Nokea
The nurse completed teaching the client who had a bone marrow transplant (BMT). Which statement by the client indicates the client misunderstood the expected changes following a BMT?
- A. “I may gain weight from my immunosuppressant medication.”
- B. “Sterility can occur from the chemotherapy and radiation.”
- C. “I may have vision changes from the total body irradiation.”
- D. “Changes to my mouth could include a white, patchy tongue.”
Correct Answer: D
Rationale: A. A common side effect of immunosuppressant medications is weight gain. B. Sterility can occur as a result of chemotherapy and the total body irradiation after BMT. C. Changes in vision are common as a result of the total body irradiation after BMT. D. A white, patchy tongue is a sign of a fungal infection with Candidiasis albicans and would not be an expected change.
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A young man who has infectious mononucleosis asks what the treatment is for his condition. What is the best response for the nurse to make?
- A. You will receive large doses of antibiotics for the next 10 days.'
- B. Rest and good nutrition are the best things you can do.'
- C. You will be given an antiviral agent that will help to control the symptoms.'
- D. You will probably be given steroid medications for several months.'
Correct Answer: B
Rationale: Rest and good nutrition support recovery from infectious mononucleosis, a viral illness with no specific antiviral or steroid treatment.
The client who received 50 mL from a unit of whole blood has low back pain. In response to this client’s symptom, which action should be taken by the nurse first?
- A. Reposition the client.
- B. Assess the pain further.
- C. Administer an analgesic.
- D. Stop the blood transfusion.
Correct Answer: D
Rationale: A. Repositioning focuses on treating the client’s back pain and not on the blood transfusion, which could be the cause of the back pain. B. Further assessment should occur after stopping the blood transfusion. C. The client may need an analgesic for pain control, but this should occur after stopping the blood transfusion. D. Low back pain is a symptom of a potentially life-threatening acute hemolytic reaction. The pain is caused from agglutination of RBCs in the kidneys and renal vasoconstriction. Hemolytic reactions occur most often within the first 50 mL of the infusion.
The client diagnosed with leukemia has received a bone marrow transplant. The nurse monitors the client’s absolute neutrophil count (ANC). What is the client’s neutrophil count if the WBCs are 2.2 (x103/mm3), neutrophils are 25%, and bands are 5%?
Correct Answer: 660
Rationale: ANC = WBC × (neutrophils% + bands%). WBC = 2,200/mm3, neutrophils = 25%, bands = 5%. ANC = 2,200 × (0.25 + 0.05) = 2,200 × 0.3 = 660/mm3.
A child who has leukemia is to have a bone marrow biopsy performed. How will the child be positioned for this procedure?
- A. On his side with the top knee flexed
- B. Prone
- C. Modified Trendelenburg position
- D. On his back with his head elevated 30 degrees
Correct Answer: B
Rationale: The prone position is used for a bone marrow biopsy from the iliac crest to access the site safely.
Which interrelated psychological concept is priority for the nurse caring for a client diagnosed with leukemia?
- A. Comfort.
- B. Stress.
- C. Grieving.
- D. Coping.
Correct Answer: C
Rationale: Leukemia’s life-threatening nature makes grieving (C) a priority, addressing loss of health. Comfort (A), stress (B), and coping (D) are secondary.