A client diagnosed with acute myelogenous leukemia (AML) develops a platelet count of 10,000 mm3 during chemotherapy treatment. What is an appropriate nursing intervention for this client, based on this finding?

Table 34.1 Review of Normal Ranges for Complete Blood Cell Counts (Adult)

Blood Cell

Normal Ranges

Red blood cells (mature, circulating)

Male: 451-6.01 million/mm3

Female: 4.01-5.51 million/mm3

Hemoglobin

Adult (15-64 yr)

Male 14-17.3 g/dL

Female 11.7-155 g/dL

Hematocrit

42%-52% in males

36% -48% in females

Reticulocytes

0.5% -2.5% of total RBC count

White blood cells (total)

4.5-11.1 10/mm3

Neutrophils

59%

Bands 3% Segs-56%

Eosinophils

2.7%

Basophils

0.5%

Lymphocytes

34%

Monocytes

4%

Platelets

150,000-450,000/mm3

Obtain a prescription for stool occult blood testing

Encourage intake of oral fluids to 3000 mL/day

Assess the temperature every four hours

Provide oral hygiene every two hours

Answer and Explanation

The Correct Answer is C

A.   This intervention can be appropriate since a very low platelet count increases the risk of bleeding, including gastrointestinal bleeding. However, this action alone does not directly address the immediate risks associated with the low platelet count.
B.   While hydration is important for overall health, this intervention does not specifically address the risks associated with a low platelet count. Additionally, excessive fluid intake may not be appropriate for all patients, especially if there are underlying kidney issues or fluid restrictions.
C.   Clients with AML and low platelet counts are at increased risk for infections and may develop febrile neutropenia. Monitoring temperature every four hours can help detect early signs of infection, allowing for timely intervention.
D.   While maintaining oral hygiene is important, especially in patients undergoing chemotherapy, this intervention may not be the most critical action based on the acute concern of a very low platelet count. However, it is important to note that patients with low platelet counts may also experience bleeding from the gums, making gentle oral care essential.

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Correct Answer is C

Explanation

A. Many women diagnosed with ovarian cancer are indeed older, but the presence of other health problems is not a primary factor in explaining the high death rates. The key issue is more related to late- stage diagnosis rather than age alone.
B. While some ovarian cancer cells can develop resistance to treatment, it is not universally true for all cases. The high mortality rate is more often due to the late stage at which the cancer is diagnosed rather than inherent resistance to treatment. Thus, this option does not fully explain the high death rates.
C. Ovarian cancer often presents with vague symptoms that can be easily overlooked in the early stages, such as bloating, abdominal discomfort, or changes in bowel habits. As a result, many women do not receive a diagnosis until the cancer has progressed to a more advanced stage, contributing significantly to the high mortality rates associated with the disease.
D. While it is true that the ovaries are located deep in the pelvis, the main treatment for ovarian cancer typically involves surgery and chemotherapy rather than radiation therapy. Radiation is not a primary treatment for this cancer type, and this statement does not accurately reflect why the death rates are high.

A. cancer antigen 125 (CA-125) and serum ceruloplasmin. B. human chorionic gonadotropin (hCG) and alpha-fetoprotein (AFP). C. serum erythropoietin (EPO) and carcinoembryonic antigen (CEA). D. prostate specific antigen (PSA) and human chorionic gonadotropin (hCG).

Correct Answer is B

Explanation

A. CA-125 is primarily associated with ovarian cancer and is not a relevant tumor marker for testicular cancer. Serum ceruloplasmin is a copper-carrying protein that can be elevated in various conditions, but it is not specific for testicular cancer. Therefore, this option is not appropriate.
B. Both hCG and AFP are tumor markers specifically associated with testicular cancer. Elevated levels of these markers can indicate the presence of non-seminomatous testicular tumors. Monitoring these markers is essential for diagnosis, assessing treatment response, and detecting recurrence.
C. EPO is involved in red blood cell production and is not a tumor marker for testicular cancer. CEA is primarily associated with colorectal cancer and some other malignancies, but it is not specific for testicular cancer.
D. PSA is a tumor marker associated with prostate cancer, not testicular cancer. While hCG is relevant for testicular cancer, the inclusion of PSA makes this option inappropriate for a client with testicular cancer.

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Blood Cell	Normal Ranges
Red blood cells (mature, circulating)	Male: 451-6.01 million/mm3 Female: 4.01-5.51 million/mm3
Hemoglobin	Adult (15-64 yr) Male 14-17.3 g/dL Female 11.7-155 g/dL
Hematocrit	42%-52% in males 36% -48% in females
Reticulocytes	0.5% -2.5% of total RBC count
White blood cells (total)	4.5-11.1 10/mm3
Neutrophils	59% Bands 3% Segs-56%
Eosinophils	2.7%
Basophils	0.5%
Lymphocytes	34%
Monocytes	4%

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

In educating clients about ovarian cancer, the nurse emphasizes death rates for ovarian cancer are high because:

Correct Answer is C

Explanation

The nurse, caring for a client diagnosed with testicular cancer, should anticipate a medical prescription for which of the following tumor marker studies? A/An:

Correct Answer is B

Explanation

A client was recently diagnosed with advanced Hodgkin's Lymphoma. Which sign or symptoms indicates that the lymphoma involves the presence of a mediastinal mass?

Which nursing intervention(s) should be employed when caring for the bone marrow donor immediately following a bone marrow aspiration? (SELECT ALL THAT APPLY)

The nurse caring for a 27-year-old female client diagnosed with acute lymphoblastic leukemia (ALL). She and her husband are concerned about the ability to eventually have children. What should the nurse include in the discussion with this client and her husband?

Which initial assessment finding(s) would the nurse expect in a client diagnosed with acute lymphocytic leukemia (ALL)?

To prevent the reoccurrence of prostatitis, the nurse should provide the client with which discharge instruction?

The nurse is caring for a client who had a thrombotic stroke in the Emergency Department. It has been less than 3 hours since the onset of symptoms. The rationale for using tissue plasminogen activator (t-PA) for this client is to:

The nurse is caring for a client that has undergone a modified left radical mastectomy with lymph node removal. Which intervention would assist in preventing lymphedema?