NCM 109 FINALS - LEUKEMIA QUESTIONS &
ANSWERS
T or F: Infants of diabetic mothers are mostly at risk for hypoglycemia - Answers - True
T or F: Sepsis is more common in post-term infants - Answers - False
The client diagnosed with leukemia has central nervous system involvement. Which
instructions should the nurse teach?"
a. Sleep with the head of the bed elevated to prevent increased intracranial pressure.
b. Take an analgesic medication for pain only when the pain becomes severe.
c. Explain that radiation therapy to the head may result in permanent hair loss.
d. Discuss end-of-life decisions prior to cognitive deterioration - Answers - Correct: c
1.Sleeping with the head of the bed elevated might relieve some intracranial pressure,
but it will not prevent intracranial pressure from occurring.
2.Analgesic medications for clients with cancer are given on a scheduled basis with a
fast-acting analgesic administered PRN for break-through pain.
3.Radiation therapy to the head and scalp area is the treatment of choice for central
nervous system involvement of any cancer. If the radiation therapy destroys the hair
follicle, the hair will not grow back.
4.Cognitive deterioration does not usually occur"
The nurse analyzes the laboratory values of a child with leukemia who is receiving
chemotherapy . The nurse notes that the platelet count is 20,000/ul. Based on the
laboratory result, which intervention will the nurse document in the plan of care?
a. Monitor closely for signs of infection
b. Monitor the temperature every 4hours
c. Initiate protective isolation precautions
d. Use soft small toothbrush for mouth care - Answers - Correct: D
If a child is severely thrombocytopenic and has a platelet count less than 20,000/ul,
bleeding precautions need to be initiated because of increased risk of bleeding or
hemorrhage. Options 1,2,3 are related to the prevention of infection rather than bleeding
A client with acute leukemia is admitted to the oncology unit. Which of the following
would be most important for the nurse to inquire?
a. ""Have you noticed a change in sleeping habits recently?"
b. ""Have you had a respiratory infection in the last 6 months?""
, c. ""Have you lost weight recently?""
d. ""Have you noticed changes in your alertness?"" - Answers - Answer B is correct.
The client with leukemia is at risk for infection and has often had recurrent respiratory
infections during the previous 6 months. Insomnolence, weight loss, and a decrease in
alertness also occur in leukemia, but bleeding tendencies and infections are the primary
clinical manifestations; therefore, answers A, C, and D are incorrect.
What nursing diagnosis is seen with acute lymphocytic leukemia and
thrombocytopenia?
a. potential for injury
b. self-care deficit
c. potential for self harm
d. alteration in comfort" - Answers - Answer: A potential for injury
Low platelet increases risk of bleeding from even minor injuries. Safety measures:
shave with an electric razor, use soft tooth brush, avoid SQ or IM meds and invasive
procedures (urinary drainage catheter or a nasogastric tube), side-rails up, remove
sharp objects, frequently assess for signs of bleeding, bruising, hemorrhage. "
When caring for a client with a diagnosis of thrombocytopenia, the nurse should plan to:
a. Discourage the use of stool softeners
b. Assess temperature readings every six hours
c. Avoid invasive procedures
d. Encourage the use of a hard, brittle toothbrush - Answers - Answer: C
Rationale: Thrombocytopenia is a deficiency of platelets, and leaves the patient more
prone to hemorrhage. For this reason, avoiding invasive procedures will limit the risk of
hemorrhage. Stool softeners should be encouraged, while hard brittle toothbrushes
should be avoided. Temperature is not the most important vital to track in this patient"
Which statement is correct about the rate of cell growth in relation to chemotherapy?
a. Faster growing cells are less susceptible to chemotherapy.
b. Nondividing cells are more susceptible to chemotherapy.
c. Faster growing cells are more susceptible to chemotherapy.
d. Slower growing cells are more susceptible to chemotherapy." - Answers - Answer c
The faster the cell grows, the more susceptible it is to chemotherapy and radiation
therapy. Slow-growing and nondividing cells are less susceptible to chemotherapy.
Repeated cycles of chemotherapy are used to destroy nondividing cells as the begin
active cell division.
ANSWERS
T or F: Infants of diabetic mothers are mostly at risk for hypoglycemia - Answers - True
T or F: Sepsis is more common in post-term infants - Answers - False
The client diagnosed with leukemia has central nervous system involvement. Which
instructions should the nurse teach?"
a. Sleep with the head of the bed elevated to prevent increased intracranial pressure.
b. Take an analgesic medication for pain only when the pain becomes severe.
c. Explain that radiation therapy to the head may result in permanent hair loss.
d. Discuss end-of-life decisions prior to cognitive deterioration - Answers - Correct: c
1.Sleeping with the head of the bed elevated might relieve some intracranial pressure,
but it will not prevent intracranial pressure from occurring.
2.Analgesic medications for clients with cancer are given on a scheduled basis with a
fast-acting analgesic administered PRN for break-through pain.
3.Radiation therapy to the head and scalp area is the treatment of choice for central
nervous system involvement of any cancer. If the radiation therapy destroys the hair
follicle, the hair will not grow back.
4.Cognitive deterioration does not usually occur"
The nurse analyzes the laboratory values of a child with leukemia who is receiving
chemotherapy . The nurse notes that the platelet count is 20,000/ul. Based on the
laboratory result, which intervention will the nurse document in the plan of care?
a. Monitor closely for signs of infection
b. Monitor the temperature every 4hours
c. Initiate protective isolation precautions
d. Use soft small toothbrush for mouth care - Answers - Correct: D
If a child is severely thrombocytopenic and has a platelet count less than 20,000/ul,
bleeding precautions need to be initiated because of increased risk of bleeding or
hemorrhage. Options 1,2,3 are related to the prevention of infection rather than bleeding
A client with acute leukemia is admitted to the oncology unit. Which of the following
would be most important for the nurse to inquire?
a. ""Have you noticed a change in sleeping habits recently?"
b. ""Have you had a respiratory infection in the last 6 months?""
, c. ""Have you lost weight recently?""
d. ""Have you noticed changes in your alertness?"" - Answers - Answer B is correct.
The client with leukemia is at risk for infection and has often had recurrent respiratory
infections during the previous 6 months. Insomnolence, weight loss, and a decrease in
alertness also occur in leukemia, but bleeding tendencies and infections are the primary
clinical manifestations; therefore, answers A, C, and D are incorrect.
What nursing diagnosis is seen with acute lymphocytic leukemia and
thrombocytopenia?
a. potential for injury
b. self-care deficit
c. potential for self harm
d. alteration in comfort" - Answers - Answer: A potential for injury
Low platelet increases risk of bleeding from even minor injuries. Safety measures:
shave with an electric razor, use soft tooth brush, avoid SQ or IM meds and invasive
procedures (urinary drainage catheter or a nasogastric tube), side-rails up, remove
sharp objects, frequently assess for signs of bleeding, bruising, hemorrhage. "
When caring for a client with a diagnosis of thrombocytopenia, the nurse should plan to:
a. Discourage the use of stool softeners
b. Assess temperature readings every six hours
c. Avoid invasive procedures
d. Encourage the use of a hard, brittle toothbrush - Answers - Answer: C
Rationale: Thrombocytopenia is a deficiency of platelets, and leaves the patient more
prone to hemorrhage. For this reason, avoiding invasive procedures will limit the risk of
hemorrhage. Stool softeners should be encouraged, while hard brittle toothbrushes
should be avoided. Temperature is not the most important vital to track in this patient"
Which statement is correct about the rate of cell growth in relation to chemotherapy?
a. Faster growing cells are less susceptible to chemotherapy.
b. Nondividing cells are more susceptible to chemotherapy.
c. Faster growing cells are more susceptible to chemotherapy.
d. Slower growing cells are more susceptible to chemotherapy." - Answers - Answer c
The faster the cell grows, the more susceptible it is to chemotherapy and radiation
therapy. Slow-growing and nondividing cells are less susceptible to chemotherapy.
Repeated cycles of chemotherapy are used to destroy nondividing cells as the begin
active cell division.
