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The client asks the nurse, 'They say I have cancer. How can they tell if I have Hodgkin's disease from a biopsy?' The nurse’s answer is based on which scientific rationale?
- A. Biopsies are nuclear medicine scans that can detect cancer.
- B. A biopsy is a laboratory test that detects cancer cells.
- C. It determines which kind of cancer the client has.
- D. The HCP takes a small piece out of the tumor and looks at the cells.
Correct Answer: C
Rationale: A biopsy identifies Hodgkin’s via Reed-Sternberg cells (C). It’s not a scan (A), not just a lab test (B), and involves microscopic cell analysis (D is partial but less precise).
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A 5-year-old boy is admitted because he bled profusely when he lost his first baby tooth. After a workup, he is diagnosed as having classic hemophilia. His mother asks the nurse if his two younger sisters will also develop hemophilia. What is the best answer for the nurse to give?
- A. They will not develop the disease.'
- B. Statistically, one of them is likely to develop the disease.'
- C. They are not likely to get the disease, but they may be carriers.'
- D. If it doesn't show up by the time they start school, they are unlikely to develop the condition.'
Correct Answer: C
Rationale: Hemophilia is an X-linked recessive disorder. Females are unlikely to develop the disease but may be carriers, especially if the mother is a carrier.
The client diagnosed with menorrhagia complains to the nurse of feeling listless and tired all the time. Which scientific rationale would explain why these symptoms occur?
- A. The pain associated with the menorrhagia does not allow the client to rest.
- B. The client’s symptoms are unrelated to the diagnosis of menorrhagia.
- C. The client probably has been exposed to a virus that causes chronic fatigue.
- D. Menorrhagia has caused the client to have decreased levels of hemoglobin.
Correct Answer: D
Rationale: Menorrhagia causes blood loss, lowering hemoglobin (D), leading to fatigue/listlessness. Pain (A) is not primary, symptoms are related (B), and viral fatigue (C) is less likely.
Ferrous sulfate is prescribed for a client. She returns to the clinic in two weeks. Which assessment by the nurse indicates that she has NOT been taking iron as ordered?
- A. The client's cheeks are flushed.
- B. The client reports having more energy.
- C. The client complains of nausea.
- D. The client's stools are light brown.
Correct Answer: D
Rationale: Iron turns stool black. Light brown stools indicate the client has not been taking iron as prescribed. Flushed cheeks, increased energy, and nausea can be associated with iron therapy compliance.
The charge nurse is making assignments on a medical floor. Which client should be assigned to the most experienced nurse?
- A. The client diagnosed with iron-deficiency anemia who is prescribed iron supplements.
- B. The client diagnosed with pernicious anemia who is receiving vitamin B12 intramuscularly.
- C. The client diagnosed with aplastic anemia who has developed pancytopenia.
- D. The client diagnosed with renal disease who has a deficiency of erythropoietin.
Correct Answer: C
Rationale: Aplastic anemia with pancytopenia (C) is complex, risking bleeding/infection, requiring experienced care. Iron (A), B12 (B), and renal anemia (D) are more stable.
The female client, who has Hodgkin’s lymphoma with cervical and axillary node involvement, is to receive chemotherapy and radiation. The nurse evaluates that the client is coping positively when the client makes which statement?
- A. “I’ve a wig that matches my hair color, but I’ll miss my own hair.”
- B. “I am so glad that the treatments won’t cause me to lose my hair.”
- C. “I’m happy that the drug-radiation combination prevents mucositis.”
- D. “I’ve faith that my doctor will cure me and I’ll never have cancer again.”
Correct Answer: A
Rationale: A. The client is expressing feelings about hair loss but has acted positively related to her feelings and obtained a wig. This statement indicates positive coping. B. This statement reflects that either the client is in denial or is uninformed regarding the effects of chemotherapy and radiation treatments. Chemotherapy and radiation will involve the cervical lymph nodes; side effects will include alopecia. C. Chemotherapy and radiation will involve the cervical lymph nodes; side effects will include mucositis. D. The risk for other cancers is increased after chemotherapy and radiation for Hodgkin’s lymphoma, so long-term surveillance is crucial.