Chapter 34 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition


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Chapter 34  Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition



Complete Chapter Questions And Answers

Sample Questions


1. 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?

  1. A)  The different leukemias all involve unregulated proliferation of white blood cells.
  2. B)  The different leukemias all have unregulated proliferation of red blood cells and

    decreased bone marrow function.

  3. C)  The different leukemias all result in a decrease in the production of white blood cells.
  4. D)  The different leukemias all involve the development of cancer in the lymphatic system.

Ans: A


Leukemia commonly involves unregulated proliferation of white blood cells. Decreased production of red blood cells is associated with anemias. Decreased production of white blood cells is associated with leukopenia. The leukemias are not characterized by their involvement with the lymphatic system.

2. A nurse is caring for a patient who has a diagnosis of acute leukemia. What assessment most directly addresses the most common cause of death among patients with leukemia?

  1. A)  Monitoring for infection
  2. B)  Monitoring nutritional status
  3. C)  Monitor electrolyte levels
  4. D)  Monitoring liver function

Ans: A


In patients with acute leukemia, death typically occurs from infection or bleeding. Compromised nutrition, electrolyte imbalances, and impaired liver function are all plausible, but none is among the most common causes of death in this patient population.

3. An oncology nurse is caring for a patient with multiple myeloma who is experiencing bone destruction. When reviewing the patient’s most recent blood tests, the nurse should anticipate what imbalance?

  1. A)  Hypercalcemia
  2. B)  Hyperproteinemia
  3. C)  Elevated serum viscosity
  4. D)  Elevated RBC count

Ans: A


Hypercalcemia may result when bone destruction occurs due to the disease process. Elevated serum viscosity occurs because plasma cells excrete excess immunoglobulin. RBC count will be decreased. Hyperproteinemia would not be present.

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4. A nurse is planning the care of a patient who has been admitted to the medical unit with a diagnosis of multiple myeloma. In the patient’s care plan, the nurse has identified a diagnosis of Risk for Injury. What pathophysiologic effect of multiple myeloma most contributes to this risk?

  1. A)  Labyrinthitis
  2. B)  Left ventricular hypertrophy
  3. C)  Decreased bone density
  4. D)  Hypercoagulation

Ans: C


Clients with multiple myeloma are at risk for pathologic bone fractures secondary to diffuse osteoporosis and osteolytic lesions. Labyrinthitis is uncharacteristic, and patients do not normally experience hypercoagulation or cardiac hypertrophy.

5. A patient with advanced leukemia is responding poorly to treatment. The nurse finds the patient tearful and trying to express his feelings, but he is clearly having difficulty. What is the nurse’s most appropriate action?

  1. A)  Tell him that you will give him privacy and leave the room.
  2. B)  Offer to call pastoral care.
  3. C)  Ask if he would like you to sit with him while he collects his thoughts.
  4. D)  Tell him that you can understand how he’s feeling.

Ans: C


Providing emotional support and discussing the uncertain future are crucial. Leaving is incorrect because leaving the patient doesn’t show acceptance of his feelings. Offering to call pastoral care may be helpful for some patients but should be done after the nurse has spent time with the patient. Telling the patient that you understand how he’s feeling is inappropriate because it doesn’t help him express his feelings.

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6. 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?

  1. A)  Activity Intolerance
  2. B)  Risk for Infection
  3. C)  Acute Confusion
  4. D)  Risk for Spiritual Distress

Ans: B


Induction therapy places the patient at risk for infection, thus this is the priority nursing diagnosis. During the time of induction therapy, the patient is very ill, with bacterial, fungal, and occasional viral infections; bleeding and severe mucositis, which causes diarrhea; and marked decline in the ability to maintain adequate nutrition. Supportive care consists of administering blood products and promptly treating infections. Immobility, confusion, and spiritual distress are possible, but infection is the patient’s most acute physiologic threat.

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