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 D

Explanation

A. Pulmonary congestion: Pulmonary congestion is associated more with fluid overload or transfusion-associated circulatory overload (TACO), not an acute hemolytic reaction.

B. Urticaria: Urticaria (hives) is more typical of a mild allergic reaction rather than an acute hemolytic reaction.

C. Vomiting: Although nausea and vomiting may occur in various transfusion reactions, it is not specific to an acute hemolytic reaction like low back pain is.

D. Low back pain: Low back pain, often around the kidneys, is a classic sign of an acute hemolytic reaction due to the breakdown of RBCs and the release of hemoglobin into the bloodstream, which can lead to renal damage. This reaction is a medical emergency requiring immediate intervention.

A. Hematocrit 35% (F 37% -47%; M 42%-52%) B. Bone pain C. Weight loss D. Platelet count 125.000/mm3 (150,000-400,000)

Correct Answer is D

Explanation

A. Hematocrit 35% (F 37%–47%; M 42%–52%): Although the hematocrit is slightly low, it is not as concerning as a low platelet count, which poses an immediate risk for bleeding.

B. Bone pain: Bone pain is common in leukemia due to bone marrow expansion, but it does not take priority over the risk of bleeding from thrombocytopenia.

C. Weight loss: Weight loss may be a symptom of leukemia, but it is not immediately life-threatening and does not take priority over a low platelet count that increases bleeding risk.

D. Platelet count 125,000/mm³ (150,000–400,000): A low platelet count is concerning in leukemia patients because it increases the risk of bleeding. Monitoring for and preventing bleeding is a high priority due to thrombocytopenia associated with leukemia.

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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 assisting with the care of a client who is receiving a blood transfusion. The nurse should monitor for which of the following findings as an indication the client is having an acute hemolytic reaction?

Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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