Olivia McRitchie
Quiz por , criado more than 1 year ago

NCLEX Nursing (Pediatrics) Quiz sobre Exemplar 2.5: Leukemia, criado por Olivia McRitchie em 04-11-2019.

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Olivia McRitchie
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Exemplar 2.5: Leukemia

Exemplar 2.5: Leukemia

Questão 1 de 25

1

You have the unfortunate task of explaining what leukemia is to a small group of parents whose children have been diagnosed with different forms of it.

Which of the following is the BEST teaching?

Selecione uma ou mais das seguintes:

  • "Leukemia is a type of cancer that happens when the body produces white blood cells that don't help with the immune response, which is what they're supposed to do. Instead, these cells clone rapidly and leak into the bloodstream, where they replace the normal white blood cells."

  • "As the bad white blood cells fill the spongy stuff in some of your bones called your bone marrow, cells that produce other blood products get crowded out."

  • "Leukemias can be acute or chronic AND they can be lymphocytic or myeloid."

  • "Acute means they happen fast and progress fast, and chronic means they happen slowly and progress slowly. Additionally, lymphocytic means they happen in immature versions of a cell called 'lymphocytes', and myeloid means they involve cells called myeloid stem cells."

  • "There are also subtypes of both acute and chronic leukemia."

  • "Acute myeloid leukemia and chronic lymphocytic leukemia are the most common types of leukemia in children."

Explicação

Questão 2 de 25

1

You are delivering teaching to parents of a child diagnosed with acute myeloid leukemia.

Which of the following statements shows that teaching has been received?

Selecione uma das seguintes:

  • "This form of leukemia is characterized by uncontrolled division of cells called myeloblasts and enlargement of the bone marrow and spleen. It's quite uncommon for people under the age of 40 to get."

  • "This form of leukemia is characterized by abnormal division of all parts of the bone marrow, and it's associated with a chromosomal abnormality called the Philadelphia chromosome. It's very rarely seen in children."

  • "Most of the time, this leukemia results from a malformation in the Philadelphia chromosome. Most cases result from cancerous transformation of B-cells, causing them to reproduce quickly but not mature. This is the most common type in children."

  • "This type of leukemia is characterized by division and build-up of small, abnormal, mature lymphocytes, usually B-lymphocytes, in different parts of the body. It is rarely seen in children and adults under the age of 40."

Explicação

Questão 3 de 25

1

You are delivering teaching to parents of a child diagnosed with chronic myeloid leukemia.

Which of the following shows that teaching has been received?

Selecione uma das seguintes:

  • "This form of leukemia is characterized by uncontrolled division of cells called myeloblasts and enlargement of the bone marrow and spleen. It's quite uncommon for people under the age of 40 to get."

  • "This form of leukemia is characterized by abnormal division of all parts of the bone marrow, and it's associated with a chromosomal abnormality called the Philadelphia chromosome. It's very rarely seen in children."

  • "Most of the time, this leukemia results from a malformation in the Philadelphia chromosome. Most cases result from cancerous transformation of B-cells, causing them to reproduce quickly but not mature. This is the most common type in children."

  • "This type of leukemia is characterized by division and build-up of small, abnormal, mature lymphocytes, usually B-lymphocytes, in different parts of the body. It is rarely seen in children and adults under the age of 40."

Explicação

Questão 4 de 25

1

You are delivering teaching to parents of a child diagnosed with acute lymphocytic leukemia.

Which of the following shows that teaching has been received?

Selecione uma das seguintes:

  • "This type of leukemia is characterized by division and build-up of small, abnormal, mature lymphocytes, usually B-lymphocytes, in different parts of the body. It is rarely seen in children and adults under the age of 40."

  • "Most of the time, this leukemia results from a malformation in the Philadelphia chromosome. Most cases result from cancerous transformation of B-cells, causing them to reproduce quickly but not mature. This is the most common type in children."

  • "This form of leukemia is characterized by abnormal division of all parts of the bone marrow, and it's associated with a chromosomal abnormality called the Philadelphia chromosome. It's very rarely seen in children."

  • "This form of leukemia is characterized by uncontrolled division of cells called myeloblasts and enlargement of the bone marrow and spleen. It's quite uncommon for people under the age of 40 to get."

Explicação

Questão 5 de 25

1

You are delivering teaching to parents of a child diagnosed with chronic lymphocytic leukemia.

Which of the following shows that teaching has been received?

Selecione uma das seguintes:

  • "This form of leukemia is characterized by uncontrolled division of cells called myeloblasts and enlargement of the bone marrow and spleen. It's quite uncommon for people under the age of 40 to get."

  • "This form of leukemia is characterized by abnormal division of all parts of the bone marrow, and it's associated with a chromosomal abnormality called the Philadelphia chromosome. It's very rarely seen in children."

  • "Most of the time, this leukemia results from a malformation in the Philadelphia chromosome. Most cases result from cancerous transformation of B-cells, causing them to reproduce quickly but not mature. This is the most common type in children."

  • "This type of leukemia is characterized by division and build-up of small, abnormal, mature lymphocytes, usually B-lymphocytes, in different parts of the body. It is rarely seen in children and adults under the age of 40."

Explicação

Questão 6 de 25

1

Which of the following is NOT a manifestation of chronic lymphoid leukemia?

Selecione uma das seguintes:

  • Fatigue and exercise intolerance r/t anemia

  • Bleeding

  • Lymphadenopathy and splenomegaly

  • Recurrent infections, pallor, edema, and thrombophlebitis

Explicação

Questão 7 de 25

1

Which of the following is NOT a manifestation of acute myeloid leukemia?

Selecione uma das seguintes:

  • Fatigue, weakness, fever, and headaches caused by anemia.

  • Bone and joint pain caused by bone infarctions or subperiosteal infiltrates.

  • Abnormal bleeding and bruising due to thrombocytopenia.

  • Recurrent infection due to neutropenia.

  • Lymphadenopathy, splenomegaly, and hepatomegaly.

  • Vomiting, visual disturbances, and seizures.

Explicação

Questão 8 de 25

1

What stage of chronic myeloid leukemia is this?

The patient is largely asymptomatic.

Selecione uma das seguintes:

  • Chronic

  • Accelerated

  • Acute

Explicação

Questão 9 de 25

1

What stage of chronic myeloid leukemia is this?

The patient has decreased appetite, weight loss, and fever.

Selecione uma das seguintes:

  • Chronic

  • Accelerated

  • Blast

Explicação

Questão 10 de 25

1

What stage of chronic myeloid leukemia is this?

The patient has decreased appetite, weight loss, fever, splenomegaly, bone damage, and an abnormal platelet count.

Selecione uma das seguintes:

  • Acute phase

  • Accelerated phase

  • Chronic phase

Explicação

Questão 11 de 25

1

Parents of a child diagnosed with acute lymphocytic leukemia asks you what this disorder is.

Select the correct teaching for these parents.

Selecione uma ou mais das seguintes:

  • "ALL is the most common type of leukemia in children. It is often caused by a mutation called a translocation in a gene called the Philadelphia chromosome."

  • "Most cases are called by cancerous changes in white blood cells called B-cells. These cells don't function effectively enough to maintain immunity."

  • "Most cases are called by cancerous changes in white blood cells called T-cells. These cells don't function effectively enough to maintain immunity."

  • "The immature white blood cells, called lymphoblasts, build up in the bone marrow , lymph nodes, spleen, and circulating blood."

  • "Because the lymphoblasts divide so fast, the body doesn't produce normal blood cells; the lymph nodes and the liver enlarges; and the bones start to hurt."

Explicação

Questão 12 de 25

1

Which of the types of leukemias may not require immediate treatment?

Selecione uma das seguintes:

  • Acute myeloid leukemia

  • Chronic myeloid leukemia

  • Acute lymphocytic leukemia

  • Chronic lymphocytic leukemia

Explicação

Questão 13 de 25

1

Most cases of leukemia are in children.

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 14 de 25

1

Select the pediatric patients that are at risk for developing acute lymphoid leukemia.

Selecione uma ou mais das seguintes:

  • A 5-year-old boy recently diagnosed with a disease causing immunodeficiency.

  • A 2-year-old girl diagnosed with Downs syndrome.

  • A 10-year-old girl who was exposed to radiation following the Fukushima Daiichi nuclear disaster in 2011.

  • An 8-year-old whose parents smoke.

  • A 15-year-old diagnosed with human papilloma virus.

  • A 12-year-old who underwent treatment for a brain tumor as a child.

Explicação

Questão 15 de 25

1

Which of the following individuals are NOT at risk of developing acute myeloid leukemia?

Selecione uma das seguintes:

  • A 50-year-old female who spent the last 34 years as a smoker.

  • A 65-year-old female who lived close to the blast site when the Chernobyl disaster happened.

  • A 5-year-old diagnosed with Kleinfelter syndrome.

  • A 30-year-old who underwent treatment for ALL as a child.

Explicação

Questão 16 de 25

1

The only proven risk factor for chronic myeloid leukemia is exposure to high-dose radiation.

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 17 de 25

1

Chronic lymphocytic leukemia has no known solid risk factors.

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 18 de 25

1

How can nurses prevent adverse effects related to infection in patients with leukemia?

Selecione uma ou mais das seguintes:

  • Implement transmission-based precautions.

  • Perform careful hand hygiene and make sure all visitors do the same.

  • Take vital signs every 4 hours and report manifestations of infection.

  • Provide oral hygiene after every meal.

  • Document manifestations of infection.

  • Take vital signs at the beginning and end of every shift to minimize contact with patient.

Explicação

Questão 19 de 25

1

Which of the following findings would you NOT report to the physician when caring for a child with leukemia?

Selecione uma das seguintes:

  • Fever, chills, and temperature spikes.

  • Chest pain, painful urination, and burning in vaginal or rectal area.

  • Coughing.

  • Purulent drainage.

  • Tachypnea, tachycardia, changes in PaO2, and hypotension.

  • Neutrophil level at 2,600/mm3

Explicação

Questão 20 de 25

1

Which of the following orders would you QUESTION on a leukemic child receiving IV chemotherapy.

Selecione uma das seguintes:

  • Administer morphine 0.2 mg/kg IV push q6 hr.

  • TPR q4 hr, or more frequently if signs of infection are found.

  • Insert urinary catheter and closely monitor I & O.

  • Monitor IV site hourly; report to physician if bleeding and/or purulent discharge is present.

  • Initiate neutropenic precautions.

Explicação

Questão 21 de 25

1

Infection is the second most common cause of death in people with leukemia, next to bleeding.

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 22 de 25

1

Select the children that are at SEVERE relative risk for infection.

Selecione uma ou mais das seguintes:

  • Neutrophils at 2000/mm3

  • Neutrophils at 1,650/mm3

  • Neutrophils at 800/mm3

  • Neutrophils at 1,200/mm3

  • Neutrophils at 450/mm3

  • Neutrophils at 286/mm3

Explicação

Questão 23 de 25

1

What interventions would you enact to assess for bleeding in a patient with leukemia?

Selecione uma ou mais das seguintes:

  • Assess vital signs and skin for pallor and diaphoresis every 4 hours.

  • Assess all body systems, including the gums and nasal membranes, for bleeding every shift.

  • Assess pain hourly, specifically asking about abdominal and head pain.

  • Instruct the patient to vomit, urinate, and defecate into provided receptacles, and to call nursing personnel when these things occur.

  • Assess saline locked IVs once a shift and running IVs every 4 hours.

  • Apply pressure to injection sites for 1 minute.

Explicação

Questão 24 de 25

1

You are receiving report on a patient with leukemia. The patient's platelet count is 40,000 cmm, and the neutrophil count is 670/mm3.

Which of the following statements would make you want to call the physician?

Selecione uma das seguintes:

  • "The patient is scheduled for a bone marrow aspiration at 1300 today."

  • "The patient has been spiking fevers, so we've been taking vitals every 2 hours and assessing him for signs of infection during his hourly safety checks. "

  • "The patient is on both neutropenic and radiation precautions. His mom is currently in the room wearing PPE, but his dad can't visit because he has a cold."

  • "We've given him some Miralax because his mom reports that he's straining while pooping."

Explicação

Questão 25 de 25

1

What lab values would you want to monitor and promptly report in a leukemia patient with thrombocytopenia?

Selecione uma ou mais das seguintes:

  • Electrolytes

  • Uric acid

  • Urea nitrogen

  • Creatinine.

  • Hemoglobin

  • Hematocrit

Explicação

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