a 77 year old male is admitted to a unit with a suspected diagnosis of acute myeloid leukemia aml when planning this patients care the nurse should be

ATI RN

Oncology Test Bank

1. When planning care for a 77-year-old male admitted with suspected acute myeloid leukemia (AML), what epidemiologic fact should the nurse be aware of?

A. Early diagnosis is associated with good outcomes.
B. Five-year survival for older adults is approximately 50%.
C. Five-year survival for patients over 75 years old is less than 2%.
D. Survival rates are wholly dependent on the patient's pre-illness level of health.

Correct answer: C

Rationale: In the context of AML, the 5-year survival rate significantly decreases with age. The 5-year survival rate for patients over 75 years old is less than 2% compared to 43% for those 50 years or younger, and 19% for those between 50 and 64 years. Choice A is incorrect as early diagnosis does not necessarily guarantee good outcomes in AML. Choice B is inaccurate as the 5-year survival rate is not approximately 50% for older adults with AML. Choice D is incorrect as survival rates for AML patients are influenced by various factors beyond just the pre-illness level of health.

2. When preparing for the patient's subsequent care after completing the full course of treatment for acute lymphocytic leukemia without a significant response, what action should the nurse take?

A. Arrange a meeting between the patient's family and the hospital chaplain.
B. Assess the factors underlying the patient's failure to adhere to the treatment regimen.
C. Encourage the patient to vigorously pursue complementary and alternative medicine (CAM).
D. Identify the patient's specific wishes around end-of-life care.

Correct answer: D

Rationale: In cases where a patient does not respond appreciably to therapy, it is crucial to identify and respect the patient's choices regarding treatment, including preferences for end-of-life care. Option A is incorrect because it focuses on spiritual support rather than the patient's care preferences. Option B is incorrect as it assumes non-adherence to treatment without evidence. Option C is incorrect as it suggests an alternative treatment approach without considering the patient's wishes for end-of-life care.

3. Which of the following is not a manifestation of breast cancer?

A. Peau d'orange
B. Painless breast mass
C. Alopecia
D. Breast enlargement

Correct answer: C

Rationale: Alopecia (hair loss) is not a direct manifestation of breast cancer but rather a common side effect of chemotherapy used in breast cancer treatment. Peau d'orange refers to the dimpling or pitting of the skin resembling an orange peel, which can be a sign of breast cancer due to blockage of lymphatic vessels. A painless breast mass and breast enlargement can both be manifestations of breast cancer, with a painless mass being a common symptom and breast enlargement sometimes occurring due to tumor growth.

4. Which of the following terms is another name for Billroth I?

A. Gastroduodenostomy
B. Gastrojejunostomy
C. Gastroileostomy
D. Gastrostomy

Correct answer: A

Rationale: The correct answer is Gastroduodenostomy. Billroth I procedure involves the removal of a part of the stomach (usually the distal portion) and anastomosis of the remaining stomach to the duodenum. This procedure is known as Gastroduodenostomy. Choices B, C, and D are incorrect as they refer to different surgical procedures involving connections with the jejunum, ileum, and creating an opening in the stomach, respectively, not the specific procedure described as Billroth I.

5. Nurse Ben is reviewing the laboratory results of a client undergoing chemotherapy. Which of the following values would require immediate intervention?

A. Platelet count of 150,000/mm3
B. White blood cell count of 6,000/mm3
C. Hemoglobin level of 14 g/dL
D. Absolute neutrophil count of 500/mm3

Correct answer: D

Rationale: An absolute neutrophil count of 500/mm3 indicates severe neutropenia, putting the client at high risk for infection. Neutrophils are crucial in fighting off infections; a low count increases susceptibility to infections. Platelet count, white blood cell count, and hemoglobin levels are within normal ranges and do not require immediate intervention in this scenario.