A patient reports severe abdominal cramping and diarrhea. Assessment reveals a temperature of 102°F (38.8°C) and pulse of 82 beats/min. Results of a complete blood count reveal lower than normal segmented and banded neutrophils and higher than normal lymphocytes. Which type of infection does the nurse suspect this patient is most likely experiencing?
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Question 2 of 51
Best tit modality in CML is:
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Question 3 of 51
Which of the following characteristics are similar with respect to Factor VIII and von Willebrand factor (vWF)?
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Question 4 of 51
Which of the following is wrong concerning Philadelphia chromosome:
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Question 5 of 51
Which of the following is associated with normocytic normochromic anaemia?
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Question 6 of 51
A patient who is taking warfarin (Coumadin) 5 mg daily has an international normalized ratio (INR) of 2.5. It is time to administer the next dose of Coumadin. What should the nurse do?
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Question 7 of 51
The nurse is reviewing laboratory results and notes an aPTT level of 28 seconds. The nurse should notify the health care provider in anticipation of adjusting which medication?
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Question 8 of 51
A 19-year old male patient with a history of acute lymphoblastic leukemia, currently 13 years from completion of therapy, presents for a fertility consultation. He is interested in his risk for infertility. Which of the following statements is true?
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Question 9 of 51
While taking a client history, which factor(s) that place the client at risk for a hematologic health problem will the nurse document? (Select all that apply.)
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Question 10 of 51
A nurse is caring for a client who is about to begin taking aspirin to reduce the risk of a cardiovascular event. The nurse should identify that the drug inhibits platelet aggregation by which of the following mechanisms?
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Question 11 of 51
A 16-year-old patient with a left-side pelvic osteosarcoma is taking extended release oxycodone twice daily as well as immediate release oxycodone for breakthrough pain approximately 2 or 3 times per day. She describes her pain as burning, tingling, and shooting in her left leg. Her pain worsens with hot showers. Her most recent EKG has a QTc of 495. What would be the best strategy to manage her pain?
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Question 12 of 51
A patient with a bleeding disorder is prescribed an infusion of plasma. What should the nurse explain as being the purpose of this infusion?
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Question 13 of 51
A 72-year-old male with enlargement of superficial lymph nodes and mild hepatosplenomegaly is diagnosed as having chronic lymphatic leukemia (CLL). The most important criteria for diagnosis of this disease is the
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Question 14 of 51
Which is not associated with hypersplenism:
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Question 15 of 51
A 6-year-old boy is noted to have worsening visual acuity on serial eye exams. Recent MRI of his brain and orbits reveals an optic chiasm mass, most consistent with an optic pathway glioma. Upon further examination, the physician notes axillary freckling and numerous “spots†on the patient's skin. This patient most likely has a which of the following genetic disorders?
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Question 16 of 51
In a study to investigate the rates of central line–acquired bacterial infections, it is discovered that patient length of stay (LOS) is not normally distributed but is highly right-skewed. What is the correct relationship between the mean, median, and mode of LOS?
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Question 17 of 51
An 18-month-old boy, whose parents are first cousins, is referred to you because of a significant episode of epistaxis. The parents report that the child had bleeding after circumcision and large hematomas with immunizations. Platelet aggregation studies show the following: This child's platelets are unable to interact with which of the following?
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Question 18 of 51
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 19 of 51
Splenectomy is contraindicated in:
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Question 20 of 51
All produce microcytic anemia except:
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Question 21 of 51
The pathophysiology of venous thrombosis is often explained by Virchow's triad, which includes hypercoagulability, endothelial injury, and venous stasis. Based on Virchow's triad and your knowledge of risk factors for thrombosis, which of the following pediatric patients has the greatest risk of hospital-acquired venous thromboembolism?
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Question 22 of 51
A 10-year-old patient with aplastic anemia, who is blood type B negative, is receiving a red blood cell transfusion. About 10 minutes after the transfusion starts, the patient develops anxiety and lower back pain. The transfusion continues for another 5 minutes until it is stopped when he develops a temperature of 40 °C with chills and rigors. A transfusion reaction work-up is most likely to reveal what findings?
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Question 23 of 51
A 12-year-old patient with localized osteosarcoma is being treated with cisplatin, doxorubicin, and high-dose methotrexate. The pain at his primary site rapidly resolves after initiation of chemotherapy. After tumor resection, pathology reveals the tumor was greater than 95% necrotic. You want to continue cisplatin, doxorubicin, and high-dose methotrexate. Which of the following is the best answer regarding the evaluations that should be performed to monitor for toxicity in patients receiving cisplatin, doxorubicin, and high-dose methotrexate?
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Question 24 of 51
Busulfan therapy lead to all except:
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Question 25 of 51
A nurse is caring for a client who is taking clopidogrel to prevent stent restenosis. The nurse should monitor the client for which of the following adverse reactions?
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Question 26 of 51
A hospitalized client has a platelet count of 58,000/mm3 (58 Ã 109/L). What action by the nurse is most appropriate?
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Question 27 of 51
A 17-year-old female presents with cervical adenopathy and a history of daily fevers and drenching night sweats. A biopsy is performed and reveals classic Hodgkin lymphoma. Which of the following is least appropriate as part of the staging workup?
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Question 28 of 51
A 30 year old patient had presented with fever and posterior cervical lymphadenopathy over the past two years. Which is the most probably causative organism?
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Question 29 of 51
A nursing student is caring for a patient with acute myeloid leukemia who is preparing to undergo induction therapy. In preparing a plan of care for this patient, the student should assign the highest priority to which nursing diagnoses?
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Question 30 of 51
A patient who is undergoing consolidation therapy for the treatment of leukemia has been experiencing debilitating fatigue. How can the nurse best meet this patient's needs for physical activity?
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Question 31 of 51
A female infant is diagnosed with hemophagocytic lymphohistiocytosis (HLH) not associated with an Epstein-Barr virus (EBV) infection. In taking the family history, you learn that another female infant died of HLH 2 years ago. Also, a newborn female child died of an unknown disease 4 years prior and was said have been bleeding profusely, jaundiced, and had a distended abdomen. When counseling the family about the genetics of HLH, how will you explain it?
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Question 32 of 51
A 3-year-old boy is referred to you for evaluation of right leukocoria. Funduscopic examination under anesthesia reveals a large amelanotic mass occupying more than two-thirds of the vitreous space in his right eye, with massive retinal detachment, consistent with group E retinoblastoma. The left eye is normal. An MRI confirms the funduscopic findings and shows no extraocular disease. What is the most appropriate next step in the management of this child's disease?
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Question 33 of 51
You are consulted on a 4-year-old girl who is newly diagnosed with standard-risk pre-B acute lymphoblastic leukemia. After reviewing her previous complete blood examinations, you note she has had a platelet count ranging from 80,000 to 100,000 cells/mcL over the past 2 years. Her father mentions that he has also been told he has mild thrombocytopenia. You suspect the child may have a cancer predisposition syndrome. Which sample should you send for analysis, and which gene is most likely implicated?
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Question 34 of 51
In microcytic hypochromic anaemia
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Question 35 of 51
Which of the following is false regarding heparin?
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Question 36 of 51
The nurse notes that a patient's gaping wound is developing a blood clot. Which body substance is responsible for this clot formation?
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Question 37 of 51
NADPH is a product of the hexose monophosphate pathway (HMP) in the red blood cell. The NADPH is used for the
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Question 38 of 51
A home health nurse is caring for a patient with multiple myeloma. Which of the following interventions should the nurse prioritize when addressing the patient's severe bone pain?
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Question 39 of 51
Your patient with relapsed high-risk neuroblastoma returns to your care after travelling to an outside institution for [131]I-MIBG therapy. In the weeks following [131]I-MIBG therapy, what adverse events directly attributable to this therapy will the patient most likely encounter?
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Question 40 of 51
Outstanding feature of ITP:
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Question 41 of 51
A patient with a diagnosis of acute myeloid leukemia (AML) is being treated with induction therapy on the oncology unit. What nursing action should be prioritized in the patient's care plan?
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Question 42 of 51
Heparin is an anticoagulant produced by the basophils. The most likely mechanism heparin prevents blood clotting is by
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Question 43 of 51
A nurse is preparing to administer a prescribed dose of desmopressin to a client who has hemophilia A. The client's laboratory results indicate that the client has a sodium level of 130 mEq/L. Which of the following actions should the nurse take?
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Question 44 of 51
The patient is a 2-month-old boy who presented with a skin abscess and is febrile. On exam, he is noted to have silvery hair and hypopigmented skin. A CBC shows a leukocyte count of 3.4 K/mcL with 10% neutrophils. What does the abnormality on the peripheral smear suggest?
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Question 45 of 51
A nurse is caring for a client who is taking filgrastim to treat neutropenia. The nurse should assess the client for which of the following adverse effects?
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Question 46 of 51
Oral iron supplements are given for iron deficiency anemia. Which of the statement is true regarding the absorption of oral iron supplements?
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Question 47 of 51
A nurse is assessing a dark-skinned client for pallor. What action is best?
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Question 48 of 51
Which of the following is the most suitable anti malarial drug for pregnant women?
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Question 49 of 51
A patient receiving blood complains of dyspnea. The nurse auscultates the patient's lungs and finds crackles that were not present before the start of the transfusion. Which type of reaction should the nurse suspect?
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Question 50 of 51
You are treating a patient with localized osteosarcoma of the distal femur with methotrexate, doxorubicin, and cisplatin (MAP) chemotherapy. At week 10 of treatment, the patient undergoes complete resection of the tumor. Pathology demonstrates 40% necrosis. Which of the following represents the most appropriate further therapy?
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Question 51 of 51
The nurse is caring for a patient who is being discharged after an emergency splenectomy following an automobile accident. Which instructions should the nurse include in the discharge teaching?
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