CH32

A 70-year-old client has recently been diagnosed with lymphoma and asks what may have contributed to this illness. Which of the following statements from the nurse would be most accurate? 1) "Previous infection with varicella, before there were immunizations against it, may have contributed to this development." "Lymphoma commonly develops in older adults because their circulation and blood-vessel functioning are weaker than in younger people." "People of all age groups are at the same risk for lymphoma." "Lymphoma incidence increases with age because of cumulative exposures to carcinogens and a decline in immune functioning."

"Lymphoma incidence increases with age because of cumulative exposures to carcinogens and a decline in immune functioning." Explanation: The risk of lymphoma is increased in older adults, primarily because of the immunologic changes of aging and prolonged exposure to carcinogens. This age group has a higher risk than others for lymphomas. Development of lymphoma has no connection to previous history of infection with varicella. Lymphoma is a problem of the lymphatic system, not of circulatory or blood-vessel functioning.

A client is recovering from infectious mononucleosis and asks the nurse when he or she will finally be rid of the disease. How should the nurse most accurately respond? 1) "You are now immune to mono, but the virus will remain in your body for the rest of your life." "You are at risk for recurrences related to stress for the rest of your life." "Your illness will clear up in 30 to 50 days." "You may redevelop the illness if you are exposed to others who have it."

"You are now immune to mono, but the virus will remain in your body for the rest of your life." The symptoms resolve in approximately 1 to 2 weeks unless complications develop. One episode of infectious mononucleosis produces subsequent immunity; however, the virus remains in the body for the person's lifetime.

A nurse is monitoring the respiratory status of a client with Hodgkin's disease who has Impaired Gas Exchange and Ineffective Airway Clearance. What is the minimum percentage of blood oxygen saturation for this client to maintain? Fill in the blank with a number.

90 % The expected outcome is that breathing will remain adequate to maintain blood oxygen saturation of 90% or greater.

Which patient assessed by the nurse is most likely to develop myelodysplastic syndrome (MDS)? 1) A 40-year-old patient with a history of hypertension A 24-year-old female taking oral contraceptives A 52-year-old patient with acute kidney injury A 72-year-old patient with a history of cancer

A 72-year-old patient with a history of cancer Primary MDS tends to be a disease of people older than 70 years. Because the initial findings are so subtle, the disease may not be diagnosed until later in the illness trajectory, if at all. Thus, the actual incidence of MDS is not known.

A client with myelodysplastic syndrome (MDS) is being treated on a medical unit. Which priority finding should prompt the nurse to contact the client's primary care provider? 1) An oral temperature of 37.5°C (99.5°F) An oxygen saturation (SpO2) of 91% on room air Reports of a frontal lobe headache An episode of urinary incontinence

An oral temperature of 37.5°C (99.5°F) Because the client with MDS is at a high risk for infection, any early signs of infection must be reported promptly. The nurse should address each of the listed assessment findings, but none is as direct a threat to the client's immediate health as an infection.

A public health nurse is planning community teaching for a group of older adults regarding aging and hematological conditions. What condition will the nurse identify as most common among this population? 1) Lymphopenia Thalassemia Leukemia Anemia

Anemia Anemia is the most common hematological condition in older adults, particularly those admitted to hospitals and long-term care facilities.

Which nursing intervention should be incorporated into the plan of care to manage the delayed clotting process in a client with leukemia? 1) Implement neutropenic precautions. Eliminate direct contact with others who are infectious. Monitor temperature at least once per shift. Apply prolonged pressure to needle sites or other sources of external bleeding.

Apply prolonged pressure to needle sites or other sources of external bleeding. For a client with leukemia, the nurse should apply prolonged pressure to needle sites or other sources of external bleeding. Reduced platelet production results in a delayed clotting process and increases the potential for hemorrhage. Implementing neutropenic precautions and eliminating direct contact with others are interventions to address the risk for infection

A client who is undergoing chemotherapy for AML reports pain in the low back. What is the nurse's first action? 1) Place heating pads on the client's back. 2) Assess renal function. 3) Refer the client to a chiropractor. 4) Administer pain medication, as ordered.

Assess renal function. Chemotherapy results in the destruction of cells and tumor lysis syndrome. Uric acid and phosphorus concentrations increase, and the client is susceptible to renal failure. The nurse should assess renal function if the client complains of low-back pain, as this could be indicative of kidney stone formation. Heating pads, pain medication, and referrals could be instituted once the cause of the pain is determined. The priority is further assessment to rule out important problems.

A client is being tested for acute myeloid leukemia (AML). The nurse knows that which diagnostic test will be used as the hallmark for the diagnosis? 1) Bone marrow analysis Complete blood count Alkaline phosphatase level Clotting factors

Bone marrow analysis Explanation: To confirm the diagnosis of AML, laboratory studies need to be performed. A bone marrow analysis shows an excess or more than 20% of blast cells which is the hallmark of the diagnosis. Clotting factors are not used to diagnose AML. The complete blood count (CBC) commonly shows a decrease in both erythrocytes and platelets but is not as specific as the bone marrow analysis. The alkaline phosphatase level measures a liver enzyme.

A nurse is documenting skin findings in a client with lymphedema. Which of the following descriptions would be most consistent with the expected presentation? 1) Cyanotic Jaundice Rubor Brawny

Brawny Explanation: The skin of the client with lymphedema can appear thickened, rough, and discolored; it is described as brawny (orange). Rubor means a red appearance; cyanotic is a bluish skin tone when oxygenation to tissues is impaired; and jaundice is a yellow skin tone that develops in client with liver problems

A nurse cares for a client with early Hodgkin lymphoma. While assessing the client, the nurse will most likely find painless enlargement of which lymph node? 1) Cervical Axillary Popliteal Inguinal

Cervical Explanation: Non painful swelling of the cervical lymph nodes is the earliest symptom of Hodgkin lymphoma.

A client with acute myeloid leukemia (AML) receiving chemotherapy is treated for an acute renal injury. What is the nurse's best understanding of the pathophysiological reason behind the client's injury? 1) The majority of the disease process occurs in the tissue of the kidneys. Chemotherapy causes an increase in kidney stone formation. The majority of the disease process occurs in the vessels of the kidneys. Chemotherapy causes destruction of the nephrons in the kidney.

Chemotherapy causes an increase in kidney stone formation. Explanation: Massive leukemic cell destruction from chemotherapy results in the release of intracellular electrolytes and fluids into the systemic circulation. This causes an increase in uric acid levels, potassium, and phosphate (also known as tumor lysis). The increase in uric acid predisposes the client to the development of kidney stones and increases the risk for renal injury.

A nurse is preparing health education for a client who has received a diagnosis of myelodysplastic syndrome (MDS). Which of the following topics should the nurse prioritize? 1) Techniques for self-palpation of the lymph nodes Emergency management of bleeding episodes Technique for the administration of bronchodilators by metered-dose inhaler Techniques for energy conservation and activity management

Emergency management of bleeding episodes Explanation: Because of clients' risks of hemorrhage, clients with MDS should be taught techniques for managing emergent bleeding episodes. Bronchodilators are not indicated for the treatment of MDS and lymphedema is not normally associated with the disease. Energy conservation techniques are likely to be useful, but management of hemorrhage is a priority because of the potential consequences.

A client recently diagnosed with a lymphatic disorder asks the nurse why the lymphatic system is so important. Which of the following would the nurse be correct in identifying as potential complications of a compromised lymphatic system? Select all that apply. 1) Digestive disorders Fluid distribution problems Tender, painful enlargement of lymph nodes Cardiovascular disease Weakened immunity

Fluid distribution problems Tender, painful enlargement of lymph nodes Weakened immunity Explanation: Disorders of the lymphatic system result in fluid distribution problems, tender and painful lymph node enlargement, compromised immune function, or a combination of these.

A patient with acute myeloid leukemia (AML) is having hematopoietic stem cell transplantation (HSCT) with radiation therapy. In which complication do the donor's lymphocytes recognize the patient's body as foreign and set up reactions to attack the foreign host? 1) Graft-versus-host disease Remission Bone marrow depression Acute respiratory distress syndrome

Graft-versus-host disease Patients who undergo HSCT have a significant risk of infection, graft-versus host disease (in which the donor's lymphocytes [graft] recognize the patient's body as "foreign" and set up reactions to attack the foreign host), and other complications.

A client with Hodgkin's disease is hospitalized and experiencing respiratory distress. In which position should the nurse place the client? 1) Sims' Trendelenburg Semi-Fowler's High Fowler's

High Fowler's The nurse should keep the neck in midline and place the client in high Fowler's position if respiratory distress develops. This position avoids unnecessary pressure on the trachea and provides for increased lung expansion and improved air exchange.

A client is recovering from infectious mononucleosis. For which of the following conditions is the nurse aware that the client may also be at increased future risk? 1) Tuberculosis Hodgkin's lymphoma Hashimoto's thyroiditis Lymphedema

Hodgkin's lymphoma Explanation: The Epstein-Barr virus is believed to trigger Hodgkin's lymphoma in approximately 40% of people with this disease.

A client with primary myelofibrosis is diagnosed with splenomegaly. Which medications will the nurse prepare teaching for this client? Select all that apply. 1) Hydroxyurea Anagrelide Interferon-alfa Thalidomide Pomalidomide

Hydroxyurea Thalidomide Pomalidomide Primary myelofibrosis is characterized by extramedullary hematopoiesis that involves the spleen causing splenomegaly. Pharmacologic agents can be used to diminish splenomegaly and include hydroxyurea, thalidomide, and pomalidomide. Anagrelide and interferon-alfa are not used to treat splenomegaly caused by primary myelofibrosis.

An oncology nurse is caring for a client with multiple myeloma who is experiencing bone destruction. When reviewing the client's most recent blood tests, the nurse should anticipate which imbalance? 1) Elevated red blood count (RBC) Hypercalcemia Hyperproteinemia Elevated serum viscosity

Hypercalcemia Hypercalcemia may result when bone destruction occurs due to the disease process. Elevated serum viscosity occurs because plasma cells excrete excess immunoglobulin but would not result from bone destruction. The RBC count will decrease, not increase, resulting in anemia due to the abnormal protein produced from the malignant cells. Hyperproteinemia is defined as high protein in the blood and is commonly seen in clients with dehydration but would not result from bone destruction.

A patient with AML is having aggressive chemotherapy to attempt to achieve remission. The patient is aware that hospitalization will be necessary for several weeks. What type of therapy will the nurse explain that the patient will receive? 1) Induction therapy Standard therapy Antimicrobial therapy Supportive therapy

Induction therapy Explanation: Despite advances in understanding of the biology of AML, substantive advances in treatment response rates and survival rates have not occurred for decades, with the exception of advances made in treating APL (see later discussion). Even for patients with subtypes that have not benefited from advances in treatment, cure is still possible. The overall objective of treatment is to achieve complete remission, in which there is no evidence of residual leukemia in the bone marrow. Attempts are made to achieve remission by the aggressive administration of chemotherapy, called induction therapy, which usually requires hospitalization for several weeks.

A client has been diagnosed with infectious mononucleosis. He asks the nurse how he contracted the illness. Which of the following would the nurse accurately identify as possible causes of the client's condition? Select all that apply. 1) Sharing cigarettes Allergic reaction to an immunization Kissing Being coughed or sneezed on Ingesting contaminated food

Kissing Sharing cigarettes Being coughed or sneezed on The Epstein-Barr virus causes infectious mononucleosis. This contagious disorder spreads by direct contact with saliva and pharyngeal secretions from an infected person. It is transmitted by kissing; oral spraying during coughing, talking, or sneezing; or sharing food, cigarettes, or other items containing oral secretions.

A nurse is helping to prepare a client with lymphedema for a procedure in which an intravenous dye and radiography will be used to detect lymph node involvement and reveal the degree and extent of blockage in the lymph system. What procedure will the client be undergoing? 1) Lymphatic tomography Lymphangiography Lympharthoscopy Magnetic resonance imaging

Lymphangiography Explanation: Lymphangiography is a special examination in which an intravenous (IV) dye and radiography are used to detect lymph node involvement, which reveals the degree and extent of blockage in the lymph system.

A 16-year-old girl has been brought to her primary care provider by her mother due to the daughter's recent malaise and lethargy. Which of the following assessments should the clinician perform in an effort to confirm or rule out infectious mononucleosis? 1) Auscultating the patient's lungs Assessing the patient for bone pain Assessing the patient's cranial nerve reflexes Palpating the patient's lymph nodes

Palpating the patient's lymph nodes In cases of infectious mononucleosis, the lymph nodes are typically enlarged throughout the body, particularly in the cervical, axillary, and groin areas. Palpation of these nodes is a priority assessment in cases of suspected mononucleosis. Bone pain, adventitious lungs sounds, and abnormal cranial nerve reflexes do not accompany mononucleosis.

A client with a diagnosis of acute myeloid leukemia (AML) is being treated with induction therapy on the oncology unit. What nursing action should be prioritized in the client's care plan? 1) Monitoring and treating the client's pain Protective isolation and vigilant use of standard precautions Including the family in planning the client's activities of daily living Provision of a high-calorie, low-texture diet and appropriate oral hygiene

Protective isolation and vigilant use of standard precautions Explanation: Induction therapy causes neutropenia and a severe risk of infection. This risk must be addressed directly in order to ensure the client's survival. For this reason, infection control would be prioritized over nutritional interventions, family care, and pain, even though each of these are important aspects of nursing care.

A young adult is preparing to begin treatment for non-Hodgkin lymphoma (NHL), a disease that has disseminated widely. What is the most likely treatment regimen for this patient that the nurse will help prepare? 1) Surgery and whole blood transfusion 2) Bone marrow or stem cell transplantation 3) Antiviral medications 4) Radiation and chemotherapy

Radiation and chemotherapy Explanation: NHL is normally treated with either radiation (early stage) or radiation and chemotherapy (later stages). Antivirals, blood transfusion, surgery, bone marrow transplantation, and stem cell transplantations are not common treatment modalities for NHLs.

An adult client's abnormal complete blood count (FBC) 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? 1) Loops of Henle Schwann cells Lewy bodies Reed-Sternberg cells

Reed-Sternberg cells 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

The nurse is reviewing the chart of a client with lymphoma. Which of the following findings would best indicate to the nurse that the client has Hodgkin's disease as opposed to non-Hodgkin's lymphoma? 1) The spleen is enlarged. Client is 58 years old. Reed-Sternberg cells are found diagnostically. Client is of male gender.

Reed-Sternberg cells are found diagnostically. Explanation: Although the exact cause of Hodgkin's disease is unknown, it appears that a virus, particularly the Epstein-Barr virus, causes mutations in some but not all lymphocytes, creating malignant cells known as Reed-Sternberg cells. Reed-Sternberg cells are present with Hodgkin's disease. The other findings, although also possible with Hodgkin's disease, could also be found in clients with non-Hodgkin's lymphoma.

A nurse is planning the care of client who has been diagnosed with essential thrombocythemia (ET). Which nursing diagnosis should the nurse prioritize when choosing interventions? 1) Risk for ineffective breathing pattern Risk for ineffective thermoregulation Risk for ineffective tissue perfusion Risk for imbalanced fluid volume

Risk for ineffective tissue perfusion Explanation: Clients with ET are at risk for hypercoagulation and consequent ineffective tissue perfusion. Fluid volume, breathing, and thermoregulation are not normally affected.

A client has received the news that the client's 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 client receives regular health assessments in the future due to the risk of which complication? 1) Secondary malignancy 2) Lymphedema 3) Hemophilia 4) Iron-deficiency anemia

Secondary malignancy Explanation: Survivors of Hodgkin lymphoma have a high risk of secondary malignancies. There is no consequent risk of anemia, lymphedema, or hemophilia

A client at the health care facility is diagnosed with Hodgkin's disease that has extended to the liver. What stage should the nurse use to describe the progress of the disease? 1) Stage IV Stage II Stage III Stage I

Stage IV Explanation: In stage IV, the disease extends to one or more extralymphatic organs or tissue. Here, it has extended to the liver. In stage I, the disease is limited to a single node or single extralymphatic site. In stage II, the disease spreads to more than a single node, but is confined to one side of the diaphragm, and in stage III, the disease is present both above and below the diaphragm.

A client is newly diagnosed with Hodgkin lymphoma. The nurse understands that the client's treatment will be based on what concept? 1) Staging of disease Involvement of lymph nodes Total blood cell count Histology of tissue

Staging of disease Explanation: Treatment of Hodgkin lymphoma is based on the stage of the disease, not the histology of tissue, involvement of lymph nodes, or total blood cell count.

Laboratory and diagnostic test results have returned for a client with suspected lymphangitis. Which of the following would be most likely for the nurse to review in the results? 1) Staphylococcus Escherichia coli Streptococcus Pseudomonas

Streptococcus An infectious agent, commonly a streptococcal microorganism, usually causes both lymphangitis and lymphadenitis.

The nurse is assessing several clients. Which client does the nurse determine is most likely to have Hodgkin lymphoma? 1) The client with painful lymph nodes in the groin. The client with painful lymph nodes under the arm. The client with a painful sore throat. The client with enlarged lymph nodes in the neck.

The client with enlarged lymph nodes in the neck. Lymph node enlargement in Hodgkin lymphoma is not painful. The client with enlarged lymph nodes in the neck is most likely to have Hodgkin lymphoma if the enlarged nodes are painless. Sore throat is not a sign for this disorder.

A 60-year-old client with chronic myeloid leukemia (CML) will be treated in the home setting, and the nurse is preparing appropriate health education. Which topic should the nurse emphasize? 1) The importance of daily physical activity The need to avoid shellfish and raw foods The need to ensure that vaccinations are up to date The importance of adhering to the prescribed drug regimen

The importance of adhering to the prescribed drug regimen Nurses need to understand that the effectiveness of the drugs used to treat CML is based on the ability of the client to adhere to the medication regimen as prescribed. Adherence is often incomplete, thus this must be a focus of health education. Vaccinations normally would not be given during treatment and daily physical activity may be impossible for the client. Dietary restrictions are not normally necessary.

A client who has Hodgkin's disease should have their bed in high-Fowler's position whenever practical to: 1) increase lung expansion. detect compromised ventilation. anticipate the need for the airway management. reduce cervical edema.

increase lung expansion. Explanation: Those who have Hodgkin's disease are at risk for ineffective airway clearance and impaired gas exchange. High-Fowler's position promotes lung expansion.

A client with Hodgkin's disease is receiving chemotherapy with the regimen called "MOPP." For which of the following drugs does the "M" stand? 1) prednisone (Meticorten) melphalan (Alkeran) mechlorethamine (Mustargen) procarbazine (Matulane)

mechlorethamine (Mustargen) Explanation: Mechlorethamine (Mustargen) is the "M" drug in the "MOPP" chemotherapeutic regimen for Hodgkin's disease. Prednisone (Meticorten) and procarbazine (Matulane) represent the "P"s in the "MOPP." Melphalan is part of another regimen.

A client presents with weeping lower extremity edema and skin that is thickened and brawny. This condition has been present for 4 weeks. The physician would likely order: 1) antibiotic treatment. symptomatic treatment. surgery. physical therapy.

symptomatic treatment. In lymphedema, treatment is usually symptomatic.

A client has a history of lymphedema. Impaired nutrition to the client's tissues could lead to: 1) tenting skin. cyanosis. evident scaring. ulcers and infection in the edematous area.

ulcers and infection in the edematous area. In a client with lymphedema, tissue nutrition is impaired from the stagnation of lymphatic fluid, leading to ulcers and infection in the edematous area.

A client with Hodgkin lymphoma is receiving information from the oncology nurse. The client asks the nurse why it is necessary to stop drinking and smoking and stay out of the sun. Which response by the nurse would be best? 1) "Engaging in these activities increases your risk of hemorrhage." 2) "These behaviors can reduce the effectiveness of your chemotherapy." 3) "It's important to reduce other factors that increase the risk of second cancers." 4) "Avoiding these factors can reduce the risk of Reed-Sternberg cells developing."

"It's important to reduce other factors that increase the risk of second cancers." The nurse should encourage clients to reduce other factors that increase the risk of developing second cancers, such as use of tobacco and alcohol and exposure to environmental carcinogens and excessive sunlight. The presence of Reed-Sternberg cells is the pathologic hallmark and essential diagnostic criterion for Hodgkin lymphoma, so avoiding these behaviors will not reduce the risk of Reed-Sternberg cells developing. There is no evidence that these behaviors will reduce the effectiveness of chemotherapy or increase the risk of hemorrhage, which is not a typical complication of Hodgkin lymphoma

Following an extensive diagnostic workup, a client has been diagnosed with myelodysplastic syndrome (MDS). Which assessment question most directly addresses the potential etiology of this client's health problem? 1) "Have you ever smoked cigarettes or used other tobacco products?" "Were you ever exposed to toxic chemicals in any of the jobs that you held?" "When you were younger, did you tend to have recurrent infections of any kind?" "Would you say that you've had a lot of sun exposure in your lifetime?"

"Were you ever exposed to toxic chemicals in any of the jobs that you held?" Explanation: MDS is idiopathic in nature due to HSC damage, although 10% to 15% of clients will develop MDS following exposure to alkylating agents, radiotherapy, or chemicals (e.g., benzene), and/or have an inherited genetic disorder, such as Fanconi anemia or trisomy 21. Genetic syndromes account for about 50% of cases (e.g., Down syndrome, trisomy 8 syndrome, neurofibromatosis type 1). MDS is not known to be caused by an infection, tobacco use, or sun exposure.

A client with leukemia has developed a cough and increased fatigue. What is the primary nursing intervention? 1) Place a cooling blanket on the client. 2) Administer an antitussive. Evaluate the client for potential infection. Medicate the client to relieve pain.

Evaluate the client for potential infection The client with leukemia has a lack of mature and normal granulocytes to fight infection. For this reason, the client is susceptible to infection. The primary nursing intervention is to evaluate for potential infection if the client has a cough and increased fatigue. Administering an antitussive would not be appropriate before determining the cause of the cough. A cooling blanket would not be needed if the client does not have a fever. Medicating the client to relieve pain would come after the assessment phase.

A client presents with painless enlargement of the cervical and axillary lymph nodes, has lost 20 pounds in the last 2 months, and reports an alarming lack of energy. The client's history is positive for infectious mononucleosis as a young teen. This client may be suffering from: 1) lymphangitis. Hodgkin's lymphoma. non-Hodgkin's lymphoma. lymphadenitis.

Hodgkin's lymphoma. Explanation: Early symptoms of Hodgkin's disease include painless enlargement of one or more lymph nodes. The cervical lymph nodes are the first to be affected. Marked weight loss, anorexia, fatigue, and weakness occur. Low-grade fever, pruritus, and night sweats are common. The Epstein-Barr virus is believed to trigger Hodgkin's lymphoma in approximately 40% of people with a history of infectious mononucleosis.

A nurse is caring for a client who is being treated for leukemia in the hospital. The client was able to maintain nutritional status for the first few weeks following the diagnosis but is now exhibiting early signs and symptoms of malnutrition. In collaboration with the dietitian, the nurse should implement what intervention? 1) Facilitate placement of a percutaneous endoscopic gastrostomy (PEG) tube. Assign responsibility for the client's nutrition to the client's friends and family. Provide the client with several small, soft-textured meals each day. Arrange for total parenteral nutrition (TPN).

Provide the client with several small, soft-textured meals each day. For clients experiencing difficulties with oral intake, the provision of small, easily chewed meals may be beneficial. This option would be trialed before resorting to tube feeding or TPN. The family should be encouraged to participate in care, but should not be assigned full responsibility.

A client is awaiting test results to diagnose Hodgkin lymphoma. The nurse knows that which result is the hallmark for the diagnosis of this condition? 1) Misshaped red blood cells Elevated platelet count Increased basophils Reed-Sternberg cells

Reed-Sternberg cells 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. These cells arise from the B lymphocyte. They may have more than one nucleus and often have an owl-like appearance. The presence of Reed-Sternberg cells is the pathologic hallmark and essential diagnostic criterion. Basophils, platelets, or red blood cells are not used to diagnose Hodgkin lymphoma

A nurse is caring for a client with acute myeloid leukemia who is preparing to undergo induction therapy. In preparing a plan of care for this client, the nurse should assign the highest priority to which nursing diagnosis? 1) Acute confusion Risk for spiritual distress Risk for infection Activity intolerance

Risk for infection Explanation: Induction therapy places the client at risk for infection, thus this is the priority nursing diagnosis. During the time of induction therapy, the client is very ill, with bacterial, fungal, and occasional viral infections; bleeding and severe mucositis, which causes diarrhea; and marked decline in the ability to maintain adequate nutrition. Supportive care consists of administering blood products and promptly treating infections. Immobility, confusion, and spiritual distress are possible, but infection is the client's most acute physiologic threat.

You are caring for a patient with Hodgkin's lymphoma at the oncology clinic. While doing patient teaching you know you need to stress what? 1) Risk of infection Need for nutritious diet Need for adequate sleep Risk of losing support network

Risk of infection Explanation: Patients need to be taught to minimize the risks of infection, to recognize signs of possible infection, and to contact their health care provider if such signs develop. A nutritious diet and adequate sleep may be included in the teaching but will not be stressed like the risk of infection. Option D is a distracter for this question.

Which statement best describes the function of stem cells in the bone marrow? 1) They produce antibodies against foreign antigens. They produce all blood cells. They are active against hypersensitivity reactions. They defend against bacterial infection.

They produce all blood cells. Explanation: All blood cells are produced from undifferentiated precursors called pluripotent stem cells in the bone marrow. Other cells produced from the pluripotent stem cells help defend against bacterial infection, produce antibodies against foreign antigens, and are active against hypersensitivity reactions.