Acute Leukemia NCLEX Exam Preparation MCQ Quiz

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

The nurse would inquire about the client's history of radiation for treatment of Hodgkin's disease as a teenager because radiation therapy is a known risk factor for the development of acute leukemia later in life. The other options may provide some information about the client's background, but they are not directly related to the evaluation for possible acute leukemia.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.