Nokea
A patient has been found to have an indolent neoplasm. The nurse should recognize what implication of this condition?
- A. The patient faces a significant risk of malignancy.
- B. The patient has a myeloid form of leukemia.
- C. The patient has a lymphocytic form of leukemia.
- D. The patient has a major risk factor for hemophilia.
Correct Answer: A
Rationale: Indolent neoplasms have the potential to develop into a neoplasm, but this is not always the case. The patient does not necessarily have, or go on to develop, leukemia. Indolent neoplasms are unrelated to the pathophysiology of hemophilia.
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A 60-year-old patient with chronic myeloid leukemia will be treated in the home setting and the nurse is preparing appropriate health education. What topic should the nurse emphasize?
- A. The importance of adhering to the prescribed drug regimen
- B. The need to ensure that vaccinations are up to date
- C. The importance of daily physical activity
- D. The need to avoid shellfish and raw foods
Correct Answer: A
Rationale: Nurses need to understand that the effectiveness of the drugs used to treat CML is based on the ability of the patient to adhere to the medication regimen as prescribed. Adherence is often incomplete, thus this must be a focus of health education. Vaccinations normally would not be administered during treatment and daily physical activity may be impossible for the patient. Dietary restrictions are not normally necessary.
A nurse is writing the care plan of a patient who has been diagnosed with myelofibrosis. What nursing diagnoses should the nurse address? Select all that apply.
- A. Disturbed Body Image
- B. Impaired Mobility
- C. Imbalanced Nutrition: Less than Body Requirements
- D. Acute Confusion
- E. Risk for Infection
Correct Answer: A,B,C,E
Rationale: The profound splenomegaly that accompanies myelofibrosis can impact the patients body image and mobility. As well, nutritional deficits are common and the patient is at risk for infection. Cognitive effects are less common.
A nurse is caring for a patient who has a diagnosis of acute leukemia. What assessment most directly addresses the most common cause of death among patients with leukemia?
- A. Monitoring for infection
- B. Monitoring nutritional status
- C. Monitor electrolyte levels
- D. Monitoring liver function
Correct Answer: A
Rationale: In patients with acute leukemia, death typically occurs from infection or bleeding. Compromised nutrition, electrolyte imbalances, and impaired liver function are all plausible, but none is among the most common causes of death in this patient population.
An oncology nurse is providing health education for a patient who has recently been diagnosed with leukemia. What should the nurse explain about commonalities between all of the different subtypes of leukemia?
- A. The different leukemias all involve unregulated proliferation of white blood cells.
- B. The different leukemias all have unregulated proliferation of red blood cells and decreased bone marrow function.
- C. The different leukemias all result in a decrease in the production of white blood cells.
- D. The different leukemias all involve the development of cancer in the lymphatic system.
Correct Answer: A
Rationale: Leukemia commonly involves unregulated proliferation of white blood cells. Decreased production of red blood cells is associated with anemias. Decreased production of white blood cells is associated with leukopenia. The leukemias are not characterized by their involvement with the lymphatic system.
A 77-year-old male is admitted to a unit with a suspected diagnosis of acute myeloid leukemia (AML). When planning this patients care, the nurse should be aware of what epidemiologic fact?
- A. Early diagnosis is associated with good outcomes.
- B. Five-year survival for older adults is approximately 50%.
- C. Five-year survival for patients over 75 years old is less than 2%.
- D. Survival rates are wholly dependent on the patients pre-illness level of health.
Correct Answer: C
Rationale: The 5-year survival rate for patients with AML who are 50 years of age or younger is 43%; it drops to 19% for those between 50 and 64 years, and drops to 1.6% for those older than 75 years. Early diagnosis is beneficial, but is nonetheless not associated with good outcomes or high survival rates. Pre-illness health is significant, but not the most important variable.