1.
A 22-year-old with stage I Hodgkin’s disease is admitted to the oncology unit for radiation therapy. During the initial assessment, the client tells you, “Sometimes I am afraid of dying.” Which response is most appropriate at this time?
Correct Answer
C. “Tell me a little bit more about your fear of dying.”
Explanation
Most assessment about what the client means is needed before any interventions can be planned or implemented. All of the other statements indicate a conclusion that the client is afraid of dying of Hodgkin’s disease. Focus: Prioritization
2.
You have developed the nursing diagnosis Risk for Impaired Tissue Integrity related to effects of radiation for a client with Hodgkin’s lymphoma who is receiving radiation to the groin area. Which nursing activity is best delegated to a nursing assistant caring for the client?
Correct Answer
D. Clean the skin over daily with a mild soap.
Explanation
Skin care is included in nursing assistant education and job description. Assessment and client teaching are more complex tasks that should be delegated to registered nurses. Use of lotions to the irradiated area is usually avoided during radiation therapy. Focus: Delegation
3.
After receiving the change-of-shift report, which client will you assess first?
Correct Answer
A. A 20-year-old with possible acute myelogenous leukemia who has just arrived on the medical unit
Explanation
The newly admitted client should be assessed first, because the baseline assessment and plan of care need to be completed. The other clients also need assessments or interventions, but do not need immediate nursing care. Focus: Prioritization
4.
A 21-year-old male with Hodgkin’s lymphoma is a senior at the local university. He is engaged to be married and is to begin a new job upon graduation. Which of the following diagnoses would be a priority for this client?
Correct Answer
A. Sexual dysfunction related to radiation therapy
Explanation
Radiation therapy often causes sterility in male clients and would be of primary importance to this client. The psychosocial needs of the client are important to address in light of the age and life choices. Hodgkin’s disease, however, has a good prognosis when diagnosed early.
5.
A patient is admitted to the oncology unit for diagnosis of suspected Hodgkin's disease. Which of the following symptoms is typical of Hodgkin's disease?
Correct Answer
B. Night sweats and fatigue.
Explanation
Symptoms of Hodgkin's disease include night sweats, fatigue, weakness, and tachycardia. The disease is characterized by painless, enlarged cervical lymph nodes. Weight loss occurs early in the disease. Nausea and vomiting are not typically symptoms of Hodgkin's disease.
6.
The Hodgkin's disease patient described in the question above undergoes a lymph node biopsy for definitive diagnosis. If the diagnosis of Hodgkin's disease were correct, which of the following cells would the pathologist expect to find?
Correct Answer
A. Reed-Sternberg cells.
Explanation
A definitive diagnosis of Hodgkin's disease is made if Reed-Sternberg cells are found on pathologic examination of the excised lymph node. Lymphoblasts are immature cells found in the bone marrow of patients with acute lymphoblastic leukemia. Gaucher's cells are large storage cells found in patients with Gaucher's disease. Rieder's cells are myeloblasts found in patients with acute myelogenous leukemia.
7.
The nurse understands that Hodgkin’s disease is suspected when a client presents with a painless, swollen lymph node. Hodgkin’s disease typically affects people in which age group?
Correct Answer
C. Young adults (ages 21-40 years)
Explanation
Hodgkin's disease is a type of lymphoma that primarily affects young adults, typically between the ages of 21 and 40 years. This age group is more commonly affected by Hodgkin's disease compared to children, teenagers, and older adults. The presence of painless, swollen lymph nodes is a common symptom of Hodgkin's disease, which helps to further support the suspicion of this condition in young adults.
8.
A male client is admitted to the hospital with a suspected diagnosis of Hodgkin’s disease. Which assessment findings would the nurse expect to note specifically in the client?
Correct Answer
D. Enlarged lympH nodes
Explanation
Hodgkin’s disease is a chronic progressive neoplastic disorder of lymphoid tissue characterized by the painless enlargement of lymph nodes with progression to extralymphatic sites, such as the spleen and liver. Weight loss is most likely to be noted. Fatigue and weakness may occur but are not related significantly to the disease.
9.
The nurse is aware that the following symptoms is most commonly an early indication of stage 1 Hodgkin’s disease?
Correct Answer
B. Night sweat
Explanation
In stage 1, symptoms include a single enlarged lymph node (usually), unexplained fever, night sweats, malaise, and generalized pruritis. Although splenomegaly may be present in some clients, night sweats are generally more prevalent. Pericarditis isn’t associated with Hodgkin’s disease, nor is hypothermia. Moreover, splenomegaly and pericarditis aren’t symptoms. Persistent hypothermia is associated with Hodgkin’s but isn’t an early sign of the disease.
10.
A newly admitted client is diagnosed with Hodgkin’s disease undergoes an excisional cervical lymph node biopsy under local anesthesia. What does the nurse assess first after the procedure?
Correct Answer
C. Airway
Explanation
Assessing for an open airway is the priority. The procedure involves the neck, the anesthesia may have affected the swallowing reflex or the inflammation may have closed in on the airway leading to ineffective air exchange.
11.
A client admitted with newly diagnosed with Hodgkin’s disease. Which of the following would the nurse expect the client to report?
Correct Answer
C. Night sweats
Explanation
Assessment of a client with Hodgkin’s disease most often reveals enlarged, painless lymph node, fever, malaise and night sweats.
12.
The two main groups of lymphoma in humans are Hodgkin lymphoma and the non-Hodgkin Lymphomas (NHL).
Correct Answer
A. True
Explanation
The statement is true because Hodgkin lymphoma and non-Hodgkin lymphoma are indeed the two main groups of lymphoma in humans. Hodgkin lymphoma is characterized by the presence of Reed-Sternberg cells, while non-Hodgkin lymphomas encompass a diverse group of lymphomas that do not have Reed-Sternberg cells. These two groups have different characteristics, treatment approaches, and prognoses, making it important to distinguish between them in order to provide appropriate care for patients.
13.
Hodgkin lymphoma, named for Thomas Hodgkin, is an American physician who identified it in 1832.
Correct Answer
B. False
Explanation
The statement is false because Hodgkin lymphoma was actually named after Thomas Hodgkin, a British physician, not an American physician. Thomas Hodgkin identified the disease in 1832, but he was not American.
14.
Hodgkin lymphoma only occurs in a group of lymph nodes, not in a single lymph node or in other parts of the lymphatic system, such as the bone marrow and spleen.
Correct Answer
B. False
Explanation
Hodgkin lymphoma can occur in a single lymph node or in multiple lymph nodes, as well as in other parts of the lymphatic system such as the bone marrow and spleen. Therefore, the statement that Hodgkin lymphoma only occurs in a group of lymph nodes is false.
15.
Non-Hodgkin lymphoma can spread to almost any part of the body, including the liver, bone marrow, and spleen.
Correct Answer
A. True
Explanation
Non-Hodgkin lymphoma is a type of cancer that can spread to various parts of the body, including the liver, bone marrow, and spleen. This is because lymphoma originates in the lymphatic system, which is a network of vessels and organs that are spread throughout the body. As the cancer progresses, it can infiltrate different organs and tissues, leading to the spread of the disease. Therefore, it is true that Non-Hodgkin lymphoma can spread to almost any part of the body.
16.
Sex is one of the risk factors for developing NHL, but race is not.
Correct Answer
B. False
Explanation
This statement is false because both sex and race are considered risk factors for developing NHL (Non-Hodgkin Lymphoma). While being male is a known risk factor, certain racial and ethnic groups have also been found to have a higher incidence of NHL. Therefore, both sex and race can contribute to the risk of developing NHL.
17.
People infected with HIV are more likely to develop lymphatic disease.
Correct Answer
A. True
Explanation
People infected with HIV are more likely to develop lymphatic disease because HIV weakens the immune system, making individuals more susceptible to infections and diseases. The lymphatic system plays a crucial role in the body's immune response, so when the immune system is compromised by HIV, it becomes easier for lymphatic diseases to develop. Therefore, it is true that people infected with HIV are more likely to develop lymphatic disease.
18.
One of the symptoms for lymphatic disease is swelling of the lymph nodes; however, this symptom may be easily overlooked because the enlargement does not cause any pain.
Correct Answer
A. True
Explanation
Swelling of the lymph nodes is indeed one of the symptoms of lymphatic disease. However, it may be easily overlooked because it does not cause any pain. Therefore, the statement is true.
19.
Hodgkin lymphoma may be cured with chemotherapy with almost no incidence of secondary acute nonlymphocytic leukemia within 10 years.
Correct Answer
B. False
Explanation
Chemotherapy is a common treatment for Hodgkin lymphoma, but it can increase the risk of developing secondary acute nonlymphocytic leukemia. Therefore, the statement that Hodgkin lymphoma may be cured with chemotherapy with almost no incidence of secondary acute nonlymphocytic leukemia within 10 years is false.