,
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ANS: B
Rationale: The client's signs are suggestive of thrombocytopenia, thus the nurse should
check the client's most recent platelet level. VTE is not a risk and this does not constitute
a need for isolation. Ambulation and activity may be contraindicated due to the risk of
bleeding.
PTS: 1 REF: p. 955
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 30: Management of Clients With Hematologic Neoplasms
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice
20. A 60-year-old client with chronic myeloid leukemia (CML) will be treated in the home
setting, and the nurse is preparing appropriate health education. Which topic should the
nurse emphasize?
A. The importance of adhering to the prescribed drug regimen
B. The need to ensure that vaccinations are up to date
C. The importance of daily physical activity
D. The need to avoid shellfish and raw foods
ANS: A
Rationale: Nurses need to understand that the effectiveness of the drugs used to treat
CML is based on the ability of the client to adhere to the medication regimen as
prescribed. Adherence is often incomplete, thus this must be a focus of health education.
Vaccinations normally would not be given during treatment, and daily physical activity
may be impossible for the client. Dietary restrictions are not normally necessary.
PTS: 1 REF: p. 955
NAT: Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
TOP: Chapter 30: Management of Clients With Hematologic Neoplasms
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
NOT: Multiple Choice
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21. A client is undergoing diagnostic testing for chronic lymphocytic leukemia (CLL).
Which assessment finding is certain to be present if the client has CLL?
A. Increased numbers of blast cells
B. Increased lymphocyte levels
C. Intractable bone pain
D. Thrombocytopenia with no evidence of bleeding
ANS: B
Rationale: An increased lymphocyte count (lymphocytosis) is always present in clients
with CLL. Each of the other listed symptoms may or may not be present, and none is
definitive for CLL.
PTS: 1 REF: p. 958
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 30: Management of Clients With Hematologic Neoplasms
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Choice
22. A client is receiving treatment for a new diagnosis of chronic lymphocytic leukemia
(CLL). Based on known risk factors, age, ethnicity, and accompanying clinical conditions,
which client is most likely to have this disease?
A. 82-year-old Vietnam War veteran with widely disseminated shingles
B. 62-year-old client of Asian descent with a left fractured hip
C. 69-year-old Gulf War veteran with deep vein thrombosis (DVT)
D. 85-year-old client of Native American/First Nation descent with chest pain
ANS: A
Rationale: CLL is a common malignancy of older adults with an average age of 71 at
diagnosis and the most prevalent leukemia in the Western world. It is rarely seen in
clients of Native American/First Nation descent and has an infrequent incidence in clients
of Asian descent. Veterans of the Vietnam War who were exposed to the herbicide Agent
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,9/2/23, 4:58 PM Brunner Suddarths Textbook of Medical Surgical Nursing 15th Edition btestbanks
ANS: B
Rationale: The client's signs are suggestive of thrombocytopenia, thus the nurse should
check the client's most recent platelet level. VTE is not a risk and this does not constitute
a need for isolation. Ambulation and activity may be contraindicated due to the risk of
bleeding.
PTS: 1 REF: p. 955
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 30: Management of Clients With Hematologic Neoplasms
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice
20. A 60-year-old client with chronic myeloid leukemia (CML) will be treated in the home
setting, and the nurse is preparing appropriate health education. Which topic should the
nurse emphasize?
A. The importance of adhering to the prescribed drug regimen
B. The need to ensure that vaccinations are up to date
C. The importance of daily physical activity
D. The need to avoid shellfish and raw foods
ANS: A
Rationale: Nurses need to understand that the effectiveness of the drugs used to treat
CML is based on the ability of the client to adhere to the medication regimen as
prescribed. Adherence is often incomplete, thus this must be a focus of health education.
Vaccinations normally would not be given during treatment, and daily physical activity
may be impossible for the client. Dietary restrictions are not normally necessary.
PTS: 1 REF: p. 955
NAT: Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
TOP: Chapter 30: Management of Clients With Hematologic Neoplasms
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
NOT: Multiple Choice
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Downloaded by Collins Mwaniki ()
, 9/2/23, 4:58 PM Brunner Suddarths Textbook of Medical Surgical Nursing 15th Edition btestbanks
21. A client is undergoing diagnostic testing for chronic lymphocytic leukemia (CLL).
Which assessment finding is certain to be present if the client has CLL?
A. Increased numbers of blast cells
B. Increased lymphocyte levels
C. Intractable bone pain
D. Thrombocytopenia with no evidence of bleeding
ANS: B
Rationale: An increased lymphocyte count (lymphocytosis) is always present in clients
with CLL. Each of the other listed symptoms may or may not be present, and none is
definitive for CLL.
PTS: 1 REF: p. 958
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 30: Management of Clients With Hematologic Neoplasms
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Choice
22. A client is receiving treatment for a new diagnosis of chronic lymphocytic leukemia
(CLL). Based on known risk factors, age, ethnicity, and accompanying clinical conditions,
which client is most likely to have this disease?
A. 82-year-old Vietnam War veteran with widely disseminated shingles
B. 62-year-old client of Asian descent with a left fractured hip
C. 69-year-old Gulf War veteran with deep vein thrombosis (DVT)
D. 85-year-old client of Native American/First Nation descent with chest pain
ANS: A
Rationale: CLL is a common malignancy of older adults with an average age of 71 at
diagnosis and the most prevalent leukemia in the Western world. It is rarely seen in
clients of Native American/First Nation descent and has an infrequent incidence in clients
of Asian descent. Veterans of the Vietnam War who were exposed to the herbicide Agent
btestbanks.com
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