A hospitalized client has a platelet count of 58,000/mm³. What action by the nurse is best?
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Question 2 of 52
The commonest cause of jaundice in thalassemia is:
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Question 3 of 52
The nurse is staying with a patient who has been started on a blood transfusion. Which assessment should the nurse perform during a blood product infusion to detect a reaction?
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Question 4 of 52
A patient with abdominal injuries from a motor vehicle crash is scheduled for surgery to remove the spleen. What bodily function will be affected by the removal of this organ?
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Question 5 of 52
An infant is born with a firm mass over the chest with a central area of purpura and a 'halo' around it. An ultrasound reveals a high-flow lesion. What is the most likely diagnosis?
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Question 6 of 52
A 40 year old patient is presented with unilateral palpebral edema and ipsilateral lymphadenopathy. He later develops megaesophagus and megacolon as complications. Which of the following vector is responsible for this parasitic infection?
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Question 7 of 52
A nurse is caring for a client who is about to begin taking epoetin. An increase in which of the following laboratory values should indicate to the nurse that the therapy is effective?
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Question 8 of 52
Which of the following moves furthest to the anode on cellulose acetate electrophoresis of normal haemoglobin at pH 8.6?
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Question 9 of 52
A nurse is caring for a client who is scheduled for an outpatient surgical procedure and reports taking aspirin 81 mg daily, including this morning. The nurse should identify that this places the client at risk for which of the following complications?
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Question 10 of 52
A 7-year-old boy presents with recent onset of vomiting and lethargy. Blood smear shows increased neutrophils with a left shift and 8% abnormal cells. Bone marrow contains 60% of the same cells. Flow cytometry shows that the cells are TdT–, CD10+, CD19+, CD20+, sIg+. What is the most likely diagnosis?
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Question 11 of 52
A study is designed to investigate the rates of central line–associated blood stream infections among pediatric hematology/oncology patients. Three common central line types (totally implanted catheter [port], peripherally inserted central catheter [PICC], and tunneled externalized catheter [TEC]) were included in the study. What data structure is central line type?
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Question 12 of 52
A nurse is preparing to assist with a bone marrow biopsy. Which anatomical site should the nurse anticipate will be used to obtain the specimen?
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Question 13 of 52
C6PD reflect false normal report in:
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Question 14 of 52
The nurse assesses a patient who has numerous petechiae on both arms. Which question should the nurse ask the patient?
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Question 15 of 52
Mr XY was found to be anemic. During history taking, he informed his doctor that he was a strict vegetarian who did not consume any meat, fish or milk products.
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Question 16 of 52
Bone marrow responds to iron therapy by increasing erythropoietic activity. Which of the following in bone marrow would most likely indicate erythropoiesis?
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Question 17 of 52
An otherwise healthy 18-year-old female is diagnosed with high-risk neuroblastoma after presenting with fatigue and bony pain. Imaging findings demonstrate a left adrenal mass with multiple osseous metastases. She successfully completes standard therapy for high-risk neuroblastoma, but experiences several episodes of disease recurrence and ultimately dies of her disease 10 years after her initial diagnosis. During her treatment, her tumor was sent for molecular analysis. Of the following, what molecular aberration was most likely to have been detected?
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Question 18 of 52
Which of the following requires IL-2 and IL-4 in the conversion of unilineage progenitor cell into mature circulating cell?
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Question 19 of 52
Which of the following alters the function of thrombin from a procoagulant protein to one that downregulates the formation of fibrinogen?
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Question 20 of 52
You are seeing a 12-year-old boy in the survivorship program who presented at 2 years old with a desmoplastic nodular medulloblastoma. You note the child recently underwent germline genetic testing and was found to have nevoid basal cell carcinoma syndrome. In which gene is the child most likely to have a pathogenic variant?
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Question 21 of 52
When assessing a newly admitted patient, the nurse notes pallor of the skin and nail beds. The nurse should ensure that which laboratory test has been ordered?
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Question 22 of 52
A nurse is caring for a patient with Hodgkin lymphoma at the oncology clinic. The nurse should be aware of what main goal of care?
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Question 23 of 52
A 9-year-old boy is being treated for standard-risk acute lymphoblastic leukemia. His treatment protocol calls for administration of intravenous methotrexate and intramuscular L-asparaginase during interim maintenance chemotherapy. What is the most appropriate sequence of drug administration?
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Question 24 of 52
A leukemia investigator plans to obtain bone marrow under general anesthesia to measure minimal residual disease (MRD) and to see if this time point can predict early relapse. The specimen will be obtained at a time point when otherwise no bone marrow would be sampled. The results are not shared with the treating oncologist, and no therapeutic interventions are decided or based on the results. Which of the following statements is most accurate about this intervention?
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Question 25 of 52
A patient is scheduled for upcoming surgery. He is on nonsteroidal anti-inflammatory drugs (NSAIDs) for rheumatoid arthritis. You are being asked what to do with his medications for the surgery. What is the mechanism of action of NSAIDS?
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Question 26 of 52
The nurse is caring for a patient who has a white blood cell (WBC) count of 8000/mm³. What concern should the nurse have about this finding?
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Question 27 of 52
Basophilic stippling is classically seen in:
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Question 28 of 52
A laboratory study is conducted to determine the optimal usage of platelets for transfusion. The blood bank inventory along with the transfusion records and medical records of subjects who were recipients of platelet transfusion are reviewed. Which of the following conclusions is most likely to be made from this study?
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Question 29 of 52
A 2-month-old infant is brought to your clinic with an extensive scaly rash on the scalp, which has been biopsied and shown to be Langerhans cell histiocytosis (LCH). You want to determine whether this patient has skin-only LCH or involvement of any of the 'high-risk' organs. The child has a normal CBC; normal liver enzymes and bilirubin; and a normal skeletal survey, skull films, and chest X ray. What other screening test will be important for finding involvement of a high-risk organ?
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Question 30 of 52
A 9-month-old boy has been referred to you for the evaluation of an enlarged abdomen. Imaging studies show a large liver mass (PRETEXT III). Alfa-fetoprotein is 98 ng/mL, and a CT scan of the lungs show bilateral lung metastases. A needle biopsy is performed, and you are planning to review the specimen with the pathologist. Which of the following diagnoses are you suspecting?
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Question 31 of 52
Which of the following best characterizes the function of ferroportin in iron metabolism?
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Question 32 of 52
Thrombocytopenia is absent in:
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Question 33 of 52
You are discussing prognosis with the mother of a patient with stage 3, group III rhabdomyosarcoma. Which of the following is the most unfavorable primary site?
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Question 34 of 52
In iron deficiency anemia there is characteristically
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Question 35 of 52
The typical Reed-Sternberg cells are either infrequent or absent. Instead, lymphocytic and histiocytic cells or 'popcorn cells' are seen within a background of inflammatory cells, which are predominantly benign lymphocytes. Which type of Hodgkin's lymphoma best suit the description?
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Question 36 of 52
A 77-year-old male is admitted to a unit with a suspected diagnosis of acute myeloid leukemia (AML). When planning this patient's care, the nurse should be aware of what epidemiologic fact?
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Question 37 of 52
An oncology nurse is providing health education for a patient who has recently been diagnosed with leukemia. What should the nurse explain about commonalities between all of the different subtypes of leukemia?
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Question 38 of 52
Dohle bodies are patches of dilated endoplasmic reticulum that appear as cerulean blue cytoplasmic puddles. These findings are mostly seen in
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Question 39 of 52
Increase serum iron:-decrease IBC a feature of:
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Question 40 of 52
A 13-year-old Hispanic girl is found to have a WBC count of 6,500/mm3 with 40% Auer rod–containing granular blasts that, by flow cytometry, express very bright CD33 but are negative for human leukocyte antigen–DR isotype (HLA-DR). She is oozing blood around her peripheral IV site. Coagulation studies reveal an international normalized ratio (INR) of 3.4, a fibrinogen of 170, and a markedly elevated D-dimer. Marrow aspirate shows nearly 90% blasts with a similar morphology. You send the marrow to the fluorescence in situ hybridization (FISH) lab and request STAT testing for the most likely recurrent genetic abnormality based on the clinical presentation. How do you plan to initiate therapy?
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Question 41 of 52
A 14-year-old boy presents with cough, shortness of breath, and difficulty lying down. His face and neck swell when his arms are raised. Chest x-ray reveals a large mediastinal mass. A tissue diagnosis is desired. A biopsy is performed with local anesthesia because the anesthesiologist thinks that the patient has a very high general anesthesia risk. Which of the following findings does not make general anesthesia unsafe?
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Question 42 of 52
A nurse is caring for a client who has renal failure and is receiving epoetin. The nurse should monitor the client for which of the following adverse effects?
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Question 43 of 52
The main vector transmitting malaria in Sabah is Anopheles balabacensis. This vector breeds in
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Question 44 of 52
An older client asks the nurse why 'people my age' have weaker immune systems than younger people. What responses by the nurse are best? (Select all that apply.)
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Question 45 of 52
A nurse is caring for a client who has hemophilia A and is about to begin taking desmopressin to prevent bleeding. The nurse should monitor the client for which of the following adverse reactions?
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Question 46 of 52
The nurse is reviewing the activated partial thromboplastin time for a patient receiving heparin. Which value indicates that the medication is within the therapeutic range?
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Question 47 of 52
A nurse is caring for a patient who has been diagnosed with leukemia. The nurse's most recent assessment reveals the presence of ecchymoses on the patient's sacral area and petechiae in her forearms. In addition to informing the patient's primary care provider, the nurse should perform what action?
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Question 48 of 52
You receive a phone call from a community pediatrician who is caring for a 2-year-old toddler with a cancer predisposition syndrome. The pediatrician describes a child at the 95th percentile for height and weight with a history of corrective oral surgery to reduce a large tongue and a history of an omphalocele in infancy. The pediatrician is currently performing ultrasound of the abdomen and laboratory evaluation for this patient every 3 months. Which tumor is this patient most at risk of developing?
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Question 49 of 52
An oncology nurse recognizes a patient's risk for fluid imbalance while the patient is undergoing treatment for leukemia. What relevant assessments should the nurse include in the patient's plan of care? Select all that apply.
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Question 50 of 52
A client is having a bone marrow aspiration and biopsy. What action by the nurse takes priority?
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Question 51 of 52
Splenectomy is curative in:
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Question 52 of 52
An 8-year-old boy undergoes a resection of a tumor in the right cerebrum next to the lateral ventricle (supratentorial). The pathologist feels the histology is most consistent with an ependymoma. The tumor is sent for advanced molecular and genetic testing. Which of the following findings would further support a diagnosis of ependymoma?
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