Nokea
The client has undergone a lymph node biopsy to differentiate between Hodgkin’s and non-Hodgkin’s lymphoma. After reviewing the client’s lymph node biopsy results, which revealed that the client has Hodgkin’s lymphoma, the nurse should obtain which educational brochure?
- A. The brochure that includes an explanation of an elevated reticulocyte count
- B. The brochure that includes an explanation of CA-125 tumor markers
- C. The brochure that includes an explanation of an elevated WBC count
- D. The brochure that includes an explanation about Reed-Sternberg cells
Correct Answer: D
Rationale: A. Reticulocytes are found in a CBC, not from a lymph node biopsy, and are not indicative of either Hodgkin’s or non-Hodgkin’s lymphoma. B. CA-125 tumor markers are sometimes used in the management of ovarian cancer. C. WBCs are collected from a complete blood panel, not a lymph node biopsy, and could be indicative of other lymphomas and/or leukemia. D. The nurse should obtain the brochure that explains about Reed-Sternberg cells. The main diagnostic feature of Hodgkin’s lymphoma is the presence of Reed-Sternberg cells in a lymph node biopsy.
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The client with hemophilia A is experiencing hemarthrosis. Which intervention should the nurse recommend to the client?
- A. Alternate aspirin and acetaminophen to help with the pain.
- B. Apply cold packs for 24 to 48 hours to the affected area.
- C. Perform active range-of-motion exercise on the extremity.
- D. Put the affected extremity in the dependent position.
Correct Answer: B
Rationale: Hemarthrosis requires cold packs (B) to reduce bleeding/swelling. Aspirin (A) increases bleeding, ROM (C) worsens damage, and dependent position (D) increases swelling.
The nurse is teaching the client who is a strict vegetarian how to decrease the risk of developing megaloblastic anemia. Which information should the nurse provide?
- A. Undergo an annual Schilling test.
- B. Increase intake of foods high in iron.
- C. Supplement the diet with vitamin B12.
- D. Have a hemoglobin level drawn monthly.
Correct Answer: C
Rationale: A. The Schilling test is used to diagnose vitamin B12 deficiency; it is not necessary to have this completed annually. B. Consuming foods high in iron will prevent iron-deficiency, not megaloblastic, anemia. C. The client consuming a vegetarian diet can prevent megaloblastic anemia from a vitamin B12 deficiency with oral vitamin supplements or fortified soy milk. D. Monthly lab work is unnecessary and costly.
A home-care nurse is following up with the client who was diagnosed with liver cancer 3 months ago. Which assessment information should the nurse communicate to the HCP?
- A. Client is weak and pale and remained in bed throughout the visit
- B. Client’s weight has remained unchanged since the previous visit.
- C. Client reports itching is relieved with diphenhydramine cream.
- D. Client’s pain level averages a 7 on a 0 to 10 scale with scheduled opioids.
Correct Answer: D
Rationale: A. Finding that the client with liver cancer is weak and pale would be important to document, but it does not warrant immediate communication to the HCP because it may be expected. B. The client’s weight being stable would not necessitate communication to the HCP, but a significant decrease would. C. Abdominal itching may occur with liver cancer, but the fact that it is relieved with diphenhydramine (Benadryl) is positive and would not necessitate a call to the HCP. D. The client’s pain level is high and does not seem to be controlled with the current opioid schedule. The nurse should notify the HCP to request a change in analgesic medication, dosing schedule, or administration route.
The nurse has been teaching the parents of a child with hemophilia about the care he will need. Which statement by the parents indicates a need for more instruction?
- A. If my child needs something for pain or a fever, I will give him acetaminophen instead of aspirin.'
- B. I will take my child to the dentist for regular checkups.'
- C. I will keep my child in the house most of the time.'
- D. My son's Medic Alert Bracelet arrived.'
Correct Answer: C
Rationale: Overprotecting the child by keeping him indoors most of the time prevents normal development. Acetaminophen, dental care, and a Medic Alert bracelet are appropriate.
The client diagnosed with sickle cell anemia asks the nurse, 'Should I join the Sickle Cell Foundation? I received some information from the Sickle Cell Foundation. What kind of group is it?' Which statement is the best response by the nurse?
- A. It is a foundation that deals primarily with research for a cure for SCA.'
- B. It provides information on the disease and on support groups in this area.'
- C. I recommend joining any organization that will help deal with your disease.'
- D. The foundation arranges for families that have children with sickle cell to meet.'
Correct Answer: B
Rationale: The Sickle Cell Foundation offers education and support groups (B). Research (A) is partial, generic advice (C) is vague, and family meetings (D) are not primary.