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Chronic Myelogenous Leukemia (CML) ATI-like Questions

Total questions: 50

Worksheet time: 38mins

Name
Class
Date
1.

A nurse is teaching a client newly diagnosed with chronic myelogenous leukemia (CML) about the cause of the disease. Which statement by the nurse is accurate?

a)

“CML develops due to a chromosome abnormality that is inherited from parents.”

b)

“CML is associated with a mutation involving the movement of genetic material between chromosomes.”

c)

“CML occurs when all cells lose their ability to produce DNA.”

d)

“CML results from damage to mitochondrial DNA within blood cells.”

2.

The nurse is reviewing laboratory teaching materials and notes the presence of a Philadelphia chromosome. This finding is most commonly associated with which condition?

a)

Acute lymphoblastic leukemia

b)

Chronic myelogenous leukemia

c)

Chronic lymphocytic leukemia

d)

Multiple myeloma

3.

Which explanation best describes how the Philadelphia chromosome forms in chronic myelogenous leukemia (CML)?

a)

DNA is completely deleted from chromosome 22.

b)

Chromosomes fail to replicate during cell division.

c)

Genetic material from one chromosome relocates to another chromosome.

d)

An extra copy of chromosome 22 is produced.

4.

A client asks whether chronic myelogenous leukemia (CML) could have been inherited from their parents. Which response by the nurse is most appropriate?

a)

“Yes, this mutation is commonly passed through families.”

b)

“No, this mutation is acquired and develops after birth.”

c)

“Only mothers can pass this mutation to their children.”

d)

“Inheritance depends on which chromosome is affected.”

5.

The nurse is reinforcing education about genetic changes in CML. Which statement should be included?

a)

“All clients with CML have a normal chromosome 22.”

b)

“The Philadelphia chromosome occurs in fewer than half of CML cases.”

c)

“Chromosome changes in CML affect only reproductive cells.”

d)

“Most clients with CML have a shortened chromosome 22.”

6.

Which statement best summarizes the genetic basis of chronic myelogenous leukemia (CML)?

a)

CML is caused by inherited mutations affecting all body cells at birth.

b)

DNA abnormalities occur only in lymphoid cells.

c)

CML develops when chromosomes lose their DNA content.

d)

CML results from an acquired chromosomal mutation involving chromosome 22.

7.

A nurse is reviewing epidemiologic data related to chronic myelogenous leukemia (CML). Which age group has both the highest incidence and the highest mortality from CML?

a)

18-44 years

b)

45-64 years

c)

65-84 years

d)

85 years and older

8.

A nurse is providing education about risk patterns associated with chronic myelogenous leukemia (CML). Which statement accurately reflects the distribution of CML by sex?

a)

CML occurs only in males

b)

CML is significantly more common in females

c)

CML occurs equally in males and females

d)

CML occurs slightly more often in males than females

9.

A nurse is reviewing risk factors associated with chronic myelogenous leukemia (CML). Which findings should the nurse identify as risk factors? Select all that apply.

a)

Older age

b)

Female sex

c)

History of radiation therapy

d)

Family history of leukemia

e)

Male sex

10.

A nurse is reviewing the plan of care for a client with chronic myelogenous leukemia (CML). Which complication places the client at greatest risk for infection?

a)

Nutrional deficiencies

b)

Immunosuppresion related to CML or its treatment

c)

Splenomegaly

d)

Reduced exercise tolerance

11.

A nurse identifies safety risks commonly associated with chronic myelogenous leukemia (CML). Which risks should the nurse include? Select all that apply.

a)

Infection

b)

Splenomegaly

c)

Anemia

d)

Nutrtional deficiencies

e)

Hypertension

12.

A nurse is assessing an older adult client with CML who reports fatigue and decreased exercise tolerance. These findings are most consistent with which complication?

a)

Anemia

b)

Splenomegaly

c)

Infection

d)

Nutrtional excess

13.

A nurse is reviewing possible causes of anemia in a client with chronic myelogenous leukemia (CML). Which factors should the nurse identify? Select all that apply.

a)

Bone marrow suppression

b)

Nutrtional deficiences

c)

Chronic disease

d)

Acute hemorrhage

e)

Treatment-related cytopenias

14.

Why is anemia particularly concerning in older adults with chronic myelogenous leukemia (CML)?

a)

Older adults experience faster disease progression

b)

Older adults have increased pain sensitivity

c)

They may live independently and lack adequate support systems

d)

They are more likely to develop hypertension

15.

If anemia in an older adult with CML is not addressed, which outcomes is the nurse most concerned about? Select all that apply.

a)

Increased risk of falls

b)

Diminished functional status

c)

Social isolation

d)

Improved endurance

e)

Enhanced mobility

16.

A client with CML reports early satiety and left upper quadrant discomfort. Which complication should the nurse suspect?

a)

Infection

b)

Anemia

c)

Splenomegaly

d)

Nutrtional deficiency

17.

Which nursing actions are appropriate when caring for a client with CML who has splenomegaly? Select all that apply.

a)

Assess for abdominal pain

b)

Palpate for an enlarged spleen

c)

Educate the client to report worsening symptoms

d)

Encourage vigorous abdominal exercise

e)

Monitor for changes in abdominal discomfort

18.

A nurse is reinforcing infection-prevention teaching for a client with chronic myelogenous leukemia (CML). Which instructions should be included? Select all that apply.

a)

Avoid contact with individuals who are ill

b)

Promptly report fever

c)

Perform frequent hand hygiene

d)

Delay reporting mild symptoms

e)

Report other signs of infection

19.

A client with chronic myelogenous leukemia (CML) reports feeling extremely tired. The nurse recognizes this manifestation is most likely to affect which aspect of the client’s health?

a)

Ability to perform daily activities

b)

Renal elimination

c)

Immune response

d)

Cardiopulmonary function

20.

Which manifestations should the nurse expect when assessing a client with chronic myelogenous leukemia (CML)? Select all that apply.

a)

Weight loss

b)

Fever

c)

Night sweats

d)

Pain on the left side below ribs

e)

Productive cough

21.

A nurse is caring for a client with CML who expresses worry about death and dying. How should the nurse interpret this concern?

a)

It is unrelated to the disease process

b)

It reflects the overall impact of CML on the client's health

c)

It indicates disease progression

d)

It suggests ineffective coping

22.

Which statement by a client newly diagnosed with CML indicates understanding of how the disease may present?

a)

“I will always notice symptoms early.”

b)

“CML is usually diagnosed after severe pain develops.”

c)

“Symptoms only occur in advanced stages.”

d)

“CML may be found during a routine medical visit even without symptoms.”

23.

A nurse reviews a client’s chart and notes a new diagnosis of CML made during a routine physical exam. The client reports no current symptoms. How should the nurse interpret this finding?

a)

The diagnosis is likely incorrect

b)

The disease is unrelated to current health

c)

CML can be present without noticable manifestations

d)

Symptoms will develop immediately

24.

A nurse is identifying factors that may contribute to the development of disseminated intravascular coagulation (DIC). Which factors should the nurse recognize? Select all that apply.

a)

Cancer

b)

Pulmonary embolism

c)

Family history of clotting disorders

d)

Chronic myelogenous leukemia (CML)

e)

Blood vessel abnormalities

25.

A nurse is caring for a client with CML who develops DIC. Which complication places the client at greatest risk for hypovolemic shock?

a)

Leukemia cell buildup

b)

Increased clot formation

c)

Bleeding caused by DIC

d)

Reduced immune response

26.

A nurse is teaching a client with CML about infection risk. Which explanation by the nurse is most accurate?

a)

Infection risk increases due to inherited immune disorders

b)

Leukemia cells build up in the blood and reduce healthy cells

c)

Infection risk is unrelated to blood cell changes

d)

Infection occurs only during active treatment

27.

Which findings explain why clients with chronic myelogenous leukemia (CML) are at increased risk for infection? Select all that apply.

a)

Buildup of leukemia cells in the blood

b)

Increased red blood cell production

c)

Suppressed immune defenses

d)

Reduced number of healthy cells

e)

Blood vessel abnormalities

28.

A nurse is reviewing factors that affect prognosis in a client with chronic myelogenous leukemia (CML). Which factors should the nurse recognize as influencing prognosis?

a)

Client age, prior health status, and stage of CML

b)

 Family history and genetic inheritance

c)

Nutritional intake and hydration status

d)

Environmental exposure and occupation

29.

Which characteristics of chronic myelogenous leukemia (CML) should the nurse include when providing client education? Select all that apply.

a)

CML is divided into three phases

b)

Disease phase determines treatment decisions

c)

CML can recur after treatment

d)

CML most commonly affects children

e)

CML typically affects adults

30.

A nurse reviews bone marrow results for a client with CML and notes that blast cells account for 8% of cells present. Which phase of CML does this finding indicate?

a)

Accelerated phase

b)

Blastic phase

c)

Relapsed phase

d)

Chronic phase

31.

A client’s laboratory findings show blast cells accounting for 15% of the bone marrow and blood. Which phase of chronic myelogenous leukemia (CML) does the nurse identify?

a)

Chronic phase

b)

Accelerated phase

c)

Blastic phase

d)

Terminal phase

32.

A nurse identifies that blast cells make up 25% of a client’s bone marrow. Which phase of CML is most consistent with this finding?

a)

Chronic phase

b)

Accelerated phase

c)

Remission phase

d)

 Blastic phase

33.

A nurse is reviewing findings that may indicate a blastic crisis in a client with chronic myelogenous leukemia (CML). Which findings should the nurse recognize? Select all that apply.

a)

Fever

b)

Splenomegaly

c)

Hypertension

d)

Fatigue

e)

Weight gain

34.

Why is accurate identification of the phase of chronic myelogenous leukemia (CML) essential?

a)

 It determines whether the disease is inherited

b)

It predicts whether infection will occur

c)

It guides treatment decisions and monitoring

d)

It eliminates the possibility of recurrence

35.

A nurse is assessing a newly diagnosed client with CML. Which information should the nurse collect to help determine prognosis? Select all that apply.

a)

Client age

b)

 Family history of leukemia

c)

Health status prior to diagnosis

d)

 Current phase of CML

e)

Presence of blast cells

36.

A nurse is caring for a client in the blastic phase of chronic myelogenous leukemia (CML). Which new finding requires immediate provider notification?

a)

8% blast cell percentage

b)

Fever and increasing fatigue

c)

300,000 platelet count

d)

Low hematocrit

37.

A nurse is teaching a client with chronic myelogenous leukemia (CML) about managing fatigue related to the disease and tyrosine kinase inhibitor (TKI) therapy. Which instructions should the nurse include? Select all that apply.

a)

Schedule frequent rest breaks

b)

Increase activity intensity to reduce fatigue

c)

Pace daily activities

d)

Use energy-conservation strategies

e)

Expect fatigue to resolve quickly with treatment

38.

A nurse is providing education to a client with chronic myelogenous leukemia (CML) who is starting tyrosine kinase inhibitor (TKI) therapy. Which symptom should the nurse emphasize as a common and expected effect?

a)

Fatigue

b)

Sudden weight gain

c)

Severe joint swelling

d)

Acute abdominal pain

39.

A client with CML reports difficulty completing daily activities due to low energy levels. Which nursing recommendation is most appropriate?

a)

Increase activity intensity to improve endurance

b)

Limit all physical activity

c)

Incorporate rest breaks and pace activities throughout the day

d)

Delay activities until fatigue resolves

40.

A nurse is educating a client with CML who experiences early satiety related to splenomegaly. Which instruction should the nurse include?

a)

Eat three large meals per day

b)

Consume small, frequent meals

c)

Restrict fluid intake during meals

d)

Follow a strict meal schedule

41.

A nurse is reinforcing education for a client with CML who is immunocompromised and experiencing emotional distress. Which interventions should the nurse include? Select all that apply.

a)

Build a support network with family or friends

b)

Report fever or signs of infection immediately

c)

Avoid contact with sick individuals

d)

Discourage discussion of emotional concerns

e)

Practice strict hand hygiene

42.

Which dietary recommendation best supports nutritional intake for a client with CML who has decreased appetite?

a)

Eliminate snacks between meals

b)

Avoid high-calorie foods

c)

Limit variety in meal choices

d)

Choose nutrient-dense foods

43.

A nurse is reinforcing infection-prevention education for a client with CML during the early phases of treatment. Which instruction is the priority?

a)

Practice strict hand hygiene

b)

Increase outdoor activities

c)

Receive all visitors without restrictions

d)

Delay reporting mild symptoms

44.

Which statement by a client with CML indicates correct understanding of when to seek medical attention?

a)

“I will wait a few days before reporting a fever.”

b)

“I only need to report symptoms if they are severe.”

c)

“I should report fever or signs of infection immediately.”

d)

“Infections are expected and usually harmless.”

45.

A nurse is addressing psychosocial needs of a client with CML who reports feeling isolated. Which intervention is most appropriate?

a)

Encourage the client to manage independently

b)

Promote building a support network and consider referrals if needed

c)

Limit social interactions to reduce stress

d)

Focus teaching only on physical symptoms

46.

A nurse is conducting an initial assessment of a client with suspected chronic myelogenous leukemia (CML). Which finding is most characteristic of CML and should be assessed during the physical examination?

a)

Splenomegaly on abdominal assessment

b)

 Peripheral edema

c)

Generalized lymphadenopathy

d)

Jugular vein distention

47.

When assessing a client with CML, which cues should the nurse recognize as consistent with disease progression or complications? Select all that apply.

a)

Fatigue

b)

Hypertension

c)

Night sweats

d)

Splenic discomfort

e)

Weight loss

48.

A nurse reviews laboratory results for a client with CML. Which abnormality requires further analysis to determine complications or progression?

a)

Normal hemoglobin and platelet count

b)

Decreased sodium level

c)

Elevated glucose level

d)

Anemia and platelet abnormalities on CBC

49.

The nurse is prioritizing care for a client with chronic myelogenous leukemia (CML). Which clinical concerns should be addressed as priorities? Select all that apply.

a)

Infection prevention

b)

Pain management

c)

Impaired vision

d)

Fatigue

e)

Risk of bleeding

50.

A nurse is collaborating with the healthcare team to develop a plan of care for a client with chronic myelogenous leukemia (CML). Which intervention should be included in the plan?

a)

Provide education about the chronic nature of CML and the importance of long-term treatment adherence

b)

Emphasize short-term symptom control without addressing long-term management

c)

B. Focus primarily on medication administration and laboratory monitoring

d)

Defer discussions about psychosocial support until disease progression occurs