Nokea
A child is being evaluated for possible leukemia. Which assessment finding is most likely to be present?
- A. Numerous bruises on the child's body
- B. Ruddy complexion
- C. Diarrhea and vomiting
- D. Chest pain
Correct Answer: A
Rationale: Numerous bruises are common in leukemia due to decreased platelets from bone marrow failure.
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The 33-year-old client diagnosed with Stage IV Hodgkin’s lymphoma is at the five (5)-year remission mark. Which information should the nurse teach the client?
- A. Instruct the client to continue scheduled screenings for cancer.
- B. Discuss the need for follow-up appointments every five (5) years.
- C. Teach the client that the cancer risk is the same as for the general population.
- D. Have the client talk with the family about funeral arrangements.
Correct Answer: A
Rationale: Post-remission Hodgkin’s requires ongoing cancer screenings (A) due to recurrence/second cancer risk. Follow-ups are more frequent than 5 years (B), risk remains elevated (C), and funeral plans (D) are premature.
The nurse is caring for the client following a total laryngectomy for treatment of laryngeal cancer. The nurse should plan consultations with which members of the multidisciplinary team?
- A. Physical therapist
- B. Dietitian
- C. Speech therapist
- D. Dentist
- E. Occupational therapist
- F. Social worker
Correct Answer: A, B, C, F
Rationale: Total laryngectomy is removal of the entire larynx as well as the hyoid bone, the true vocal cords, the false vocal cords, the epiglottis, the cricoid cartilage, and two to three tracheal rings. The physical therapist is needed for neck exercises. B. The dietitian is needed to ensure adequacy of oral intake. C. The speech therapist is needed for other forms of communication and swallowing. D. The dentist is not routinely consulted when caring for a laryngectomy client. E. An occupational therapist is not routinely consulted when caring for a laryngectomy client. F. The social worker is needed for contact with outside resources to assist the client in ongoing needs.
The client is diagnosed with leukemia and has leukocytosis. Which laboratory value would the nurse expect to assess?
- A. An elevated hemoglobin.
- B. A decreased sedimentation rate.
- C. A decreased red cell distribution width.
- D. An elevated white blood cell count.
Correct Answer: D
Rationale: Leukocytosis in leukemia causes elevated WBCs (D). Hb (A) is low, ESR (B) is elevated, and RDW (C) is unrelated.
Which of the following assessment findings should alert the nurse that the elderly client should be evaluated for pernicious anemia?
- A. Clubbing of the nails
- B. Bloody stools
- C. Beefy-red tongue
- D. Enlarged lymph nodes
Correct Answer: C
Rationale: A beefy-red tongue is a classic symptom of pernicious anemia due to vitamin B12 deficiency.
The client is diagnosed with hemophilia. Which safety precaution should the nurse encourage?
- A. Wear helmets and pads during contact sports.
- B. Take antibiotics prior to any dental work.
- C. Keep clotting factor VIII on hand at all times.
- D. Use ibuprofen, an NSAID, for mild pain.
Correct Answer: C
Rationale: Hemophilia requires factor VIII availability (C) for bleeding emergencies. Contact sports (A) are risky, antibiotics (B) are for endocarditis, and ibuprofen (D) increases bleeding.