Acute Leukemia NCLEX Exam Preparation MCQ Quiz
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A 33-year-old male is being evaluated for possible acute leukemia. Which of the following would the nurse inquire about as a part of the assessment?
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The client collects stamps as a hobby.
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The client recently lost his job as a postal worker.
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The client had radiation for treatment of Hodgkin’s disease as a teenager.
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The client’s brother had leukemia as a child.
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Are you a person who has a good understanding of acute leukemia and its related concepts? If yes, then this interesting MCQ quiz about Acute Leukemia NCELX Exam Preparation will be very helpful in testing your knowledge of this subject. All you have to do is choose the correct answer for every question. Sounds easy, right? So, let's see how See moremuch you can score on this test. Good luck! Do share the quiz with friends if you find the MCQs useful.
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- 2.
An African American client is admitted with acute leukemia. The nurse is assessing for signs and symptoms of bleeding. Where is the best site for examining for the presence of petechiae?
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The abdomen
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The thorax
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The earlobes
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The soles of the feet
Correct Answer
A. The soles of the feetExplanation
The soles of the feet are the best site for examining for the presence of petechiae in this case. Petechiae are small, pinpoint-sized red or purple spots on the skin that occur due to bleeding under the skin. In a client with acute leukemia, petechiae may be present as a result of low platelet count or abnormal clotting factors. The soles of the feet are commonly checked for petechiae because they are less likely to be exposed to trauma or pressure, making any petechiae found in this area more indicative of a bleeding disorder.Rate this question:
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- 3.
A client with acute leukemia is admitted to the oncology unit. Which of the following would be most important for the nurse to inquire?
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"Have you noticed a change in sleeping habits recently?"
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"Have you had a respiratory infection in the last 6 months?"
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"Have you lost weight recently?"
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"Have you noticed changes in your alertness?"
Correct Answer
A. "Have you had a respiratory infection in the last 6 months?"Explanation
The nurse should inquire about a respiratory infection in the last 6 months because acute leukemia can weaken the immune system, making the client more susceptible to infections. Infections can be life-threatening for clients with leukemia, so it is crucial for the nurse to assess if the client has had any recent respiratory infections to determine the need for further interventions or precautions to prevent infection.Rate this question:
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- 4.
Which of the following would be the priority nursing diagnosis for the adult client with acute leukemia?
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Oral mucous membrane, altered related to chemotherapy
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Risk for injury related to thrombocytopenia
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Fatigue related to the disease process
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Interrupted family processes related to life-threatening illness of a family member
Correct Answer
A. Risk for injury related to thrombocytopeniaExplanation
The priority nursing diagnosis for the adult client with acute leukemia would be "Risk for injury related to thrombocytopenia." Thrombocytopenia is a common complication of leukemia, characterized by a low platelet count. This puts the client at a higher risk for bleeding and injury. Therefore, the priority nursing diagnosis would be focused on preventing and managing bleeding episodes to ensure the client's safety.Rate this question:
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- 5.
A 4-year-old is admitted with acute leukemia. It will be most important to monitor the child for:
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Abdominal pain and anorexia
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Fatigue and bruising
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Bleeding and pallor
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Petechiae and mucosal ulcers
Correct Answer
A. Bleeding and pallorExplanation
In acute leukemia, the bone marrow produces abnormal white blood cells that crowd out healthy cells, leading to a decrease in red blood cells and platelets. This can result in bleeding and pallor. Bleeding occurs due to low platelet count, while pallor is caused by a decrease in red blood cells, leading to anemia. Monitoring for these symptoms is crucial to detect any worsening of the condition and to provide appropriate interventions such as blood transfusions or medications to stimulate blood cell production.Rate this question:
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- 6.
What is the peak age range in acquiring acute lymphocytic leukemia (ALL)?
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4 to 12 years.
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20 to 30 years
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40 to 50 years
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60 to 70 years
Correct Answer
A. 4 to 12 years.Explanation
Acute lymphocytic leukemia (ALL) is a type of cancer that affects the blood and bone marrow. It is more commonly found in children than in adults. The peak age range for acquiring ALL is between 4 to 12 years. This means that children between these ages are more likely to develop ALL compared to other age groups.Rate this question:
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- 7.
Marie with acute lymphocytic leukemia suffers from nausea and headache. These clinical manifestations may indicate all of the following except
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Effects of radiation
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Chemotherapy side effects
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Meningeal irritation
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Gastric distension
Correct Answer
A. Gastric distensionExplanation
The clinical manifestations of nausea and headache in a patient with acute lymphocytic leukemia can be attributed to various factors. Chemotherapy side effects are commonly associated with nausea and headache. Meningeal irritation can cause headaches but is less likely to cause nausea. Effects of radiation can also cause nausea and headache. However, gastric distension, which refers to the bloating of the stomach due to excessive gas or fluid accumulation, is not typically associated with nausea and headache in the context of leukemia.Rate this question:
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- 8.
The nurse is reviewing the laboratory report of a client who underwent a bone marrow biopsy. The finding that would most strongly support a diagnosis of acute leukemia is the existence of a large number of immature:
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Lymphocytes
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Thrombocytes
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Reticulocytes
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Leukocytes
Correct Answer
A. LeukocytesExplanation
The finding that would most strongly support a diagnosis of acute leukemia is the existence of a large number of immature leukocytes. Acute leukemia is a type of cancer that starts in the bone marrow and causes the production of immature white blood cells. These immature leukocytes, also known as blasts, are not fully developed and cannot carry out their normal functions. Therefore, the presence of a large number of immature leukocytes in the laboratory report suggests a disruption in the normal production of white blood cells, which is a characteristic feature of acute leukemia.Rate this question:
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- 9.
Francis with leukemia has neutropenia. Which of the following functions must frequently assessed?
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Blood pressure
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Bowel sounds
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Heart sounds
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Breath sounds
Correct Answer
A. Breath soundsExplanation
Patients with neutropenia are at a higher risk of developing respiratory infections due to a weakened immune system. Therefore, it is important to frequently assess their breath sounds to detect any signs of respiratory distress or infection.Rate this question:
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- 10.
Situation: Stacy is diagnosed with acute lymphoid leukemia (ALL) and beginning chemotherapy. Stacy is discharged from the hospital following her chemotherapy treatments. Which statement of Stacy’s mother indicated that she understands when she will contact the physician?
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“I should contact the physician if Stacy has difficulty in sleeping”.
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“I will call my doctor if Stacy has persistent vomiting and diarrhea”.
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“My physician should be called if Stacy is irritable and unhappy”.
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“Should Stacy have continued hair loss, I need to call the doctor”.
Correct Answer
A. “I will call my doctor if Stacy has persistent vomiting and diarrhea”.Explanation
The correct answer is "I will call my doctor if Stacy has persistent vomiting and diarrhea". This statement indicates that Stacy's mother understands that she should contact the physician if Stacy experiences persistent vomiting and diarrhea, which can be side effects of chemotherapy. It shows that she is aware of the potential complications and is prepared to seek medical attention if necessary.Rate this question:
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- 11.
The laboratory results of the client with leukemia indicate bone marrow depression. The nurse should encourage the client to:
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Increase his activity level and ambulate frequently
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Sleep with the head of his bed slightly elevated
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Drink citrus juices frequently for nourishment
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Use a soft toothbrush and electric razor
Correct Answer
A. Use a soft toothbrush and electric razorExplanation
The client with leukemia has bone marrow depression, which can lead to a decreased production of platelets and an increased risk of bleeding. Using a soft toothbrush and electric razor can help prevent injury to the gums and skin, reducing the risk of bleeding. Increasing activity level and ambulating frequently may increase the risk of injury and bleeding. Sleeping with the head of the bed slightly elevated and drinking citrus juices do not directly address the risk of bleeding associated with bone marrow depression.Rate this question:
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- 12.
A client jokes about his leukemia even though he is becoming sicker and weaker. The nurse’s most therapeutic response would be:
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“Your laugher is a cover for your fear.”
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“He who laughs on the outside, cries on the inside.”
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“Why are you always laughing?”
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“Does it help you to joke about your illness?”
Correct Answer
A. “Does it help you to joke about your illness?”Explanation
The nurse's most therapeutic response would be "Does it help you to joke about your illness?" because it shows empathy and encourages the client to express their feelings and thoughts about using humor as a coping mechanism. This response allows for open communication and understanding between the nurse and the client, which can contribute to the client's emotional well-being and overall therapeutic relationship.Rate this question:
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- 13.
A leukemia patient has a relative who wants to donate blood for transfusion. Which of the following donor medical conditions would prevent this?
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A history of hepatitis C five years previously.
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Cholecystitis requiring cholecystectomy one year previously.
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Asymptomatic diverticulosis.
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Crohn's disease in remission.
Correct Answer
A. A history of hepatitis C five years previously.Explanation
A history of hepatitis C five years previously would prevent the relative from donating blood for transfusion because hepatitis C is a viral infection that can be transmitted through blood transfusion. Even though the relative may have had the infection five years ago, there is still a risk of the virus being present in their blood, which could be transmitted to the leukemia patient during transfusion. Therefore, it is important to exclude individuals with a history of hepatitis C from donating blood to ensure the safety of the recipient.Rate this question:
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- 14.
A patient with leukemia is receiving chemotherapy that is known to depress bone marrow. A CBC (complete blood count) reveals a platelet count of 25,000/microliter. Which of the following actions related specifically to the platelet count should be included on the nursing care plan?
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Monitor for fever every 4 hours.
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Require visitors to wear respiratory masks and protective clothing.
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Consider transfusion of packed red blood cells.
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Check for signs of bleeding, including examination of urine and stool for blood.
Correct Answer
A. Check for signs of bleeding, including examination of urine and stool for blood.Explanation
The patient's platelet count of 25,000/microliter indicates thrombocytopenia, which is a low platelet count. Platelets are responsible for blood clotting, so a low platelet count puts the patient at risk for bleeding. Checking for signs of bleeding, including examining urine and stool for blood, is important in monitoring the patient's condition and detecting any potential bleeding. Monitoring for fever, requiring visitors to wear respiratory masks and protective clothing, and considering a transfusion of packed red blood cells are not directly related to the platelet count and do not address the risk of bleeding.Rate this question:
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- 15.
A patient is undergoing the induction stage of treatment for leukemia. The nurse teaches family members about infectious precautions. Which of the following statements by family members indicates that the family needs more education?
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We will bring in books and magazines for entertainment.
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We will bring in personal care items for comfort.
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We will bring in fresh flowers to brighten the room.
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We will bring in family pictures and get well cards.
Correct Answer
A. We will bring in fresh flowers to brighten the room.Explanation
During the induction stage of treatment for leukemia, the patient's immune system is compromised, making them more susceptible to infections. Bringing in fresh flowers can introduce bacteria and other pathogens into the room, increasing the risk of infection. Therefore, this statement indicates that the family needs more education on infectious precautions.Rate this question:
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- 16.
A nurse is caring for a patient with acute lymphoblastic leukemia (ALL). Which of the following is the most likely age range of the patient?
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3-10 years.
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25-35 years.
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45-55 years.
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Over 60 years.
Correct Answer
A. 3-10 years.Explanation
Acute lymphoblastic leukemia (ALL) is most commonly diagnosed in children, with the peak incidence occurring between the ages of 2 and 5 years. While ALL can occur in adults, it is much more prevalent in children. Therefore, the most likely age range for a patient with ALL would be 3-10 years.Rate this question:
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- 17.
The client with leukemia is receiving busulfan (Myleran) and allopurinol (Zyloprim). The nurse tells the client that the purpose if the allopurinol is to prevent:
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Nausea
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Alopecia
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Vomiting
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Hyperuricemia
Correct Answer
A. HyperuricemiaExplanation
Allopurinol is a medication commonly used to prevent hyperuricemia, which is the buildup of uric acid in the blood. In patients with leukemia, high levels of uric acid can be a side effect of chemotherapy treatment. Allopurinol works by inhibiting the production of uric acid, thus preventing its accumulation and reducing the risk of complications such as kidney stones or gout. Therefore, the purpose of allopurinol in this case is to prevent hyperuricemia.Rate this question:
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- 18.
The treatment protocol for a client with acute lymphatic leukemia includes prednisone, methotrexate, and cimetadine. The purpose of the cimetadine is to:
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Decrease the secretion of pancreatic enzymes
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Enhance the effectiveness of methotrexate
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Promote peristalsis
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Prevent a common side effect of prednisone
Correct Answer
A. Prevent a common side effect of prednisoneExplanation
Cimetadine is used to prevent a common side effect of prednisone. Prednisone is a corticosteroid medication that can cause stomach irritation and ulcers. Cimetadine is a histamine-2 blocker that reduces the production of stomach acid, which helps to prevent these side effects and protect the stomach lining.Rate this question:
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- 19.
A child with leukemia is being discharged after beginning chemotherapy. What instructions will the nurse include in the teaching plan for the parents of this child?
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Provide a diet low in protein and high in carbohydrates
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Avoid fresh vegetables that are not cooked or peeled
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Notify the M.D. if the child’s temperature exceeds 101F (39C)
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Increase the use of humidifiers throughout the house
Correct Answer
A. Avoid fresh vegetables that are not cooked or peeledExplanation
The nurse will include the instruction to avoid fresh vegetables that are not cooked or peeled in the teaching plan for the parents of the child with leukemia. This is because raw vegetables may contain harmful bacteria or parasites that can pose a risk to the child's weakened immune system due to chemotherapy. Cooking or peeling the vegetables helps to eliminate or reduce this risk.Rate this question:
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- 20.
A 68-year-old woman is diagnosed with thrombocytopenia due to acute lymphocytic leukemia. She is admitted to the hospital for treatment. The nurse should assign the patient
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To a private room so she will not infect other patients and health care workers.
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To a private room so she will not be infected by other patients and health care workers.
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to a semiprivate room so she will have stimulation during her hospitalization.
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To a semiprivate room so she will have the opportunity to express her feelings about her illness.
Correct Answer
A. To a private room so she will not be infected by other patients and health care workers.Explanation
The correct answer is to assign the patient to a private room so she will not be infected by other patients and health care workers. This is because the patient has thrombocytopenia, which is a condition characterized by a low platelet count. This puts the patient at a higher risk for bleeding and infections. By placing her in a private room, the risk of exposure to infectious agents from other patients and health care workers is minimized, reducing the chances of infection.Rate this question:
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- 21.
A 22-year-old man is admitted to the hospital with complaints of fatigue and weight loss. Physical examination reveals pallor and multiple bruises on his arms and legs. The results of the patients tests reveal acute lymphocytic leukemia and thrombocytopenia. Which of the following nursing diagnoses MOST accurately reflects his condition?
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Potential for injury.
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Self-care deficit
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Potential for self-harm.
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Alteration in comfort.
Correct Answer
A. Potential for injury.Explanation
The patient's symptoms of fatigue, weight loss, pallor, and multiple bruises indicate a compromised immune system and decreased platelet count, which are characteristic of acute lymphocytic leukemia and thrombocytopenia. Thrombocytopenia increases the risk of bleeding and bruising, making the patient susceptible to injury. Therefore, the nursing diagnosis of "Potential for injury" accurately reflects the patient's condition.Rate this question:
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- 22.
Which of the following would the nurse identify as the initial priority for a child with acute lymphocytic leukemia?
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Instituting infection control precautions
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Encouraging adequate intake of iron-rich foods
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Assisting with coping with chronic illness
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Administering medications via IM injections
Correct Answer
A. Instituting infection control precautionsExplanation
The nurse would identify instituting infection control precautions as the initial priority for a child with acute lymphocytic leukemia because these children are at a higher risk for infections due to their compromised immune system. By implementing infection control precautions, the nurse can help prevent the child from acquiring any infections that could further compromise their health. This includes measures such as hand hygiene, isolation precautions, and proper cleaning and disinfection of the environment.Rate this question:
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- 23.
A child is undergoing remission induction therapy to treat leukemia. Allopurinol is included in the regimen. The main reason for administering allopurinol as part of the client’s chemotherapy regimen is to:
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Prevent metabolic breakdown of xanthine to uric acid
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Prevent uric acid from precipitating in the ureters
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Enhance the production of uric acid to ensure adequate excretion of urine
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Ensure that the chemotherapy doesn’t adversely affect the bone marrow
Correct Answer
A. Prevent metabolic breakdown of xanthine to uric acidExplanation
Allopurinol is administered as part of the client's chemotherapy regimen to prevent the metabolic breakdown of xanthine to uric acid. Chemotherapy can cause rapid cell death, leading to the release of large amounts of purines, which are converted to uric acid. Increased levels of uric acid can lead to kidney damage and the formation of kidney stones. Allopurinol inhibits the enzyme xanthine oxidase, which is responsible for the conversion of xanthine to uric acid, thereby preventing the buildup of uric acid and its associated complications.Rate this question:
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- 24.
The patient receiving mitoxantrone (Novantrone) for treatment of secondary progressive multiple sclerosis (MS) is closely monitored for
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leukopenia and cardiac toxicity.
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Mood changes and fluid and electrolyte alterations.
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Renal insufficiency.
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Hypoxia.
Correct Answer
A. leukopenia and cardiac toxicity.Explanation
Patients receiving mitoxantrone for the treatment of secondary progressive multiple sclerosis are closely monitored for leukopenia and cardiac toxicity. Leukopenia refers to a decrease in the number of white blood cells, which can increase the risk of infections. Mitoxantrone can also cause cardiac toxicity, which may manifest as heart failure or arrhythmias. Therefore, monitoring for these adverse effects is important to ensure patient safety and adjust the treatment if necessary.Rate this question:
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- 25.
The treatment for patients with leukemia is bone marrow transplantation. Which statement about bone marrow transplantation is not correct?
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The patient is under local anesthesia during the procedure
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The aspirated bone marrow is mixed with heparin.
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The aspiration site is the posterior or anterior iliac crest.
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The recipient receives cyclophosphamide (Cytoxan) for 4 consecutive days before the procedure.
Correct Answer
A. The patient is under local anesthesia during the procedureExplanation
The patient is not under local anesthesia during a bone marrow transplantation procedure. The procedure is typically done under general anesthesia, where the patient is unconscious and unable to feel pain.Rate this question:
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- 26.
During chemotherapy for lymphocytic leukemia, Mathew develops abdominal pain, fever, and "horse barn" smelling diarrhea. It would be most important for the nurse to advise the physician to order:
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Enzyme-linked immunosuppressant assay (ELISA) test.
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Electrolyte panel and hemogram.
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stool for Clostridium difficile test.
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Flat plate X-ray of the abdomen.
Correct Answer
A. stool for Clostridium difficile test.Explanation
The symptoms described by Mathew, including abdominal pain, fever, and "horse barn" smelling diarrhea, are suggestive of a Clostridium difficile infection. Clostridium difficile is a bacteria that can cause severe diarrhea and other gastrointestinal symptoms, especially in individuals undergoing chemotherapy. Therefore, it would be most important for the nurse to advise the physician to order a stool test specifically for Clostridium difficile to confirm the diagnosis and guide appropriate treatment.Rate this question:
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Mar 22, 2023Quiz Edited by
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Apr 09, 2013Quiz Created by
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