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A patient with a diagnosis of acute myeloid leukemia (AML) is being treated with induction therapy on the oncology unit. What nursing action should be prioritized in the patients care plan?
- A. Protective isolation and vigilant use of standard precautions
- B. Provision of a high-calorie, low-texture diet and appropriate oral hygiene
- C. Including the family in planning the patients activities of daily living
- D. Monitoring and treating the patients pain
Correct Answer: A
Rationale: Induction therapy causes neutropenia and a severe risk of infection. This risk must be addressed directly in order to ensure the patients survival. For this reason, infection control would be prioritized over nutritional interventions, family care, and pain, even though each of these are important aspects of nursing care.
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A nurse at a long-term care facility is amending the care plan of a resident who has just been diagnosed with essential thrombocythemia (ET). The nurse should anticipate the administration of what medication?
- A. Dalteparin
- B. Allopurinol
- C. Hydroxyurea
- D. Hydrochlorothiazide
Correct Answer: C
Rationale: Hydroxyurea is effective in lowering the platelet count for patients with ET. Dalteparin, allopurinol, and HCTZ do not have this therapeutic effect.
A young adult patient has received the news that her treatment for Hodgkin lymphoma has been deemed successful and that no further treatment is necessary at this time. The care team should ensure that the patient receives regular health assessments in the future due to the risk of what complication?
- A. Iron-deficiency anemia
- B. Hemophilia
- C. Hematologic cancers
- D. Genitourinary cancers
Correct Answer: C
Rationale: Survivors of Hodgkin lymphoma have a high risk of second cancers, with hematologic cancers being the most common. There is no consequent risk of anemia or hemophilia, and hematologic cancers are much more common than GU cancers.
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.
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 recognizes a patients risk for fluid imbalance while the patient is undergoing treatment for leukemia. What relevant assessments should the nurse include in the patients plan of care? Select all that apply.
- A. Monitoring the patients electrolyte levels
- B. Monitoring the patients hepatic function
- C. Measuring the patients weight on a daily basis
- D. Measuring and recording the patients intake and output
- E. Auscultating the patients lungs frequently
Correct Answer: A,C,D,E
Rationale: Assessments that relate to fluid balance include monitoring the patients electrolytes, auscultating the patients chest for adventitious sounds, weighing the patient daily, and closely monitoring intake and output. Liver function is not directly relevant to the patients fluid status in most cases.