Nokea
The nurse is caring for a group of clients. Which client does the nurse suspect is most likely to have mononucleosis?
- A. A 46-year-old who is complaining of chest pain and weakness
- B. A 19-year-old college student with cervical node enlargement and fever
- C. A 28-year-old with lower abdominal discomfort and vaginal discharge
- D. A 30-year-old with a cough, chest discomfort, and fever
Correct Answer: B
Rationale: The virus most commonly affects young adults, especially those in close living quarters, such as armed services housing and college dormitories. Fatigue, fever, sore throat, headache, and cervical lymph node enlargement typically occur. The tonsils ooze white or greenish-gray exudates. Pharyngeal swelling can compromise swallowing and breathing. Some clients develop a faint red rash on their hands or abdomen. The liver and spleen become enlarged. The other clients with presenting symptoms do not correlate with the symptoms of mononucleosis.
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A client with lymphadenitis has developed persistent swelling of the affected area. What would be important information for the nurse to teach this client?
- A. How to apply an elastic sleeve or stocking
- B. How to apply ice to the affected area
- C. How to do exercises to increase blood flow in the area
- D. How to dependently do activities of daily living
Correct Answer: A
Rationale: The nurse inspects the area two to three times daily and notes the client's response to antibiotic therapy. He or she gives assistance if the discomfort interferes with activities of daily living. Elevation reduces the swelling. Warmth promotes comfort and enhances circulation. The nurse notifies the physician if the affected area appears to enlarge, additional lymph nodes become involved, or body temperature remains elevated. In severe cases with persistent swelling, the nurse teaches the client how to apply an elastic sleeve or stocking. Ice does not reduce the swelling. Exercise does not reduce the swelling.
The client is receiving chemotherapy for a diagnosis of lymphosarcoma. The client experiences nausea. What measures should the nurse suggest to help the client reduce the feeling of nausea?
- A. Administer immunosuppressive drugs.
- B. Apply ice to the skin for brief periods.
- C. Offer clear liquids such as carbonated beverages, water, and ice pops.
- D. Advise bed rest as much as possible.
Correct Answer: C
Rationale: To help reduce the feeling of nausea in a client who underwent chemotherapy, the nurse should offer clear liquids such as carbonated beverages, water, ice pops, and gelatin until the nausea subsides. Immunosuppressive drugs are known to cause non-Hodgkin's lymphoma when administered to prevent a transplant rejection. These drugs do not help in reducing the feeling of nausea. The nurse may need to apply ice to the skin to prevent it from itching and thereby promote the skin integrity. Bed rest, analgesic and antipyretic therapy, and increased fluid intake are recommended to clients with infectious mononucleosis.
A client with lymphedema in the left arm has weeping from the skin and has a small 2-cm ulcer on the upper arm. What test does the nurse anticipate the client will be prepared for?
- A. X-ray of the left arm
- B. Ultrasound of the left arm
- C. CT scan
- D. Lymphangiography
Correct Answer: D
Rationale: Lymphangiography is a special examination in which an intravenous dye and radiography are used to detect lymph node involvement that reveals the degree and extent of blockage in the lymph system. An x-ray of the arm, ultrasound, or CT scan will not reveal the extent of blockage.
A young client has just been diagnosed with lymphoma. The client asks the nurse what a lymphoma is. What would be the nurse's best answer?
- A. It is a group of cancers that affect the body.
- B. It is a group of cancers connected to the hematopoietic system.
- C. It is a group of cancers that affect the lymphatic system.
- D. It is a group of cancers connected to the cardiovascular system.
Correct Answer: C
Rationale: The term lymphoma applies to a group of cancers that affect the lymphatic system. The correct option is more specific than the option of 'a group of cancers that affect the body.' Lymphomas are not related to the hematopoietic or cardiovascular systems.
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.