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
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 B
Explanation
A. WBCs: White blood cell counts may vary in multiple myeloma, but they are not typically increased; in fact, WBC counts can be low due to bone marrow crowding.
B. Calcium: Multiple myeloma often causes hypercalcemia because of increased bone breakdown, leading to the release of calcium into the bloodstream.
C. Absolute neutrophil count: The absolute neutrophil count may actually decrease as a result of bone marrow dysfunction, not increase.
D. Platelets: Platelet counts are often decreased in multiple myeloma due to bone marrow involvement, not increased.
Correct Answer is A
Explanation
A. The spleen is the primary site for platelet destruction. In ITP, the spleen often sequesters and destroys platelets, leading to low platelet levels. Removing the spleen reduces platelet destruction and can help increase platelet counts in affected patients.
B. The spleen is at risk for infection due to the critical loss of WBCs. While infection risk increases after splenectomy, this is not the rationale for the procedure. The spleen does play a role in immune function, but splenectomy is indicated for reducing platelet destruction, not infection prevention.
C. Your spleen is making too many platelets. The spleen does not produce platelets; rather, it filters and sometimes destroys them, particularly in ITP. This choice does not accurately reflect the pathophysiology of ITP.
D. The spleen causes an overabundance of immature platelets. The spleen does not cause an increase in immature platelets. In ITP, platelets are destroyed, not overproduced.