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Leukemia NCLEX questions

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Terms in this set (38)

"In formulating a nursing "Correct Answers: B, C, D

diagnosis of risk for infection Rationale: Chronic lymphoid leukemia (CLL) is
for a client with chronic characterized by a proliferation and accumulation
lymphoid leukemia (CLL), of small, abnormal mature lymphocytes in bone
nursing measures should marrow, peripheral blood, and body tissues.
include: (Select all that apply.) Infections and fever are frequent complications of
"A. Maintaining a clean CLL."
technique for all invasive
procedures.
B. Placing the client in
protective isolation.
C. Limiting visitors who have
colds and infections.
D. Ensuring meticulous
handwashing by all persons
coming in contact with the
client."

Leukemia NCLEX questions

"The client diagnosed with "Correct: 3
leukemia has central nervous 1.Sleeping with the head of the bed elevatedmight
system involvement. relieve some intracranial pressure, but it will not
Whichinstructions should the prevent intracranial pressure from
nurse teach? occurring.2.Analgesic medications for clients with
"1.Sleep with the head of the cancer are given on a scheduled basis with a fast-
bed elevated to prevent acting analgesic administered PRN for break-
increased intracranial pressure. through pain.3.Radiation therapy to the head and
2.Take an analgesic medication scalp area is the treatment of choice for central
for pain only when the pain nervous system involvement of any cancer. If the
becomes severe. radiation therapy destroys the hair follicle, the hair
3.Explain that radiation therapy will not grow back.4.Cognitive deterioration does
to the head may result in not usually occur"
permanent hair loss.
4.Discuss end-of-life decisions
prior to cognitive
deterioration"

Leukemia NCLEX questions

The nurse analyzes the Correct Ans 4 If a child is severely
laboratory values of a child thrombocytopenic and has a platelet count less
with leukemia who is receiving than 20,000/ul, bleeding precautions need to be
chemotherapy . The nurse initated because of increased risk of bleeding or
notes that the platelet count is hemorrhage. Options 1,2,3 are related to the
20,000/ul. Based on the prevention of infection rather than bleeding
laboratry result, which
intervention will the nurse
document in the plan of care?
1 Mointor closely for signs of
infection 2. Mointor the
temperature every 4hours 3.
Initate prptective isolation
precautions 4. Use soft small
toothbrush for mouth care

"A client with acute leukemia is Answer B is correct. The client with leukemia is at
admitted to the oncology unit. risk for infection and has often had recurrent
Which respiratory infections during the previous 6 months.
of the following would be most Insomnolence, weight loss, and a decrease in
important for the nurse to alertness also occur in leukemia, but bleeding
inquire? tendencies and infections are the primary clinical
"a. ""Have you noticed a manifestations; therefore, answers A, C, and D are
change in sleeping habits incorrect.
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?"""

Leukemia NCLEX questions

"What nursing diagnosis is seen "Answer: A potential for injury
with acute lymphocytic Low platelet increases risk of bleeding from even
leukemia and minor injuries. Safety measures: shave with an
thromocytopenia? electric razor, use soft tooth brush, avoid SQ or IM
"A. potential for injury meds and invasive procedures (urinary drainage
B. self-care deficit catheter or a nasogastric tube), side-rails up,
C. potential for self harm remove sharp objects, frequently assess for signs of
D. alteration in comfort" bleeding, bruising, hemorrhage. "

"When caring for a client with a "Answer: C

diagnosis of Rationale:
thrombocytopenia, the nurse
should plan to: Thrombocytopenia is a deficiency of platelets, and
"a.Discourage the use of stool leaves the patient more prone to hemmorrhage. For
softeners this reason, avoiding invasive procedures will limit
b.Assess temperature readings the risk of hemorrhage. Stool softeners should be
every six hours encouraged, while hard brittle toothbrushes should
c.Avoid invasive procedures be avoided. Temperature is not the most important
d.Encourage the use of a hard, vital to track in this patient"
brittle toothbrush

"

Leukemia NCLEX questions

"Which statement is correct "Answer 3
about the rate of cell growth in The faster the cell grows, the more susceptible it is
relation to chemotherapy? to chemotherapy and radiation therapy. Slow-
"1. Faster growing cells are less growing and nondividing cells are less susceptible
susceptible to chemotherapy. to chemotherapy. Repeated cycles of
2. Nondividing cells are more chemotherapy are used to destroy nondividing cells
susceptible to chemotherapy. as the begin active cell division."
3. Faster growing cells are
more susceptible to
chemotherapy.
4. Slower growing cells are
more susceptible to
chemotherapy."

"The nurse is caring for a client "Correct: 4

diagnosed with acute myeloid 1.These vital signs are not alarming. The vitalsigns are
leukemia. Which assess-ment slightly elevated and indicate moni-toring at
data warrant immediate intervals, but they do not indicate animmediate
intervention? need.
1.T 99, P 102, R 22, and BP 2.Hyperplasia of the gums is a symptom of myeloid
132/68. leukemia, but it is not an emergency.
2.Hyperplasia of the gums. 3.Weakness and fatigue are symptoms of thedisease
3.Weakness and fatigue. and are expected.
4.Pain in the left upper 4.Pain is expected, but it is a priority, andpain
quadrant." control measures should be imple-mented."

Leukemia NCLEX questions

 "Correct: C

1. Because of the ineffective or nonexistent WBCs

characteristic of leukemia, the body cannot fight
infections, and antibiotics are given to treat
"Which medication is infections.
contraindicated for a client 2. Leukemic infiltrations into the organs or the CNS
diagnosed with leukemia? cause pain. Morphine is the drug of choice for most
1. Bactrim, a sulfa antibiotic clients with cancer.
2. Morphine, a narcotic 3. Epogen is a biologic response modifier that
analgesic stimulates the bone marrow to produce RBCs. The
3. Epogen, a biologic response bone marrow is the area of malignancy in leukemia.
modifier Stimulating the bone marrow would be generally
4. Gleevec, a genetic blocking ineffective for the desired results and would have
agent" the potential to stimulate malignant growth.
4. Gleevec is a drug that specifically works in
leukemic cells to block the expression of the BCR-
ABL protein, preventing the cells from growing and
dividing."

Leukemia NCLEX questions

"A 68-year-old woman is "Correct Answer: B
diagnosed with
thrombocytopenia due to A. To a private room so she will not infect other
acute lymphocytic leukemia. patients and health care workers — poses little or
She is admitted to the hospital no threat
for treatment. The nurse should B. To a private room so she will not be infected by
assign the patient: other patients and health care workers — CORRECT:
"A. To a private room so she protects patient from exogenous bacteria, risk for
will not infect other patients developing infection from others due to depressed
and healthcare workers WBC count, alters ability to fight infection
B. To a private room so she will C. To a semiprivate room so she will have
not be infected by other stimulation during her hospitalization — should be
patients and healthcare placed in a room alone
workers D. To a semiprivate room so she will have the
C. To a semiprivate room so opportunity to express her feelings about her illness
she will have stimulation during — ensure that patient is provided with opportunities
her hospitalization to express feelings about illness"
D. To a semiprivate room so
she will have the opportunity
to express her feelings about
her illness"

Leukemia NCLEX questions

"A 33-year-old male is being Answer C is correct. Radiation treatment for other
evaluated for possible acute types of cancer can result in leukemia. Some
leukemia. Which of the hobbies and occupations involving chemicals are
following would the nurse linked to leukemia, but not the ones in these
inquire about as a part of the answers; therefore, answers A and B are incorrect.
assessment? Answer D is incorrect because the incidence of
"a. The client collects stamps as leukemia is higher in twins than in siblings.
a hobby.
b. The client recently lost his
job as a postal worker.
c. The client had radiation for
treatment of Hodgkin's disease
as a teenager.
d. The client's brother had
leukemia as a child."

"A child with leukemia is "Correct: 1.

complaining of nausea. A nurse With nausea, cool and clear liquids are better
suspects that the nausea is tolerated. Do not offer foods when the child is
related to the chemotherapy nauseated so he doesn't associate if with being sick.
regimen. The nurse, concerned Support nutrition with oral supplements and foods
about the child's nutritional high in proteins and calories"
status, most appropriately
would offer which of the
following during this episode
of nausea?
"1. Cool, clear liquids
2. Low protein foods
3. Low-calorie foods
4. The child's favorite food"

Leukemia NCLEX questions

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"The nurse is caring for a 59- "Correct answer: D

year-old woman who had Rationale: While the patient is waiting for diagnostic
surgery 1 day ago for removal study results, the nurse should be available to
of a suspected malignant actively listen to the patient's concerns and should
abdominal mass. The patient is be skilled in techniques that can engage the patient
awaiting the pathology report. and the family members or significant others in a
She is tearful and says that she discussion about their cancer-related fears."
is scared to die. The most
effective nursing intervention
at this point is to use this
opportunity to:
"a. Motivate change in
unhealthy lifestyles.
b. Educate her about the seven
warning signs of cancer.
c. Instruct her about healthy
stress relief and coping
practices.
d. Allow her to communicate
about the meaning of this
experience."

Leukemia NCLEX questions

Which of the following "Correct: 1.
laboratory values could 1. YES! - A normal WBC count is approximately 4.5
indicate that a child has mm3 - 11.0 mm3. In leukemia a high WBC count is
leukemia? diagnostic and is usually confirmed by a blood
"1. WBCs 32,000/mm3 smear.
2. Platelets 300,000/mm3 2-4. None of these indicate leukemia,"
3. Hemoglobin 15g/dL
4. Blood pH of 7.35"

The nurse is caring for a patient "Correct Answer: D

suffering from anorexia
secondary to chemotherapy. The nurse can increase the nutritional density of
Which of the following foods by adding items high in protein and/or
strategies would be most calories (such as peanut butter, skim milk powder,
appropriate for the nurse to cheese, honey, or brown sugar) to the foods that a
use to increase the patient's patient will eat.
nutritional intake?
"A. Increase intake of liquids at Other Rationales: Increasing liquids at meals can
mealtime to stimulate the cause a patient to feel full faster, leading to eating
appetite. fewer calories.
B. Serve three large meals per Eating three large meals isn't possible for a patient
day plus snacks between each on chemotherapy due to the decreased taste
meal. sensation.
C. Avoid the use of liquid Liquid protein supplements should when needed
protein supplements to but they lead to less eating during mealtimes due to
encourage eating at mealtime. feeling of satiation."
D. Add items such as skim milk
powder, cheese, honey, or
peanut butter to selected
foods."

Leukemia NCLEX questions

A client has developed oral "2) D
mucositis as a result of Oral mucositis (irritation, inflammation, and/or
radiation to the head and neck. ulceration of the mucosa) commonly occurs in
The nurse shouls teach the clients receiving radiation to the head and neck.
client to incorporate which of Measures need to be taken to soothe the mucosa as
the following measures in his or well as provide effective cleansing of the oral cavity.
her daily home care routine? A combination of a weak saline and water solution is
a) oral hygiene should be an effective cleansing agent."
performed in the morning and
evening
b) high-protein foods, such as
peanut butter, should be
incorporated in the diet
c) a glass of wine per day will
not pose any further harm to
the oral cavity
d) a combination of a weak
saline and water solution
should be used to rinse the
mouth before and after each
meal"

Leukemia NCLEX questions

"The nurse and the unlicensed "Correct: A.
assistive personnel (UAP) are Explanation:
caring for clients in a bone A. After the first 15 minutes during which the client
marrow transplantation unit. tolerates the blood transfusion, it is appropriate to
Which nursing task should the ask the UAP to take the vital signs as long as the
nurse delegate? UAP has been given specific parameters for the vital
"A. Take the hourly vital signs signs. Any vital sign outside the normal parameters
on a client receiving blood must have an intervention by the nurse.
transfusions. B. Antineoplastic medication infusions must be
B. Monitor the infusion of monitored by a chemotherapy-certified, competent
antineoplastic medications. nurse.
C. Transcribe the HCP's orders C. This is the responsibility of the word secretary or
onto the Medication the nurse, not the unlicensed personnel.
Administration Record. D. This represents the evaluation portion of the
D. Determine the client's nursing process and cannot be delegated."
reponse to the therapy."

"The most common signs and "Answer A is Correct.

symptoms of leukemia related Signs of infiltration of the bone marrow are
to bone marrow involvement petechiae from lowered platelet count, fever
are which of the following? related to infection from the depressed number of
"A. Petechiae, fever, fatigue effective leukocytes, and fatigue from the anemia."
B. Headache, papilledema,
irritability
C. Muscle wasting, weight loss,
fatigue
D. Decreased intracranial
pressure, psychosis, confusion"

Leukemia NCLEX questions

"A client, diagnosed with "Correct: D.
chronic lymphocytic leukemia, 1. does not meet need for rest
is admitted to the hospital for 2. no info given about WBC or reverse isolation, on
treatment of hemolytic anemia. reverse isolation if neutrophil count is less than
Which of the following 500/mm3
measures, if incorporated into 3. needed for wound healing and resistance to
the nursing care plan, would infection, not best choice
best address the patient's 4. primary problem activity intolerance due to
needs? fatigue. Correct"
"1. Encourage activities with
other patients in the day room.
2. Isolate him from visitors and
patients to avoid infection.
3. Provide a diet high in Vitamin
C
4. Provide a quiet environment
to promote adequate rest."

"A client diagnosed with "Correct answer is 1.

leukemia is being admitted for 1. A left shift indicates immature white blood cells
an induction course of are being produced and released into the
chemotherapy. Which circulating blood volume. This should be
laboratory values indicate a investigated for the malignant process of leukemia."
diagnosis of leukemia?
1. A left shift in the white blood
cell count differential.
2. A large number of WBCs that
decrease after the
administration of antibiotics.
3. An abnormally low
hemoglobin (Hb) and
hematocrit (Hct) level.
4. Red blood cells that are
larger than normal."

Leukemia NCLEX questions

A pediatric nurse clinician is 4. Reed-sternberg Cell is found in Hodgkins
discussing the pathophysiology
related to childhood leukemia
with a class of nursing students.
Which statement made by a
nursing student indicates a lack
of understanding of the
pathophysiology of this
disease? "
1. Normal bone marrow is
replaced by blast cells
2. Red blood cell production is
affected
3. the platelet count is
decreased
4. the presence of a reed-
sternberg cell is found on
biopsy"

Which of the following findings 1) Presence of a mediastinal mass indicates a poor

yields a poor prognosis for a prognosis. The rest of the choices refer to diagnosis
pediatric patient with not prognosis.
leukemia? "
1) Presence of a mediastinal
mass
2) Late CNS leukemia
3) Normal WBC count at
diagnosis
4) Disease presents between
age 2 and 10"

Leukemia NCLEX questions

"The nurse writes a nursing "Answer: 2
problem of "altered nutrition" 1. The nurse should administer an antiemetic prior to
for a client diagnosed meals, not an antidiarrheal medication
withleukemia who has received 2. Serum albumin is a measure of the protein
a treatment regimen of content in the blood that is derived form food
chemotherapy and radiation. eaten; albumin monitors nutritional status
Which nursing intervention 3. Assessment of the nutritional status is indicated
should be implemented? for this problem, not assessment of the s/sx of
"1. Administer an antidiarrheal infections.
medication prior to meals 4. This addresses an altered skin integrity problem"
2. Monitor the client's serum
albumin levels
3. Assess for signs and
symptoms of infection
4. Provide skin care to
irradiated areas"

A 43-year-old African Answer D is correct. It is important to assess the

American male is admitted with extremities for blood vessel occlusion in the client
sickle cell anemia. The nurse with sickle cell anemia because a change in
plans to assess circulation in capillary refill would indicate a change in circulation.
the lower extremities every 2 Body temperature, motion, and sensation would not
hours. Which of the following give information regarding peripheral circulation;
outcome criteria would the therefore, answers A, B, and C are incorrect.
nurse use? "
a. Body temperature of 99°F or
less
b. Toes moved in active range
of motion
c. Sensation reported when
soles of feet are touched
d. Capillary refill of < 3
seconds"

Leukemia NCLEX questions

"The mother of a 5-year-old "Correct: A.
child asks the nurse questions Appropriate use of sunscreen decreases the risk of
regarding the importance of skin cancer.
vigilant use of sunscreen. While all of the answer choices are correct,
Which information is most recommending the use of sunscreen to decrease
important for the nurse to the incidence of skin cancer is the best response.
convey to the mother? Nursing Process: Implementation
"A. Appropriate use of Category of Client Need: Health Promotion and
sunscreen decreases the risk of Maintenance
skin cancer. Cognitive Level: Application"
B. Repeated exposure to the
sun causes premature aging of
the skin.
C. A child's skin is delicate, and
burns easily.
D. In addition to causing skin
cancer, repeated sun exposure
predisposes the child to other
forms of cancer."

Leukemia NCLEX questions

A 4 yo is admitted for "Correct: 3.
abdominal pain. She has been 3 leukemia is a malignant increase in the number of
pale and excessively tired and leukocytes, usually at an immature stage, in the
is bruising easily. On physical bone marrow. The confirmatory test is microscopic
exam, lymphadenopathy and exam of bone marrow obtained by bone marrow
hepatosplenomaegaly are aspirate and biopsy. a lumbar puncture may be
noted. Diagnostic studies are done to look for blast cells in the scfluid that
being performed on the child indicate CNS disease. The wbc count may be
because acute lymphocytic normal, high or low in leukemia an altered platelet
leukemia is suspected. Which count occurs as a result of the disease but also may
diagnostic study would occur as a result of chemotherapy and does not
confirm this diagnosis confirm the diagnosis"
"1. Platelet count
2. LUmbar puncture
3. bone marrow biopsy
4. wbc count"

"Nursing considerations related "Correct: C 3. Chemotherapeutic agents can be

to the administration of extremely damaging to cells. Nurses experienced
chemotherapeutic drugs with the administration of vesicant drugs should be
include which of the following? responsible for giving these drugs and be prepared
"A. Anaphylaxis cannot occur, to treat
since the drugs are considered extravasations if necessary.
toxic to normal cells. 1. Anaphylaxis is a possibility with some
B. Infiltration will not occur chemotherapeutic and immunologic agents.
unless superficial veins are 2. Infiltration and extravasations are always a risk,
used for the intravenous especially with peripheral veins.
infusion. 4. Gloves are worn to protect the nurse when
C. Many chemotherapeutic handling the drugs, and the hands should be
agents are vesicants that can thoroughly washed afterward.
cause severe cellular damage
if drug infiltrates. Level of cognitive ability: Analysis
D. Good hand washing is Area of client needs: Physiologic
essential when handling Integrity/Pharmacologic and Parenteral Therapy
chemotherapeutic drugs, but Integrated process: Teaching/Learning; Nursing
Leukemia NCLEX questionsProcess: Implementation"
gloves are not necessary."
 "Correct: A, C
"After a client with a potential ANSWER: Reports of fatigue and weakness Signs of
diagnosis of leukemia is bruising easily
admitted to the Rationale: General manifestations of leukemia
hospital, the nurse should result from anemia, infection, and bleeding. The
assess for which of the client would complain
following? (Select of fatigue and weakness and show signs of bruising.
all that apply.)" " Leukemic cells
A. Reports of fatigue and replace normal hematopoietic elements preventing
weakness the formation of mature
B. An elevation in the leukocytes. Neutrophil count would be decreased.
leukocytes Because of an
especially neutrophils increased metabolism, weight loss may occur.
C. Signs of bruising easily Strategy: It is important to read every word in the
D. Recent weight gain" question. Do not speed-read."

"After a client is admitted to the "Answer: B

pediatric unit with a diagnosis Rationale: Neutropenia is a decreased number of
of acute lymphocytic leukemia, neutrophil cells in the blood which are responsible
the laboratory test indicates for the body's
that the client is neutropenic. defense against infection. Rest and avoid exertion
The nurse should perform would be related to
which of the following?" erythrocytes and oxygen carrying properties.
"A. advise the client to rest and Monitoring the blood
avoid exertion pressure, and observing for bruising would be
B. prevent client exposure ot related to platelets and
infections sign and symptoms of bleeding.
C. monitor the blood pressure Objective: Describe the major types of leukemia
frequently and the most common treatment modalities and
D. observe for increased nursing interventions."
bruising"

Leukemia NCLEX questions

"The mother of a child "Answer B
diagnosed with a potentially Parents of children diagnosed with cancer require
life-threatening form of cancer major emotional support, and should be allowed to
says to the nurse, ""I don't express their feelings. Prevention and blaming
understand how this could oneself is not supportive, nor is telling the parents
happen to us. We have been so that there are many other children with cancer."
careful to make sure our child
is healthy."" Which response by
the nurse is most appropriate?
"A. Why do you say that? Do
you think that you could have
prevented this?""
B. ""This must be a difficult time
for you and your family. Would
you like to talk about how you
are feeling?""
C. ""You shouldn't feel that you
could have prevented the
cancer. It is not your fault.""
D.""Many children are
diagnosed with cancer. It is not
always life-threatening."""

Leukemia NCLEX questions

 "Correct: 1.
1. Fever and infection are hallmark symptoms of
The nurse is assessing a client
leukemia. They occur because the bone marrow is
diagnosed with acute myeloid
unable to produce WBCs of the number and
leukemia. Which assessment
maturity needed to fight infection (CORRECT). 2.
data support this diagnosis?
Nausea and vomiting are symptoms related to the
"1.) Fever and infections.
treatment of cancer but not to the diagnosis of
2.) Nausea and vomiting.
leukemia (omit #2). 3. The clients are frequently
3.) Excessive energy and high
fatigued and have low platelet counts. The platelet
platelet counts.
count is low as a result of the inability of the bone
4.) Cervical lymph node
marrow to produce the needed cells (omit #3). 4.
enlargement and positive acid-
Cervical lymph node enlargement is associated with
fast bacillus."
Hodgkin's lymphoma, and positive acid-fast bacillus
is diagnostic for tuberculosis (omit #4)."

Leukemia NCLEX questions

"A bone marrow transplant is "Correct Answer: A
being considered
for treatment of a patient with The patient requires strict protective isolation to
acute leukemia that has not prevent infection for 2 to 4 weeks after HSCT while
responded to chemotherapy. waiting for the transplanted marrow to start
In discussing the treatment with producing cells. The transplanted cells are infused
the patient, the nurse explains through an IV line, so the transplant is not painful,
that nor is an operating room required. The HSCT takes
"a. hospitalization will be place 1 or 2 days after chemotherapy to prevent
required for several weeks damage to the transplanted cells by the
after the hematopoietic stem chemotherapy drug."
cell transplant (HSCT).
b. the transplant of the
donated cells is painful
because of the nerves in the
tissue lining the bone.
c. donor bone marrow cells are
transplanted immediately after
an infusion of chemotherapy.
d. the transplant procedure
takes place in a sterile
operating room to minimize the
risk for infection."

Leukemia NCLEX questions

A bone marrow transplant is A
being considered for treatment Rationale: The patient requires strict protective
of a patient with acute isolation to prevent infection for 2 to 4 weeks after
leukemia that has not HSCT while waiting for the transplanted marrow to
responded to chemotherapy. start producing cells. The transplanted cells are
In discussing the treatment with infused through an IV line, so the transplant is not
the patient, the nurse explains painful, nor is an operating room required. The
that HSCT takes place 1 or 2 days after chemotherapy to
a. hospitalization will be prevent damage to the transplanted cells by the
required for several weeks chemotherapy drugs.
after the hematopoietic stem
cell transplant (HSCT).
b. the transplant of the
donated cells is painful
because of the nerves in the
tissue lining the bone.
c. donor bone marrow cells are
transplanted immediately after
an infusion of chemotherapy.
d. the transplant procedure
takes place in a sterile
operating room to minimize the
risk for infection.

Leukemia NCLEX questions

After the nurse has explained C
the purpose of and schedule Rationale: The patient who has a new cancer
for chemotherapy to a 23-year- diagnosis is likely to have high anxiety, which may
old patient who recently impact learning and require that the nurse repeat
received a diagnosis of acute and reinforce information. The patient's history of a
leukemia, the patient asks the recent diagnosis suggests that infiltration of the
nurse to repeat the leukemia is not a likely cause of the confusion. The
information. Based on this patient asks for the information to be repeated,
assessment, which nursing indicating that lack of interest in learning and denial
diagnosis is most likely for the are not etiologic factors.
patient?
a. Acute confusion related to
infiltration of leukemia cells
into the central nervous system
b. Knowledge deficit:
chemotherapy related to a lack
of interest in learning about
treatment
c. Risk for ineffective health
maintenance related to anxiety
about new leukemia diagnosis
d. Risk for ineffective
adherence to treatment related
to denial of need for
chemotherapy

Leukemia NCLEX questions

A hospitalized patient who has A
received chemotherapy for Rationale: Fresh, thinned-skin peaches are not
leukemia develops permitted in a neutropenic diet because of the risk
neutropenia. Which of bacteria being present. The patient should
observation by the RN caring ambulate in the room rather than the hospital
for the patient indicates that hallway to avoid exposure to other patients or
the nurse should take action? visitors. Because overuse of soap can dry the skin
a. The patient's visitors bring in and increase infection risk, showering every other
some fresh peaches from day is acceptable. Careful cleaning after having a
home. bowel movement will help to prevent perineal skin
b. The patient ambulates breakdown and infection.
several times a day in the room.
c. The patient uses soap and
shampoo to shower every
other day.
d. The patient cleans with a
warm washcloth after having a
stool.

Which action by a nursing A

assistant (NA) when caring for Rationale: Use of dental floss is avoided in patients
a patient who is pancytopenic with pancytopenia because of the risk for infection
indicates a need for the nurse and bleeding. The other actions are appropriate for
to intervene? oral care of a pancytopenic patient.
a. The NA assists the patient to
use dental floss after eating.
b. The NA makes an oral rinse
using 1 teaspoon of salt in a
liter of water.
c. The NA adds baking soda to
the patient's saline oral rinses.
d. The NA puts fluoride
toothpaste on the patient's
toothbrush.

Leukemia NCLEX questions

Which information noted by B
the nurse reviewing the Rationale: Neutropenia places the patient at risk for
laboratory results of a patient severe infection and is an indication that the
who is receiving chemotherapy chemotherapy dose may need to be lower or that
is most important to report to white blood cell (WBC) growth factors such as
the health care provider? filgrastim (Neupogen) are needed. The other
a. Hemoglobin of 10 g/L laboratory data do not indicate any immediate life-
b. WBC count of 1700/µl threatening adverse effects of the chemotherapy.
c. Platelets of 65,000/µl
d. Serum creatinine level of 1.2
mg/dl

A chemotherapeutic agent B
known to cause alopecia is Rationale: The patient is taught to anticipate hair loss
prescribed for a patient. To and to be prepared with wigs, scarves, or hats.
maintain the patient's self- Limiting social contacts is not appropriate at a time
esteem, the nurse plans to when the patient is likely to need a good social
a. suggest that the patient limit support system. The damage occurs at the hair
social contacts until regrowth follicle and will occur regardless of gentle washing
of the hair occurs. or use of a mild shampoo. The information that the
b. encourage the patient to hair will grow back is not immediately helpful in
purchase a wig or hat and wear maintaining the patient's self-esteem
it once hair loss begins.
c. have the patient wash the
hair gently with a mild
shampoo to minimize hair loss.
d. inform the patient that hair
loss will not be permanent and
that the hair will grow back.