Medical-Surgical Nursing: Med Surg Test 1 H &N-H Lymphomas Flashcards

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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
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
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
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
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
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
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
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
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
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?


Breast and colorectal


Skin and lymphoma


Liver and stomach


Uterine and ovarian


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?


Lung and prostate


Bone and leukemia


Skin and lymphoma


Stomach and esophageal


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

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


“Radiation does not cause the problems with sexual functioning that occur with chemotherapy or surgical procedures used to treat cancer.”


“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.”


“The radiation will make you sterile, but your ability to have sexual intercourse will not be changed by the treatment.”


“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

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
DIF: Cognitive Level: Apply (application) REF: 272-273
OBJ: Special Questions: Prioritization TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity