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

Petechiae and epistaxis

Generalized edema and rash

Alopecia and pallor

Bradycardia and lethargy

Answer and Explanation

The Correct Answer is A

A.   Petechiae (small red or purple spots caused by bleeding under the skin) and epistaxis (nosebleeds) result from thrombocytopenia, which is a low platelet count often seen in leukemia. The compromised bone marrow function leads to inadequate production of platelets, resulting in bleeding and bruising.
B.   While generalized edema and rash can occur in various conditions, they are not specific to ALL and are not common initial findings. Edema might be seen in certain contexts (e.g., renal involvement or fluid overload), but it is not a hallmark of ALL.
C.   Alopecia (hair loss) and pallor (paleness) can occur in clients undergoing chemotherapy for ALL, but they are not typically initial findings at the time of diagnosis. Pallor may result from anemia, which can develop as a consequence of the disease, but it is not the most immediate or characteristic symptom of ALL.
D.   Bradycardia (slow heart rate) and lethargy are not typical initial findings of ALL. Lethargy could be present due to anemia or other systemic effects, but bradycardia is not commonly associated with the disease and would require further investigation for other underlying causes.

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Correct Answer is B

Explanation

A. This statement is false in terms of being a major risk factor for cervical cancer. While excessive alcohol consumption may have various health implications, moderate drinking, such as a glass of red wine with dinner, is not directly linked to an increased risk of cervical cancer.

B. Infection with certain high-risk strains of HPV is a major risk factor for cervical cancer. HPV is a sexually transmitted virus that can cause changes in cervical cells, leading to dysplasia and potentially progressing to cancer if not monitored and treated.
C. In fact, regular Pap tests are a preventive measure that can help detect cervical changes early before they develop into cancer. They are not a risk factor but rather a protective factor against the progression of cervical dysplasia to cancer.
D. While sexual history can influence HPV transmission, simply being married to the same person for an extended period does not inherently increase the risk of cervical cancer.

A. Avoid sexual activity for twelve hours B. Teach to self-catheterize every 4 hours C. Urinate in a sitting position post infusion D. Increase fluid intake for 8 hours prior to infusion

Correct Answer is C

Explanation

A. After intravesical therapy, there may be recommendations to avoid sexual activity for a certain period (often 24 hours) to prevent exposure to the medication by a partner. However, the specifics can vary based on the medication used. Twelve hours might not be sufficient depending on the protocol.
B. Self-catheterization is not routinely required unless there is a specific reason (e.g., urinary retention or difficulty voiding). This statement is not relevant to the therapy itself.
C. Urinating in a sitting position can help ensure more complete emptying of the bladder and can be safer, particularly for women. It also may minimize contact with any residual medication in the bladder, which can be a consideration post-infusion.
D. Patients are usually advised to avoid excessive fluid intake immediately before the infusion to prevent bladder distention during the treatment.

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

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