QUIZ LEUKEMIA

LA MADRID, HANNA MAE B.

1. A type of leukemia that results from the defect on the differentiation of hematopoietic
stem cells.
a. Chronic myeloid leukemia
b. Acute lymphocytic leukemia
c. Acute myeloid leukemia
d. Chronic lymphocytic leukemia

2. Acute lymphocytic leukemia can cause meningismus due_____.

a. Myelodepression
b. Angioedema
c. Cerebral edema
d. Intracranial hypertension

3. A client with AML is about to be given with carboplatin IV. Which of the following
medications should the nurse anticipate giving the client prior to administration of
carboplatin?
a. Palonosetron IV + dexamethasone IV
b. Metoclopramide IV + haloperidol IV
c. Erythropoietin alfa SQ
d. Omeprazole IV + granisetron IV

4. A client underwent radiotherapy due to CML. His absolute neutrophil count was
2000/cu.mm. Which of the following should the nurse anticipate to administer?
a. Erythropoietin alfa SQ
b. Oprelvekin
c. Filgrastim
d. Pegfilgrastim

5. A client was seen in the clinic with sudden weight loss, several lymphadenopathies and
easing bruising. The doctor suspect of leukemia. Which of the following diagnostic tools
confirms this diagnosis?
a. CT scan with contrast
b. Lymph node aspiration
c. Bone marrow aspiration
d. MRI with gadolinium-dye enhancement
6. You are caring for a client with terminal stage AML with infiltration of the spleen and
secondary tumor growth in the femoral structures. He is in patient-controlled analgesia
with the following settings: continuous infusion of morphine sulfate at 1mg per hour, an
IV bolus of 0.5mg every 4 hours and a patient-controlled IV bolus of 0.5mg, maximum of
8 boluses in 24 hours. The infusion was started at 11pm. At around 8am the following
 day, the client has already consumed the 8 patient-controlled IV boluses and has been
complaining of severe pain in the femur he graded as 10/10. Which of the following
actions should the nurse do?
a. Tell the client that he has consumed the 8 IV boluses he can manually administer
and wait for the next cycle at 11pm today.
b. Tell the client that the pain is all in his brain, as the PCA pump continuously
infuses 1mg of morphine every hour.
c. Ask the doctor if he can adjust or increase the number of IV boluses the client can
administer manually
d. Give an IV bolus of NSS telling the client it is morphine.

7. The client with ALL was admitted in the hospital. His ANC is at 2010/cu.mm. Which of
the following should the nurse implement? Select all that apply.
a. Strict observance of aseptic technique.
b. Put a vase of fresh flower inside the client’s room
c. Encourage her relatives to visit him
d. Put the client in a positive-pressure room
e. Monitor client’s VS especially her temperature
f. Share the equipment used for her with other clients in the floor.

8. You are about to admit a 34 year old male client with CML, however, the floor has no
private room available. Which of the following client can the nurse cohort the CML
client?
a. A 13 year old female client with viral conjunctivitis
b. A 30 year-old male with infected scabies
c. A 29 year old male with thalassemia major on blood transfusion
d. A 31 year old male with suspected fentanyl abuse on four-point restraint 1 hour
ago

9. A client with AML has received PBSCT a few days ago. While having your morning
hand-off report, she told you that she noticed a bloody streak on her urine this morning
and had been experiencing crampy abdominal pain more on the lower back and the RUQ.
Which of the following should the nurse suspect?
a. GVHD
b. Recurrence of the AML
c. Cholelithiasis and nephrolithiasis
d. Splenomegaly

10. A client who was diagnosed with ALL several months ago have been admitted to the
hospital due to cerebral infiltration of leukemic cells and was not able to communicate
and lethargic since then. Upon reading her chart, you noticed that she has a written
advance directive indicating that should she become incapable of deciding for herself, she
does not want any form of enteral feeding. However, her husband has been insisting to
have her an NGT inserted. Which of the following should the nurse do?
a. Follow the wishes of the husband, since the client cannot decide for herself
anymore.
 b. Follow the wishes of the client as indicated in her advance directive
c. Refer the matter to the hospital’s legal counsel
d. Teach the husband on how to insert an NGT and let him do procedure himself.

11. A client is about to undergo an induction of her chemotherapy for AML. While reading
the chart of the client you noticed that doxorubicin, an emetogenic antineoplastic is one
of the agents that they will use in the induction. Knowing that this drug may cause severe
vomiting, which of the following should the nurse do in anticipation of the effects of the
drug?
a. Request the physician to replace doxorubicin with a low-emetogenic drug instead
b. Request the physician to order an antiemetic IV prior to induction
c. Report the incident to the quality assurance team as the physician did not observe
the procedures prior to administration of emetogenic drugs
d. Educate the client the use of guided imagery.

12. The client with AML has undergone a series of radiotherapy to suppress the bone marrow
in preparation for BMT. He was put in strict protective isolation. His relatives came and
want to see him. However, given the client’s condition, you cannot allow them to visit
him. Which of the following should the nurse do to address the client’s need for
psychosocial stimulation and support?
a. Let the family visit him one-by-one, observing them how they wash their hands
and letting them wear surgical masks.
b. Explain to them they cannot see or speak with client. However, let them write a
letter for him.
c. Let the family members use the intercom of the hospital to talk with the client.
d. Tell the family to leave the hospital as they might carry germs from outside.

13. You admitted a client with ALL with an ANC of 2600/cu.mm is put in the unit’s private
room. His family members came and wanted to talk to him. Which of the following
members should the nurse not permit to enter the client’s room? Select all that apply.
a. The client’s pregnant wife who has just received the TT vaccine 2 days ago.
b. The client’s child who received his OPV 14 days ago
c. The client’s mother who was sneezing due to allergic rhinitis, as claimed
d. The client’s father who was diagnosed with hydronephrosis and BPH

14. A client with CLL and a platelet count of 30,000 was admitted to the unit. Which of the
following should the nurse refrain from doing?
a. Shaving the client using an electric razor
b. Providing a non-skid device in the client’s bathroom
c. Giving morphine SO4 IM every 6 hours using the finest needle
d. Putting the client’s bed at the lowest position possible

15. A 25 year-old client with AML on chemotherapy was admitted to the hospital due to
severe anemia for blood transfusion of 4 units of PRBC stat. While assessing the client,
you came to know that he has been converted a few weeks ago from a Baptist to
Jehovah’s Witness and he refused to have the transfusion. Which of the following should
the nurse do?
a. Explain the consequences of the client’s decision and let him sign a waiver of
refusal of treatment
b. Obtain a court order to force the client to accept the treatment
c. Confront your client, tell him you do not agree with his decision and tell your
supervisor to assign you to a different client.
d. Administer a sedative and do the transfusion while he is asleep.