Deck 16: Disorders of White Blood Cells

Question 1

When reviewing the medical record of a patient with Hodgkin lymphoma, the oncology nurse would expect to note the presence of:

A) Reed-Sternberg cells.
B) hypercalcemia.
C) a history of substance abuse.
D) malignant plasma cells.

Answer 1

Reed-Sternberg cells.

Question 2

Which statement by a patient recently diagnosed with acute myelogenous leukemia indicates that the patient does not understand the staging process?

A) "Staging helps my doctors plan my treatment."
B) "Staging will help determine my prognosis."
C) "Staging can help the doctors determine how long I have to live."
D) "Staging is useful for research on my type of cancer."

Answer 2

"Staging can help the doctors determine how long I have to live."

Question 3

Which laboratory result would the nurse expect in a patient with acute myelogenous leukemia (AML)?

A) Polycythemia
B) Thrombocytosis
C) Pancytopenia
D) Hemoglobinemia

Answer 3

Pancytopenia

Question 4

Which findings are typical of data collected on patients with AML who experience leukocytosis?

A) Headache and diplopia
B) Weakness and fatigue
C) Fever and infection
D) Ecchymosis and epistaxis

Question 5

When developing a plan of care for a patient with acute myelogenous leukemia (AML), the oncology nurse should keep in mind that:

A) consolidation therapy uses low-dose chemotherapy to maintain remission.
B) induction therapy reduces the leukemic cell burden.
C) consolidation therapy is given to induce remission.
D) induction therapy eliminates all cancer cells

Question 6

The pediatric oncology nurse is caring for a 5-year-old child newly diagnosed with acute lymphocytic leukemia (ALL). How should the nurse respond when the parent asks about the prognosis of this disease?

A) "Five-year-old children fare better than infants or teens."
B) "Male children tend to have a better prognosis than females."
C) "African American children have a slightly higher survival rate than Caucasian children."
D) "Children with a white blood cell count below 50,000/µL have a poorer prognosis."

Question 7

In a child with acute lymphocytic leukemia (ALL), which manifestations are due to thrombocytopenia?

A) Weakness and fatigue
B) Bleeding and bruising
C) Fever and enlarged lymph nodes
D) Bone pain and limping

Question 8

In evaluating the effectiveness of induction therapy in a child with acute lymphocytic leukemia, the nurse should expect:

A) eradication of 99% of leukemic cells.
B) no rejection of stem cell transplantation.
C) elimination of residual disease.
D) complete eradication of the disease.

Question 9

A patient in the chronic phase of chronic myelogenous leukemia (CML) will meet which criteria?

A) Blast cells account for less than 10% of all cells in blood or bone marrow.
B) Blast cells account for 10-19% of all cells in blood or bone marrow.
C) Blast cells account for 20-49% of all cells in blood or bone marrow.
D) Blast cells account for more than 50% of all cells in blood or bone marrow.

Question 10

In a patient with chronic myelogenous leukemia (CML), which manifestation(s) would the nurse expect to find caused by splenomegaly?

A) Excessive sweating and night sweats
B) Joint pain with joint splinting
C) Weakness and fatigue
D) Abdominal pain referred to the left shoulder

Question 11

Which individual is at most risk for developing chronic lymphocytic leukemia (CLL)?

A) A 65-year-old Caucasian man
B) A 65-year-old Asian man
C) A 25-year-old Caucasian man
D) A 25-year-old Asian man

Question 12

The oncology nurse assessing a patient with Rai stage II chronic lymphocytic leukemia (CLL) will most likely find:

A) lymphocytosis and no enlargement of the lymph nodes, spleen, or liver.
B) lymphocytosis, an enlarged spleen, and possibly an enlarged liver.
C) lymphocytosis, anemia, and possibly an enlarged spleen or liver.
D) lymphocytosis, thrombocytopenia, and possibly anemia, enlarged lymph nodes, spleen, or liver.

Question 13

The oncology nurse is preparing a teaching plan for a patient with Binet Stage B chronic lymphocytic leukemia (CLL). Which patient statement indicates that the patient understands her current stage?

A) "I have two areas of lymph node involvement, and my red cell and platelet counts are good."
B) "I have three areas of lymph node involvement, and my red cell and platelet counts are good."
C) "I have three areas of lymph node involvement, and my red cell and platelet counts are low."
D) "I have two areas of lymph node involvement, and my red cell and platelet counts are low."

Question 14

Which symptoms would the nurse expect in a patient with chronic lymphocytic leukemia (CLL) who is being admitted to the oncology unit with B symptoms?

A) Agranulocytosis and hypogammaglobinemia
B) Anemia, thrombocytopenia, and autoimmune hemolytic anemia
C) Night sweats and fever but no infection
D) Lymphadenopathy, splenomegaly, and hepatomegaly

Question 15

Which statement by the oncology nurse is most appropriate when teaching an asymptomatic patient in the early stage of chronic lymphocytic leukemia (CLL) about treatment?

A) "CLL requires aggressive treatment in the early stages."
B) "There is no treatment because CLL is not curable."
C) "CLL is treated conservatively in the early stages."
D) "In those who are asymptomatic, chemotherapy is used to induce remission."

Question 16

Which characteristics should the oncology nurse expect when assessing a patient recently diagnosed with indolent non-Hodgkin lymphoma (NHL)?

A) No discernible symptoms
B) Painful lymphadenopathy
C) Night sweats and unexplained fever
D) Anemia and fatigue

Question 17

Which statement by a patient with non-Hodgkin lymphoma (NHL) indicates that more teaching about chemotherapy is needed?

A) "High grade NHL is treated with combination chemotherapy."
B) "A watch and wait approach may be used in indolent NHL."
C) "Slow growing NHL may be treated with one chemotherapeutic agent."
D) "Chemotherapy is more effective in treating indolent disease."

Question 18

When assessing a patient with newly diagnosed Hodgkin lymphoma (HL), the oncology nurse is most likely to palpate enlarged lymph nodes in the:

A) neck.
B) axilla.
C) inguinal area.
D) postauricular area.

Question 19

Multiple myeloma occurs predominantly in which patients?

A) Young Black patients
B) Young White patients
C) Elderly Black patients
D) Elderly White patients

Question 20

A patient with multiple myeloma will most likely exhibit signs and symptoms of which type of anemia?

A) Normochromic
B) Macrocytic
C) Hypochromic
D) Microcytic