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The client is diagnosed with Hodgkin’s disease. Which data are diagnostic for Hodgkin’s disease?
- A. Night sweats and low-grade fever.
- B. Cavitation noted on the chest x-ray.
- C. Reed-Sternberg cells found on biopsy.
- D. Weight loss and palpable inguinal lymph nodes.
Correct Answer: C
Rationale: Reed-Sternberg cells on biopsy (C) are diagnostic for Hodgkin’s. Night sweats/fever (A) and weight loss/nodes (D) are supportive, and cavitation (B) suggests TB.
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The client’s CBC indicates an RBC 6 (x106/mm3), Hb 14.2 g/dL, Hct 42%, and platelets 69 (x103/mm3). Which intervention should the nurse implement?
- A. Teach the client to use a soft-bristle toothbrush.
- B. Monitor the client for elevated temperature.
- C. Check the client’s blood pressure.
- D. Hold venipuncture sites for one (1) minute.
Correct Answer: A
Rationale: Platelets 69,000 indicate thrombocytopenia; a soft-bristle toothbrush (A) prevents gum bleeding. Fever (B), BP (C), and brief pressure (D) are insufficient for bleeding risk.
The nurse is caring for a client who is thought to have pernicious anemia. What signs and symptoms would the nurse expect in this person?
- A. Easy bruising
- B. Beefy-red tongue
- C. Fine red rash on the extremities
- D. Pruritus
Correct Answer: B
Rationale: A beefy-red tongue is a hallmark symptom of pernicious anemia due to vitamin B12 deficiency.
The client diagnosed with iron-deficiency anemia is prescribed ferrous gluconate orally. Which should the nurse teach the client?
- A. Take Imodium, an antidiarrheal, over-the-counter (OTC) for diarrhea.
- B. Limit exercise for several weeks until a tolerance is achieved.
- C. The stools may be very dark, and this can mask blood.
- D. Eat only red meats and organ meats for protein.
Correct Answer: C
Rationale: Ferrous gluconate darkens stools (C), potentially masking GI bleeding. Imodium (A) is premature, exercise (B) is encouraged, and diet (D) should be varied, not meat-only.
The client is experiencing pain due to cancer treatment- The client tells the nurse, “Methadone has always worked well for me in the past.” Which effects of methadone should the nurse consider when administering methadone?
- A. Has a long half-life and high level of potency
- B. May cause an increase in BP and confusion
- C. Causes severe allergic reactions and liver failure
- D. Has active metabolites, but it is well tolerated
Correct Answer: A
Rationale: bg
The nurse knows that infectious mononucleosis is caused by which of the following?
- A. Cytomegalovirus
- B. Beta-hemolytic Streptococcus
- C. Epstein-Barr virus
- D. Herpes simplex virus I
Correct Answer: C
Rationale: Infectious mononucleosis is caused by the Epstein-Barr virus.