Transcript
Chapter 29: Alterations in WBC Function and Oncologic Emergencies
NCLEX® Review
This activity contains 10 questions.
A patient who is undergoing radiation for cancer comes to the Emergency Department complaining of recurrent fever, chills, and malaise. Previous to the radiation therapy, the patient had several rounds of chemotherapy. Lab work reveals neutropenia. After interpreting these results and history, the nurse expects interventions to counteract which cause of neutropenia?
Destruction of neutrophils by the spleen
Decreased production of neutrophils
Premature destruction of neutrophils
Drug-induced hypersensitivity response destroying neutrophils
A patient who received a kidney transplant is now experiencing a type III hypersensitivity response to the foreign tissue. The nurse monitors for assessment findings indicating which effects of this reaction? Select all that apply.
Increased vascular permeability
Antigen-antibody complex infiltration of vessel intima
Alteration of blood flow
Primary IgE effects
Destruction by inflammatory cells
The nurse is explaining autoimmune disease to a patient who has systemic lupus erythematosus (SLE). Which other examples of autoimmune diseases would the nurse offer the patient? Select all that apply.
Poliomyelitis
Pneumocystis jiroveci
Cardiomyopathy
Addison's disease
Ulcerative colitis
A patient with leukemia is receiving "consolidation" therapy. How does the nurse explain the goal of this therapy?
"This therapy will eliminate leukemic cells from your central nervous system."
"This treatment will halt all of your bone marrow cell production."
"This treatment will help ensure that your remission continues and that all leukemic cells are gone."
"This treatment should result in complete remission."
A patient has just been diagnosed with mild neutropenic enterocolitis. Which interventions would the nurse expect to provide for this patient? Select all that apply.
Preparation for surgery to create a colostomy
Administration of a broad-spectrum antibiotic
IV fluid support
Soft diet as tolerated
Placement of a nasogastric tube
A patient is diagnosed with hemophilia and must receive transfusions of factor VIII. The nurse explains that the risk of contracting bloodborne pathogens such as the HIV virus is higher for which reason?
HIV is more difficult to detect in blood components than in whole blood or packed cells.
The virus attaches to large amounts of factor VIII.
The screening procedures for factor VIII lack the sophistication of whole blood testing.
A large number of donors are required to produce therapeutic amounts of factor VIII.
A nurse works to reduce pain and stress for a patient who has been injured in an automobile accident. This intervention is important to reduce which effect of the increased levels of cortisol released during stress?
Stimulation of T cell production
Inhibition of interleukin-1 and -2
Increased production of glycogen
Accelerated production of immunoglobulin by B cells
A patient is receiving filgrastim (Neupogen) to stimulate neutrophil production. The nurse should monitor this patient for which common adverse effects? Select all that apply.
Shortness of breath
Chest pain
Fever
Bone pain
Nausea
A patient who has had several rounds of chemotherapy and who is currently undergoing radiation therapy has an ANC below 500 cells. The nurse carefully plans care for this patient, who is at high risk for developing which complication?
Liver dysfunction
Bone marrow failure
Sepsis
Splenomegaly
A patient who has leukemia develops dyspnea, confusion, and severe headache. Lab results reveal a leukocyte count of 105,000/mcL. The nurse plans care for this patient, who may be suffering from which complication of leukemia?
Severe neutropenia
CNS infiltration
Leukostasis
Bone marrow failure
