A client was recently diagnosed with advanced Hodgkin's Lymphoma. Which sign or symptoms indicates that the lymphoma involves the presence of a mediastinal mass?

Shortness of breath, especially when lying flat

Pain/swelling of the lymph nodes

Low grade fevers of unknown etiology

Drenching night sweats

Answer and Explanation

The Correct Answer is A

A.   A mass in the mediastinum can compress the trachea or major blood vessels, leading to shortness of breath, particularly when the patient is in a supine position (lying flat). This symptom is indicative of significant obstruction or compression, making it a key sign.
B.   While lymphadenopathy (swelling of lymph nodes) is a hallmark of Hodgkin's Lymphoma, it does not specifically indicate the presence of a mediastinal mass. Lymph nodes can swell throughout the body, including cervical, axillary, and inguinal regions, but this symptom is more general and not exclusive to mediastinal involvement.
C.   Low-grade fevers can occur in Hodgkin's Lymphoma due to systemic effects of the cancer, such as cytokine release. However, this symptom is nonspecific and does not directly indicate a mediastinal mass. It is more indicative of the body's response to cancer rather than localized effects.
D.   Drenching night sweats are another common systemic symptom associated with Hodgkin's Lymphoma. Like low-grade fevers, night sweats are part of the B symptoms that can occur with lymphoma but are not specifically indicative of a mediastinal mass.

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Correct Answer is C

Explanation

A. This response shows some awareness but does not indicate a sufficient understanding of the risks. Straight razors can pose a significant risk of cuts and bleeding, especially in a patient who has received t- PA, which can increase the likelihood of bleeding.
B. This response suggests a misunderstanding. Using multiple razor blades does not inherently reduce the risk of bleeding and could increase the chance of cuts or nicks. This response does not indicate an appropriate understanding of safety precautions related to t-PA.
C. This response indicates an understanding of safety precautions. Electric razors are safer for clients who are at risk of bleeding because they do not have sharp blades that can easily cause cuts. This choice minimizes the risk of injury while allowing for personal grooming.
D. While disposable razors may seem convenient, they still carry a risk of cuts and bleeding. This response does not reflect a full understanding of the precautions necessary for a client who has received t-PA, as it does not prioritize safety in the same way that using an electric razor does.

A. The patient should be placed in isolation to prevent radiation exposure to others. B. The patient should avoid consuming any food or fluids for 24 hours prior to the treatment. C. The patient should avoid all physical activity for 72 hours after the treatment. D. The patient should discontinue all other medications for a week before the treatment.

Correct Answer is A

Explanation

A. This is a valid consideration. Patients receiving radioactive iodine may emit radiation, so placing them in a private room can help minimize exposure to family members and staff. Isolation may be more strictly enforced based on the dose administered and hospital protocols.
B. This is generally not required for radioactive iodine treatment. Patients are often advised to have a low-iodine diet in the weeks leading up to treatment, but complete fasting for 24 hours prior is not standard practice. Clear instructions from the healthcare provider should be followed regarding diet.
C. This is typically not a requirement. While some patients may be advised to avoid strenuous activities immediately after treatment, there is no strict guideline stating that all physical activity must be avoided for 72 hours. Patients are usually encouraged to follow normal activities while being mindful of minimizing close contact with others.
D. This statement is generally incorrect. While certain medications may need to be adjusted or stopped before radioactive iodine treatment (for instance, thyroid medications), it’s not a blanket recommendation to stop all medications for a week. Patients should consult with their healthcare provider for personalized advice regarding their specific medications.

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Blood Cell	Normal Ranges
Red blood cells (mature, circulating)	Male: 451-6.01 million/mm3 Female: 4.01-5.51 million/mm3
Hemoglobin	Adult (15-64 yr) Male 14-17.3 g/dL Female 11.7-155 g/dL
Hematocrit	42%-52% in males 36% -48% in females
Reticulocytes	0.5% -2.5% of total RBC count
White blood cells (total)	4.5-11.1 10/mm3
Neutrophils	59% Bands 3% Segs-56%
Eosinophils	2.7%
Basophils	0.5%
Lymphocytes	34%
Monocytes	4%


Platelets	150,000-450,000/mm3

A client was recently diagnosed with advanced Hodgkin's Lymphoma. Which sign or symptoms indicates that the lymphoma involves the presence of a mediastinal mass?

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

The nurse should implement which safety considerations for a patient when administering oral iodine radioactive for thyroid cancer?

Correct Answer is A

Explanation

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