NUR 211 EXAM 2 STUDY QUESTIONS WITH CORRECT ANSWERS
1. An oncology nurse is providing#$%^&*()(uygfghjkl:
health education for a client who has recently been
diagnosed with leukemia. What should the nurse explain about common- alities between
all the different subtypes of leukemia?
A. The different leukemias all involved 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 lym- phatic
system.(ANSWER) A. The ditterent leukemias all involve unregulated proliferation of white blood cells.
Rationale(ANSWER) Leukemia commonly involves unregulated proliferation of WBCs. Decreased production of WBCs is
associ- ated with leukopenia. The leukemias are not characterized by their involvement with the lymphatic system.
2. A nurse is caring for a client who has a diagnosis of acute myelocytic leukemia (AML).
Assessment of which factor most directly addresses the most common cause of death
among clients with leukemia?
A. Infection status
B. Nutritional status
C. Electrolyte status
D. Liver function(ANSWER) A. Infections status
Rationale(ANSWER) Because of the lack of mature and normal granulocytes that help fight infections, clients with leukemia
are prone to infections. In clients with AML, death typically occurs from INFECTION of BLEEDING. Symptoms of AML
include weight loss, fever, night sweats, and fatigue, which would guide the nurse to monitor the client's nutrition and electrolytes.
GI problems (nausea and vomiting) and electrolyte imbalances (hyperkalemia and hypocalcemia) may result from chemotherapy
use. The liver is responsible for metabolism and metabolic detox, so monitoring liver function is important for the client who is
receiving chemo. These problems may contribute to and/or result in death but are not the most common cause.
3. A client with a new diagnosis of leukemia is about to start treatment and expresses
fear and anxiety with the prognosis. Which action is the nurse's MOST appropriate?
,NUR 211 EXAM 2 STUDY QUESTIONS WITH CORRECT ANSWERS
A. Communicate to the health care#$%^&*()(uygfghjkl: provider the need to provide more informa- tion to the
client and the family.
B. Assess how much information is desired from the client in terms of illness, treatment,
and complications.
C. Offer to call pastoral services and review hospice and/or palliative care so the client
can have a quiet, dignified death.
D. Encourage the client to call their family and discuss immediate role restruc- turing in
both their families and professional life.(ANSWER) B. Assess how much information is desired from
the client in terms of illness, treatment, and complications.
Rationale(ANSWER) As with any client exhibiting anxiety and fear about a prognosis, listening should come first in order to assess
how much info the client wants to have regarding the illness, treatment and potential complications. This is an ongoing assessment,
since needs and interest in info changes throughout the course of treatment. Managing a client's care is a team ettort, so involving
the primary care provider and family is important, but not the nurse' s priority action. Ottering pastoral services and role
restructuring has its place in treatment but should be discussed after an assessment of the client's needs. A discussion about
palliative care and hospice is not appropriate at this time. Ottering realistic hope is important and only after all treatment options
are exhausted, or the client is diagnosed as terminal, should palliative and/or hospice care be considered.
4. A nurse is caring for a client with acute myeloid leukemia who is preparing to
undergo inductions therapy. In preparing a plan of care for this client, the nurse should
assign the HIGHEST priority to which nursing diagnosis?
A. Activity intonlerance
B. Risk for infection
C. Acute confusion
D. Risk for spiritual distress(ANSWER) B. Risk for infection
Rationale(ANSWER) Induction therapy places the client at risk for infection, thus this is the priority nursing diagnosis. During the
time of induction therapy, the client is very ill, with bacterial, fungal, and occasional viral infections; bleeding and severe mucositis,
which causes diarrhea; and marked decline in the ability to maintain adequate nutrition. Supportive care consists of administering
blood products and promptly treating infections. Immobility, confusion, and spiritual distress are possible, but infection is the
client's most acute physiologic threat.
, NUR 211 EXAM 2 STUDY QUESTIONS WITH CORRECT ANSWERS
5. A 35-year-old client is admitted#$%^&*()(uygfghjkl:
to the hospital reporting severe headaches,
vomiting, and testicular pain. The client's blood work shows reduced numbers of
platelets, leukocytes, and erythrocytes, and a high proportion of immature cells. The
nurse caring for this client suspects which diagnosis?
A. Acute Myeloid Leukemia (AML)
B. Chronic Myeloid Leukemia (CML)
C. Myelodysplastic Syndromes (MDS)
D. Acute Lymphocytic Leukemia (ALL)(ANSWER) D. Acute Lymphocytic Leukemia (ALL)
Rationale(ANSWER) In acute lymphocytic leukemia (ALL) manifestations of leukemic cell infiltration into other organs are more
common than with other forms of leukemia, and include pain from an enlarged liver or spleen, as well as bone pain. The CNS is
frequently a site for leukemic cells; thus, clients may exhibit headache and vomiting because of meningeal involvement. Other
extranodal sites include the testes and breasts. All the listed types of leukemia, depending on severity and stage, can have the same
blood work results. The ditterence is the client's signs and symptoms, which are closely associated with ALL. A large number of
clients when first diagnosed with any type of leukemia are asymptomatic or have nonspecific symptoms. It is discovered on
routine lab work.
6. A client with leukemia has developed stomatitis and is experiencing a nu- tritional
deficit. An oral anesthetic has consequently been prescribed. What health education
should the nurse provide to the client?
A. Chew with care to avoid inadvertently biting the tongue.
B. Use the oral anesthetic 1 hour prior to meal time.
C. Brush teeth before and after eating.
D. Swallow slowly and deliberately.(ANSWER) A. Chew with care to avoid inadvertently biting the tongue.
Rationale(ANSWER) If oral anesthetics are used, the client must be warned to chew with extreme care to avoid inadvertently biting
the tongue or buccal mucosa. An oral anesthetic would be metabolized by the time the client eats if it is used 1 hour prior to
meals. There is no specific need to warn the client about brushing teeth or swallowing slowly because an oral anesthetic has been
used.
7. A client diagnosed with acute myeloid leukemia has just been admitted to the
oncology unit. When writing this client's care plan, which potential complica- tion
should the nurse address?
A. Pancreatitis
1. An oncology nurse is providing#$%^&*()(uygfghjkl:
health education for a client who has recently been
diagnosed with leukemia. What should the nurse explain about common- alities between
all the different subtypes of leukemia?
A. The different leukemias all involved 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 lym- phatic
system.(ANSWER) A. The ditterent leukemias all involve unregulated proliferation of white blood cells.
Rationale(ANSWER) Leukemia commonly involves unregulated proliferation of WBCs. Decreased production of WBCs is
associ- ated with leukopenia. The leukemias are not characterized by their involvement with the lymphatic system.
2. A nurse is caring for a client who has a diagnosis of acute myelocytic leukemia (AML).
Assessment of which factor most directly addresses the most common cause of death
among clients with leukemia?
A. Infection status
B. Nutritional status
C. Electrolyte status
D. Liver function(ANSWER) A. Infections status
Rationale(ANSWER) Because of the lack of mature and normal granulocytes that help fight infections, clients with leukemia
are prone to infections. In clients with AML, death typically occurs from INFECTION of BLEEDING. Symptoms of AML
include weight loss, fever, night sweats, and fatigue, which would guide the nurse to monitor the client's nutrition and electrolytes.
GI problems (nausea and vomiting) and electrolyte imbalances (hyperkalemia and hypocalcemia) may result from chemotherapy
use. The liver is responsible for metabolism and metabolic detox, so monitoring liver function is important for the client who is
receiving chemo. These problems may contribute to and/or result in death but are not the most common cause.
3. A client with a new diagnosis of leukemia is about to start treatment and expresses
fear and anxiety with the prognosis. Which action is the nurse's MOST appropriate?
,NUR 211 EXAM 2 STUDY QUESTIONS WITH CORRECT ANSWERS
A. Communicate to the health care#$%^&*()(uygfghjkl: provider the need to provide more informa- tion to the
client and the family.
B. Assess how much information is desired from the client in terms of illness, treatment,
and complications.
C. Offer to call pastoral services and review hospice and/or palliative care so the client
can have a quiet, dignified death.
D. Encourage the client to call their family and discuss immediate role restruc- turing in
both their families and professional life.(ANSWER) B. Assess how much information is desired from
the client in terms of illness, treatment, and complications.
Rationale(ANSWER) As with any client exhibiting anxiety and fear about a prognosis, listening should come first in order to assess
how much info the client wants to have regarding the illness, treatment and potential complications. This is an ongoing assessment,
since needs and interest in info changes throughout the course of treatment. Managing a client's care is a team ettort, so involving
the primary care provider and family is important, but not the nurse' s priority action. Ottering pastoral services and role
restructuring has its place in treatment but should be discussed after an assessment of the client's needs. A discussion about
palliative care and hospice is not appropriate at this time. Ottering realistic hope is important and only after all treatment options
are exhausted, or the client is diagnosed as terminal, should palliative and/or hospice care be considered.
4. A nurse is caring for a client with acute myeloid leukemia who is preparing to
undergo inductions therapy. In preparing a plan of care for this client, the nurse should
assign the HIGHEST priority to which nursing diagnosis?
A. Activity intonlerance
B. Risk for infection
C. Acute confusion
D. Risk for spiritual distress(ANSWER) B. Risk for infection
Rationale(ANSWER) Induction therapy places the client at risk for infection, thus this is the priority nursing diagnosis. During the
time of induction therapy, the client is very ill, with bacterial, fungal, and occasional viral infections; bleeding and severe mucositis,
which causes diarrhea; and marked decline in the ability to maintain adequate nutrition. Supportive care consists of administering
blood products and promptly treating infections. Immobility, confusion, and spiritual distress are possible, but infection is the
client's most acute physiologic threat.
, NUR 211 EXAM 2 STUDY QUESTIONS WITH CORRECT ANSWERS
5. A 35-year-old client is admitted#$%^&*()(uygfghjkl:
to the hospital reporting severe headaches,
vomiting, and testicular pain. The client's blood work shows reduced numbers of
platelets, leukocytes, and erythrocytes, and a high proportion of immature cells. The
nurse caring for this client suspects which diagnosis?
A. Acute Myeloid Leukemia (AML)
B. Chronic Myeloid Leukemia (CML)
C. Myelodysplastic Syndromes (MDS)
D. Acute Lymphocytic Leukemia (ALL)(ANSWER) D. Acute Lymphocytic Leukemia (ALL)
Rationale(ANSWER) In acute lymphocytic leukemia (ALL) manifestations of leukemic cell infiltration into other organs are more
common than with other forms of leukemia, and include pain from an enlarged liver or spleen, as well as bone pain. The CNS is
frequently a site for leukemic cells; thus, clients may exhibit headache and vomiting because of meningeal involvement. Other
extranodal sites include the testes and breasts. All the listed types of leukemia, depending on severity and stage, can have the same
blood work results. The ditterence is the client's signs and symptoms, which are closely associated with ALL. A large number of
clients when first diagnosed with any type of leukemia are asymptomatic or have nonspecific symptoms. It is discovered on
routine lab work.
6. A client with leukemia has developed stomatitis and is experiencing a nu- tritional
deficit. An oral anesthetic has consequently been prescribed. What health education
should the nurse provide to the client?
A. Chew with care to avoid inadvertently biting the tongue.
B. Use the oral anesthetic 1 hour prior to meal time.
C. Brush teeth before and after eating.
D. Swallow slowly and deliberately.(ANSWER) A. Chew with care to avoid inadvertently biting the tongue.
Rationale(ANSWER) If oral anesthetics are used, the client must be warned to chew with extreme care to avoid inadvertently biting
the tongue or buccal mucosa. An oral anesthetic would be metabolized by the time the client eats if it is used 1 hour prior to
meals. There is no specific need to warn the client about brushing teeth or swallowing slowly because an oral anesthetic has been
used.
7. A client diagnosed with acute myeloid leukemia has just been admitted to the
oncology unit. When writing this client's care plan, which potential complica- tion
should the nurse address?
A. Pancreatitis
