Nokea
A client has developed an infection that resulted in lymphangitis. What does the nurse suspect the causative organism is that caused the infection?
- A. A streptococcal microorganism
- B. A Staphylococcus microorganism
- C. Escherichia coli
- D. Candida albicans
Correct Answer: A
Rationale: An infectious agent, commonly a streptococcal microorganism, usually causes both lymphangitis and lymphadenitis. It is not commonly caused by staph, E. coli, or C. albicans (a fungal infection).
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A client with Hodgkin's disease has bilateral lymph nodes that are affected with extension through the spleen as well as affecting the bone marrow. What stage of the disease does the nurse recognize the client is in?
- A. I
- B. II
- C. III
- D. IV
Correct Answer: D
Rationale: Stage IV involves bilateral lymph nodes affected and extension includes spleen plus one or more of the following: bones, bone marrow, lungs, liver, skin, gastrointestinal structures, or other sites. Stage I is single lymph node region. Stage II is two or more lymph node regions on one side of the diaphragm. Stage III is lymph node regions on both sides of the diaphragm, but extension is limited to the spleen.
The nurse is caring for a client in the hospital who is being treated for Hodgkin's disease and is taking a chemotherapeutic regimen in the hospital's oncology unit. When reviewing the client's medication history, what regimen does the nurse recognize as the drugs in the treatment of Hodgkin's disease?
- A. Ceftriaxone, furosemide, rifampin, ibuprofen
- B. Doxorubicin, bleomycin, vinblastine, dacarbarine
- C. Albuterol, ipratropium, methylprednisolone, acetylcysteine
- D. Enalapril, atenolol, verapamil, lovastatin
Correct Answer: B
Rationale: Doxorubicin, bleomycin, vinblastine, and dacarbarine are a combination of medications for the chemotherapeutic treatment of Hodgkin's disease. There are several different regimens that may be used but the medications in the other options are not used for the treatment of Hodgkin's disease.
Which client does the nurse recognize as most likely to be diagnosed with non-Hodgkin's lymphoma rather than Hodgkin's lymphoma?
- A. A 55-year-old client with an immunosuppression disorder
- B. A 35-year-old client with type 2 diabetes mellitus
- C. A 20-year-old client with infectious mononucleosis
- D. A 40-year-old client with Reed-Sternberg cells in an axillary lymph node
Correct Answer: A
Rationale: Non-Hodgkin's lymphoma peak onset is after 50 years and is common among clients with immune suppression. There is no correlation with client that has diabetes and non-Hodgkin's lymphoma. Forty percent of affected clients test positive for Epstein-Barr virus that causes infectious mononucleosis and that test positive for Reed-Sternberg cells in the lymph nodes that are correlated with Hodgkin's lymphoma.
The nurse is caring for a client with Hodgkin's disease who has developed anemia. What would the nurse expect to be prescribed for this client?
- A. Lower doses of radiation
- B. Transfusions
- C. A break in chemotherapy
- D. Increased rest and fluid
Correct Answer: B
Rationale: Transfusions are prescribed to control anemia. If resistance to treatment develops, autologous bone marrow or peripheral stem cells are harvested, followed by high doses of chemotherapy that destroy the bone marrow. A transplant is performed after separating the normal stem cells from the malignant cells in the harvested specimen. Lower doses of radiation, breaks in chemotherapy, and increased rest and fluid are not considered part of the treatment regimen for anemia.
An adolescent client diagnosed with infectious mononucleosis asks the nurse if it is possible to keep getting the disease in the future. What is the best response by the nurse?
- A. After having the disease, the virus dissipates and is gone forever.'
- B. Once you get the virus, it will infect you when your immune system is compromised.'
- C. One episode produces immunity, but the virus remains for a lifetime.'
- D. Once you have the symptoms of the virus, it will go away within a week and there will be no further episodes.'
Correct Answer: C
Rationale: One episode of infectious mononucleosis produces subsequent immunity; however, the virus remains in the body for the person's lifetime. The virus does not dissipate and go away. If a client has an incidence of infection, the client is immune from further infections of Epstein-Barr virus. The symptoms do not generally go away for 2 to 6 weeks.