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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.
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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.
Which information about reproduction should be taught to the 27-year-old female client diagnosed with Hodgkin's disease?
- A. The client’s reproductive ability will be the same after treatment.
- B. The client should practice birth control for at least two (2) years following therapy.
- C. All clients become sterile from the therapy and should plan to adopt.
- D. The therapy will temporarily interfere with the client’s menstrual cycle.
Correct Answer: D
Rationale: Hodgkin’s therapy (chemo/radiation) often temporarily disrupts menstruation (D). Fertility may recover (A, C incorrect), and birth control (B) is advised during treatment, not 2 years post.
The nurse administers iron using the Z track technique. What is the primary reason for administering iron via Z track?
- A. To prevent adverse reactions
- B. To prevent staining of the skin
- C. To improve the absorption rate
- D. To increase the speed of onset of action
Correct Answer: B
Rationale: The Z track technique prevents iron from leaking into subcutaneous tissue, reducing skin staining.
The nurse is admitting a client with a diagnosis of rule-out Hodgkin's lymphoma. Which assessment data support this diagnosis?
- A. Night sweats and fever without 'chills.'
- B. Edematous lymph nodes in the groin.
- C. Malaise and complaints of an upset stomach.
- D. Pain in the neck area after a fatty meal.
Correct Answer: A
Rationale: Night sweats and fever (A) are classic Hodgkin’s B symptoms. Edematous nodes (B) are not typical (firm, non-tender), malaise/stomach (C) is nonspecific, and neck pain (D) suggests gallbladder issues.
The client diagnosed with leukemia has central nervous system involvement. Which instruction should the nurse teach?
- A. Sleep with the HOB elevated to prevent increased intracranial pressure.
- B. Take an analgesic medication for pain only when the pain becomes severe.
- C. Explain radiation therapy to the head may result in permanent hair loss.
- D. Discuss end-of-life decisions prior to cognitive deterioration.
Correct Answer: D
Rationale: CNS leukemia risks cognitive decline; discussing end-of-life decisions (D) is critical before deterioration. HOB elevation (A) is for ICP, not routine, analgesics (B) should be proactive, and hair loss (C) is secondary.