AML) has a neutrophil count that persists at less than 100/mm3. What should the nurse cautiously monitor this patient for
answer

Infection
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The nurse is aware that chronic lymphocytic leukemia, a common malignancy in those older than 60, has an early stage and a late stage. The nurse assesses a patient for late stage CLL by looking for
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Thrombocytopenia
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A nurse is teaching a client with MM about the therapeutic benefits of radiation therapy. Which statements will the nurse include in the teaching. Select all that apply
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It helps to strengthen the bone It helps to decrease the bone pain
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A nurse has established for a client the nursing diagnosis of risk for infection. Which of the following interventions would the nurse include in the plan of care for this client? Select all answers that apply.
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Encourage the client to take deep breath every 4 hours while awake Assess skin and mucous membrane every shift Auscultate lung sounds every shift and prn
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The clinic nurse is caring for client diagnosed with leukopenia. What does the nurse know this client has
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A general reduction in all white blood cells
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Which term refers to a form of white blood cell involved in immune response
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Lymphocyte
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Which assessment findings support the client’s diagnosis of acute myeloid leukemia? Select all that apply
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Weakness and fatigue Petechiae Enlarged lymph nodes Bone pain
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After chemotherapy for AML, what interventions will best to help to prevent renal complications. Select all that apply
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Increase hydration Administer allopurinol Administer rasburicase
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A client presents with peripheral neuropathy and hypothesis of the feet. What is the best nursing intervention
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Assess for signs of injury
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The nurse is caring for a patient with chronic CML who is taking gleevec. In what phase of leukemia does the nurse understand that this medication is most useful to induce remission
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Chronic
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The nurse is assessing a patient with polycythemia vera. What skin assessment data would the nurse determine is a normal finding for this patient
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Ruddy complexion
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A patient is schedule for a test to help confirm the diagnosis fo AML. Which of the following is the result that the nurse knows is consistent with the diagnosis
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Excess of immature blast cells
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The nurse cares for a client with AML with severe bone pain. What pathophysiological concept does the nurse understand is the reason for the client’s pain
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Bone marrow expans
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A nurse is providing teaching to a client who will undergo chemotherapy and radiation prior to hematopoietic stem cell transplantation for AML. What statement will the nurse use to describe the purpose of chemotherapy and radiation
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These therapies destroy the ability of your body to produce blood cells inside your bone marrow
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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
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Cervical