ONCC ONCC Hematologic Malignancies

Question 1

A patient with acute myeloid leukemia (AML) has a WBC of 120,000/µL. The nurse should prioritize assessment for which life-threatening complication?

Accepted Answer

Tumor lysis syndrome and leukostasis

Answer

Hyponatremia and fluid overload

Answer

Hypoglycemia and adrenal insufficiency

Answer

Deep vein thrombosis and pulmonary embolism

Question 2

Which laboratory finding is most characteristic of chronic myeloid leukemia (CML)?

Accepted Answer

Philadelphia chromosome (BCR-ABL fusion) detected by cytogenetics or PCR

Answer

Presence of Reed-Sternberg cells on biopsy

Answer

Monoclonal immunoglobulin spike on serum protein electrophoresis

Answer

Hypercalcemia with lytic bone lesions

Question 3

A patient with multiple myeloma presents with back pain, fatigue, and a calcium level of 12.5 mg/dL. The nurse recognizes these findings as consistent with:

Accepted Answer

The CRAB criteria (hypercalcemia, renal failure, anemia, bone lesions) indicating end-organ damage

Answer

Hypocalcemia from bisphosphonate therapy

Answer

Side effects of proteasome inhibitor therapy

Answer

Neutropenic fever requiring immediate antibiotics

Question 4

Which medication class is the first-line targeted therapy for CML and works by inhibiting the BCR-ABL tyrosine kinase?

Accepted Answer

Tyrosine kinase inhibitors (e.g., imatinib)

Answer

Monoclonal antibodies (e.g., rituximab)

Answer

Proteasome inhibitors (e.g., bortezomib)

Answer

Checkpoint inhibitors (e.g., pembrolizumab)

Question 5

A patient with non-Hodgkin lymphoma is receiving rituximab. The nurse should monitor for which infusion-related reaction most closely during the FIRST infusion?

Accepted Answer

Fever, chills, hypotension, and bronchospasm (cytokine release syndrome)

Answer

Severe hypertension and bradycardia

Answer

Anaphylaxis to the diluent only

Answer

Delayed hypersensitivity occurring 48 hours after infusion

Question 6

Hodgkin lymphoma is distinguished from non-Hodgkin lymphoma by the presence of which pathognomonic cell type?

Accepted Answer

Reed-Sternberg cells

Answer

Blast cells

Answer

Plasma cells

Answer

Auer rods