Which initial assessment findings would the nurse expect in a client diagnosed with acute lymphocytic leukemia ALL? (SELECT ALL THAT APPLY)

Ascites

Alopecia

Generalized edema

Petechiae

Epistaxis

Answer and Explanation

Correct Answer : D,E

A) Ascites
Ascites, the accumulation of fluid in the peritoneal cavity, is not a typical initial assessment finding in acute lymphocytic leukemia (ALL). While ascites can occur in some cancers or in cases of liver failure, it is not a hallmark or common finding in ALL. The focus in ALL would generally be on hematologic and immunologic symptoms rather than fluid accumulation in the abdomen.

B) Alopecia
Alopecia (hair loss) is more commonly associated with chemotherapy treatment for leukemia rather than the leukemia itself. While chemotherapy for ALL can lead to hair loss, it is not typically an initial symptom of the disease itself. Alopecia may appear later, as a side effect of cancer treatment.

C) Generalized edema
Generalized edema (swelling) is not a common or early sign of acute lymphocytic leukemia. While edema can occur in certain malignancies or complications (like in cases of renal failure or heart failure), it is not typically an initial presenting symptom of ALL. The key manifestations of ALL tend to relate to hematologic abnormalities, rather than fluid accumulation.

D) Petechiae
Petechiae (small, red or purple spots on the skin) are a common finding in ALL. They occur due to thrombocytopenia (low platelet count), which is a hallmark of leukemia. Thrombocytopenia impairs the blood’s ability to clot, leading to bleeding under the skin. Petechiae is often one of the first visible signs of blood dyscrasia in leukemia patients.

E) Epistaxis
Epistaxis (nosebleeds) is another common initial finding in ALL. Like petechiae, epistaxis occurs due to thrombocytopenia, which impairs normal clotting and leads to spontaneous bleeding. Nosebleeds are frequently observed in patients with low platelet counts, especially in leukemia.

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Correct Answer is ["A"]

Explanation

A) There are no obvious symptoms or problems: Ovarian cancer is often referred to as the "silent killer" because it tends to develop without noticeable symptoms in the early stages. When symptoms do appear, they are often vague and nonspecific, such as bloating, abdominal discomfort, or changes in bowel habits. By the time ovarian cancer is diagnosed, it is frequently at an advanced stage, making it more difficult to treat effectively. This lack of early, clear symptoms contributes significantly to the high death rate associated with the disease.

B) Radiation therapy is ineffective because the ovaries are located so deep within the pelvis: While ovarian cancer is located deep within the pelvis, radiation therapy can still be effective for certain types of tumors. However, the primary reason for high death rates is not the location of the ovaries, but the late-stage diagnosis and difficulty in detecting the cancer early.

C) The causative cancer cell is resistant to chemotherapy or radiation: While some ovarian cancer cells may exhibit resistance to treatment, this is not the main reason for the high mortality rate. The real issue is the lack of early detection, as ovarian cancer is often diagnosed when it has already spread beyond the ovaries. Early-stage ovarian cancer may be more responsive to treatment, but by the time symptoms are noticeable, the cancer is often advanced, which limits the effectiveness of chemotherapy and radiation.

D) Ovarian cancer occurs primarily among women over age 70 that also have other complicating health problems: Although the incidence of ovarian cancer increases with age, particularly after age 60, it is not the primary factor contributing to high death rates. Many women diagnosed with ovarian cancer are relatively healthy except for the cancer itself.

A. Glascow Coma Scale B. NIH Stroke Scale C. Romberg Test D. Mini Mental Status Exam

Correct Answer is A

Explanation

A) Glasgow Coma Scale:
The Glasgow Coma Scale (GCS) is a standardized neurological assessment tool used to assess a patient's level of consciousness based on three criteria: eye opening, verbal response, and motor response. Each of these categories is scored, and the total score helps to determine the depth of the patient's consciousness. The GCS is commonly used to monitor changes in a patient's neurological status, especially after trauma, stroke, or other conditions that may impair brain function.

B) NIH Stroke Scale:
The NIH Stroke Scale (NIHSS) is used to assess the severity of stroke symptoms and includes measures such as facial droop, arm and leg motor function, speech, and language abilities. It is used specifically to evaluate stroke symptoms and is not designed for the rapid assessment of general consciousness like the Glasgow Coma Scale.

C) Romberg Test:
The Romberg Test is a test of balance that is performed by having the patient stand with their feet together, eyes closed, and observing for any swaying or loss of balance. It is used to evaluate proprioception and cerebellar function, not to assess the level of consciousness.

D) Mini Mental Status Exam:
The Mini-Mental Status Exam (MMSE) is a brief cognitive screening tool that assesses aspects of cognitive function such as orientation, attention, memory, language, and visuospatial skills. While the MMSE can provide insight into cognitive function, it does not focus on the specific assessment of consciousness level (eye opening, verbal response, motor response) as the GCS does.

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Which initial assessment findings would the nurse expect in a client diagnosed with acute lymphocytic leukemia ALL? (SELECT ALL THAT APPLY)

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Correct Answer is ["A"]

Explanation

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Correct Answer is A

Explanation

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