RN Nursing · Leukemia · Practice question
A client in the oncologist's office has leukemia. As the client and family are leaving the office, the parent says to the nurse, "I didn't quite get it when the doctor explained it. What exactly is happening in my son's body with this leukemia?" What is an appropriate response by the nurse?
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"Cancer cells have overcrowded the blood and spill over into the bone marrow."
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✓
"There is uncontrolled growth of cancer cells in the bone marrow."
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"The bone marrow has many good cells, but a few cancer cells are mixed in with the good cells."
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"The cancer is in the bone marrow and will not go anywhere else in the body."
Answer & explanation
Correct: "There is uncontrolled growth of cancer cells in the bone marrow."
Leukemia is characterized by the uncontrolled proliferation of malignant (cancerous) white blood cells within the bone marrow. These abnormal cells crowd out normal hematopoietic cells, impairing the production of healthy red blood cells, platelets, and functional white blood cells. The correct explanation — that there is uncontrolled growth of cancer cells in the bone marrow — is accurate and concise enough for a family member to understand. The option stating that cancer cells have overcrowded the blood and spilled over into the bone marrow reverses the actual pathophysiology; the disease originates in the bone marrow and the abnormal cells then spill into the peripheral bloodstream, not the other way around. The option suggesting only a few cancer cells are mixed with many good cells is inaccurate because leukemia involves a predominance of malignant cells that displace normal marrow elements. The statement that the cancer stays in the bone marrow and will not spread elsewhere is also incorrect; leukemic cells circulate through the blood and can infiltrate organs such as the lymph nodes, liver, and spleen. Providing an accurate, understandable explanation supports informed consent and helps the family prepare for treatment discussions.
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