The nurse is caring for a patient with stage IV Hodgkin disease. Where should the nurse expect to find enlarged lymph nodes during the assessment?

Two areas of lymph nodes above and below the diaphragm

Two or more areas on the same side of the diaphragm

Localized in the cervical neck area only

Generalized throughout the body within multiple organs

Answer and Explanation

The Correct Answer is D

A. Two areas of lymph nodes above and below the diaphragm: This describes stage III Hodgkin disease, where lymph node involvement occurs both above and below the diaphragm, but not necessarily in multiple organs.

B. Two or more areas on the same side of the diaphragm: This corresponds to stage II Hodgkin disease, which is limited to two or more lymph node regions on the same side of the diaphragm.

C. Localized in the cervical neck area only: Stage I Hodgkin disease typically involves a single lymph node region, often the cervical nodes, without generalized or extensive spread.

D. Generalized throughout the body within multiple organs: In stage IV Hodgkin disease, the cancer has spread beyond the lymph nodes to other organs and tissues, leading to generalized lymphadenopathy and potential organ involvement.

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Correct Answer is C

Explanation

A. Folate: Folate is important for red blood cell production but does not address the Vitamin B12 deficiency seen in pernicious anemia.

B. Vitamin C: Vitamin C does not impact pernicious anemia as it is not involved in Vitamin B12 absorption.

C. Vitamin B12: Pernicious anemia occurs due to a lack of intrinsic factor, which is necessary for Vitamin B12 absorption. After a total gastrectomy, intrinsic factor is no longer produced, requiring Vitamin B12 supplementation.

D. Iron: Iron deficiency anemia is different from pernicious anemia, which specifically requires Vitamin B12 supplementation.

A. Blood pressure B. Skin assessment C. Breath sounds D. Oxygen saturation E. WBC count F. Retractions G. Respiratory rate H. Hemoglobin

Correct Answer is ["B","C","D","F","G"]

Explanation

A. Blood pressure: The blood pressure is within normal limits and does not indicate an acute issue in this context.

B. Skin assessment: The presence of pallor and bruising indicates potential anemia and thrombocytopenia, common in leukemia patients but concerning signs that need to be monitored.

C. Breath sounds: Rhonchi in the upper lobes suggest respiratory congestion or infection, which is dangerous in an immunocompromised child.

D. Oxygen saturation: A drop in oxygen saturation to 90% indicates impaired oxygenation, which could signify respiratory distress or worsening infection.

E. WBC count: Although WBC count is within the low-normal range, it does not independently indicate an immediate change in the child’s condition.

F. Retractions: Subcostal retractions indicate respiratory distress, which is critical to report as it could escalate quickly in a child.

G. Respiratory rate: The increased respiratory rate (from 22 to 30/min) reflects respiratory distress and may worsen if the infection progresses.

H. Hemoglobin: While low, the hemoglobin is not acutely life-threatening in this case and would not necessarily prompt urgent intervention without other symptoms.

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The nurse is caring for a patient with stage IV Hodgkin disease. Where should the nurse expect to find enlarged lymph nodes during the assessment?

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Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching about pernicious anemia with a client following a total gastrectomy. Which of the following dietary supplements should the nurse include in the teaching as the treatment for pernicious anemia?

Correct Answer is C

Explanation

A pediatric nurse is assisting with the care of a school-age child who has leukemia. Exhibits Which of the following data collection findings should the nurse report to the provider? Select the 5 findings that should be reported to the provider.

Correct Answer is ["B","C","D","F","G"]

Explanation

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