New Book
Brunner & Suddarth 14th Edition
The home health nurse is performing a home visit for an oncology
patient discharged 3 days ago after
completing treatment for
non-Hodgkin lymphoma. The nurses assessment should include
examination
for the signs and symptoms of what
complication?
A) Tumor lysis syndrome (TLS)
B) Syndrome of
inappropriate antiduretic hormone (SIADH)
C) Disseminated
intravascular coagulation (DIC)
D) Hypercalcemia
Ans: A
Feedback:
TLS is a potentially fatal complication
that occurs spontaneously or more commonly following
radiation,
biotherapy, or chemotherapy-induced cell destruction of large or
rapidly growing cancers such
as leukemia, lymphoma, and small
cell lung cancer. DIC, SIADH and hypercalcemia are less
likely
complications following this treatment and diagnosis.
An emergency department nurse is triaging a 77-year-old man who
presents with uncharacteristic fatigue
as well as back and rib
pain. The patient denies any recent injuries. The nurse should
recognize the need
for this patient to be assessed for what
health problem?
A) Hodgkin disease
B) Non-Hodgkin
lymphoma
C) Multiple myeloma
D) Acute thrombocythemia
Ans: C
Feedback:
Back pain, which is often a presenting
symptom in multiple myeloma, should be closely investigated
in
older patients. The lymphomas and bleeding disorders do not
typically present with the primary
symptom of back pain or rib pain.
A nurse is caring for a patient with Hodgkin lymphoma at the oncology
clinic. The nurse should be
aware of what main goal of
care?
A) Cure of the disease
B) Enhancing quality of
life
C) Controlling symptoms
D) Palliation
Ans: A
Feedback:
The goal in the treatment of Hodgkin
lymphoma is cure. Palliation is thus not normally
necessary.
Quality of life and symptom control are vital, but the
overarching goal is the cure the disease.
An adult patient has presented to the health clinic with a complaint
of a firm, painless cervical lymph
node. The patient denies any
recent infectious diseases. What is the nurses most appropriate
response to
the patients complaint?
A) Call 911.
B)
Promptly refer the patient for medical assessment.
C) Facilitate
a radiograph of the patients neck and have the results forwarded to
the patients primary
care provider.
D) Encourage the patient
to track the size of the lymph node and seek care in 1 week.
Ans: B
Feedback:
Hodgkin lymphoma usually begins as an
enlargement of one or more lymph nodes on one side of the
neck.
The individual nodes are painless and firm but not hard. Prompt
medical assessment is necessary if
a patient has this
presentation. However, there is no acute need to call 911. Delaying
care for 1 week
could have serious consequences and x-rays are
not among the common diagnostic tests.
An adult patients abnormal complete blood count (CBC) and physical
assessment have prompted the
primary care provider to order a
diagnostic workup for Hodgkin lymphoma. The presence of
what
assessment finding is considered diagnostic of the
disease?
A) Schwann cells
B) Reed-Sternberg cells
C)
Lewy bodies
D) Loops of Henle
Ans: B
Feedback:
The malignant cell of Hodgkin lymphoma is
the Reed-Sternberg cell, a gigantic tumor cell that
is
morphologically unique and thought to be of immature lymphoid
origin. It is the pathologic hallmark
and essential diagnostic
criterion. Schwann cells exist in the peripheral nervous system and
Lewy bodies
are markers of Parkinson disease. Loops of Henle
exist in nephrons.
A young adult patient has received the news that her treatment for
Hodgkin lymphoma has been deemed
successful and that no further
treatment is necessary at this time. The care team should ensure that
the
patient receives regular health assessments in the future due
to the risk of what complication?
A) Iron-deficiency
anemia
B) Hemophilia
Test Bank - Brunner & Suddarth's
Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) 672
C)
Hematologic cancers
D) Genitourinary cancers
Ans: C
Feedback:
Survivors of Hodgkin lymphoma have a high
risk of second cancers, with hematologic cancers being the
most
common. There is no consequent risk of anemia or hemophilia, and
hematologic cancers are much
more common than GU cancers.
The clinical nurse educator is presenting health promotion education
to a patient who will be treated for
non-Hodgkin lymphoma on an
outpatient basis. The nurse should recommend which of the
following
actions?
A) Avoiding direct sun exposure in excess
of 15 minutes daily
B) Avoiding grapefruit juice and fresh
grapefruit
C) Avoiding highly crowded public places
D) Using
an electric shaver rather than a razor
Ans: C
Feedback:
The risk of infection is significant for
these patients, not only from treatment-related
myelosuppression
but also from the defective immune response that
results from the disease itself. Limiting infection
exposure is
thus necessary. The need to avoid grapefruit is dependent on the
patients medication
regimen. Sun exposure and the use of razors
are not necessarily contraindicated.
The nurse is leading a workshop on sexual health for men. The nurse
should teach participants that
organic causes of erectile
dysfunction include what? Select all that apply.
A)
Diabetes
B) Testosterone deficiency
Test Bank - Brunner
& Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle
2017) 1128
C) Anxiety
D) Depression
E) Parkinsonism
Ans: A, B, E
Feedback:
Organic causes of ED include
cardiovascular disease, endocrine disease (diabetes, pituitary
tumors,
testosterone deficiency, hyperthyroidism, and
hypothyroidism), cirrhosis, chronic renal failure,
genitourinary
conditions (radical pelvic surgery), hematologic conditions (Hodgkin
disease, leukemia),
neurologic disorders (neuropathies,
parkinsonism, spinal cord injury, multiple sclerosis), trauma to
the
pelvic or genital area, alcohol, smoking, medications, and
drug abuse. Anxiety and depression are
considered to be
psychogenic causes.
New Book
Ignataviticus Edition 7 & 9
The nurse is planning a cancer education event in an Asian community center. The nurse plans to present information specifically on which types of cancer?
a.
Breast and colorectal
b.
Skin and lymphoma
c.
Liver and stomach
d.
Uterine and ovarian
ANS: A
Asians have higher rates of breast, colorectal, prostate, lung, and stomach cancers than are seen in the general population.
DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Physiological Integrity (Physiological AdaptationPathophysiology)
MSC: Integrated Process: Nursing Process (Planning)
In preparing a cancer risk reduction pamphlet for African-American clients, it is most important that the nurse include information on prevention and early detection for which types of cancer?
a.
Lung and prostate
b.
Bone and leukemia
c.
Skin and lymphoma
d.
Stomach and esophageal
ANS: A
African Americans have higher incidences of lung, prostate, breast, colorectal, and uterine cancers than are seen in the general population.
DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Physiological Integrity (Physiological AdaptationPathophysiology)
MSC: Integrated Process: Nursing Process (Planning)
A client has Hodgkins lymphoma, Ann Arbor stage Ib. For what
manifestations should the nurse assess the
client? (Select all
that apply.)
a. Headaches
b. Night sweats
Test Bank -
Medical-Surgical Nursing: Concepts for Interprofessional Collaborative
Care 9e 339
c. Persistent fever
d. Urinary frequency
e.
Weight loss
ANS: B, C, E
In this stage, the disease is located in a single
lymph node region or a single nonlymph node site. The
client
displays night sweats, persistent fever, and weight loss.
Headache and urinary problems are not related.
DIF:
Understanding/Comprehension REF: 827
KEY: Hematologic system|
lymphoma| nursing assessment
MSC: Integrated Process: Nursing
Process: Assessment
NOT: Client Needs Category: Physiological
Integrity: Reduction of Risk Potential
A nurse is caring for a young male client with lymphoma who is to
begin treatment. What teaching topic is
a priority?
a.
Genetic testing
b. Infection prevention
c. Sperm
banking
d. Treatment options
ANS: C
All teaching topics are important to the client with
lymphoma, but for a young male, sperm banking is of
particular
concern if the client is going to have radiation to the lower abdomen
or pelvis.
DIF: Understanding/Comprehension REF: 827
KEY:
Lymphoma| hematologic system| caring| reproductive problems
MSC:
Integrated Process: Teaching/Learning
NOT: Client Needs Category:
Health Promotion and Maintenance
A patient with Hodgkin’s lymphoma is undergoing external radiation therapy on an outpatient basis. After 2 weeks of treatment, the patient tells the nurse, “I am so tired I can hardly get out of bed in the morning.” An appropriate intervention for the nurse to plan with the patient is to
a. exercise vigorously when fatigue is not as noticeable.
b. consult with a psychiatrist for treatment of depression.
c. establish a time to take a short walk every day.
d. maintain bed rest until the treatment is completed.
Correct Answer: C
Rationale: Walking programs are used to keep the patient active without excessive fatigue. Vigorous exercise when the patient is less tired may lead to increased fatigue. Fatigue is expected during treatment and is not an indication of depression. Bed rest will lead to weakness and other complications of immobility.
Cognitive Level: Application Text Reference: p. 297
Nursing Process: Planning NCLEX: Physiological Integrity
A 32-year-old male patient is to undergo radiation therapy to the pelvic area for Hodgkin’s lymphoma. He expresses concern to the nurse about the effect of chemotherapy on his sexual function. The best response by the nurse to the patient’s concerns is
a.
“Radiation does not cause the problems with sexual functioning that occur with chemotherapy or surgical procedures used to treat cancer.”
b.
“It is possible you may have some changes in your sexual function, and you may want to consider pretreatment harvesting of sperm if you want children.”
c.
“The radiation will make you sterile, but your ability to have sexual intercourse will not be changed by the treatment.”
d.
“You may have some temporary impotence during the course of the radiation, but normal sexual function will return.”
Correct Answer: B
Rationale: The impact on sperm count and erectile function depends on the patient’s pretreatment status and on the amount of exposure to radiation. The patient should consider sperm donation before radiation. Radiation (like chemotherapy or surgery) may affect both sexual function and fertility either temporarily or permanently.
Cognitive Level: Application Text Reference: p. 301
Nursing Process: Implementation NCLEX: Physiological Integrity
The nurse assesses a patient with non-Hodgkin's lymphoma who is
receiving an
infusion of rituximab (Rituxan). Which assessment
finding would require the most rapid action by
the nurse?
a.
Shortness of breath
b. Temperature 100.2° F (37.9° C)
c.
Shivering and complaint of chills
d. Generalized muscle aches and pains
ANS: A
Rituximab (Rituxan) is a monoclonal antibody. Shortness
of breath should be investigated rapidly because
anaphylaxis is a
possible reaction to monoclonal antibody administration. The nurse
will need to rapidly
take actions such as stopping the infusion,
assessing the patient further, and notifying the health
care
provider. The other findings will also require action by the
nurse, but are not indicative of
life-threatening
complications.
DIF: Cognitive Level: Apply
(application) REF: 272-273
OBJ: Special Questions: Prioritization
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity