A 14-year-old boy is diagnosed with Hodgkin disease. When palpating for enlarged lymph nodes, the nurse would expect to find which nodes as most commonly enlarged? Select all that apply

A) Cervical
B) Axillary
C) Supraclavicular
D) Occipital
E) Inguinal


Ans: A, C
Enlarged lymph nodes may feel rubbery and tend to occur in clusters. Although any lymph nodes may be involved, the lymph nodes most commonly affected are in the cervical and supraclavicular areas.

Nursing

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A child, aged 11 years, stays home from school to care for his siblings while his mother works, because the family cannot afford a babysitter

The home is cluttered and dirty when the community mental health nurse visits to investigate the child's school absences. When the parents arrive home from work, the child's father behaves angrily. He orders his wife and son about. He finds fault with the son, asking him twice, "Why are you such a stupid kid?" The wife tells the nurse she has difficulty disciplining the children and gets frustrated easily. The nurse desires to build some trust and continue to gather assessment data. The remark or question that would interfere with the nurse's goals is: a. "Tell me what happens when the children misbehave.". b. "When your baby cries, how do you get him to stop?" c. "Caring for three young children must be difficult.". d. "Do you or your husband ever beat the children?"

Nursing

A 57-year-old woman has been diagnosed with atrophic vaginitis and has expressed surprise to her care provider, citing a lifetime largely free of gynecological health problems

She has asked what may have contributed to her problem. How can the care provider best respond? A) "The lower levels of estrogen since you've begun menopause make your vagina prone to infection." B) "Vaginitis is not usually the direct result of any single problem, but rather an inevitability of the vaginal dryness that accompanies menopause." C) "This type of vaginitis is most commonly a symptom of a latent sexually transmitted infection that you may have contracted in the distant past." D) "The exact cause of this problem isn't known, but it can usually be resolved with a diet high in probiotic bacteria."

Nursing

Leda is a 38-year-old woman who began to experience weight gain, mood swings, and weakness. When her periods became irregular, she went to her physician

Leda's physician heard the symptoms Leda was concerned about and then ordered a 24-hour free cortisol urine test and an overnight dexamethasone suppression test and measured her serum ACTH levels. The results indicated that Leda had Cushing disease, a condition caused by the hypersecretion of ACTH by the anterior pituitary and resulting in elevated cortisol levels. To confirm the diagnosis, Leda's physician ordered a cranial MRI to identify the presence of a pituitary tumor. The dexamethasone test involves the administration of a synthetic glucocorticoid (i.e., cortisol). Knowing what you do about negative feedback mechanisms, how might this test be used to assess pituitary function? Describe how the steroid hormones, like cortisol, are metabolized in the body. What are the advantages of using a 24-hour urine test to measure this hormone? Protein-based and steroid-based hormones trigger cellular responses in different ways. What are the differences between the mechanism of action of ACTH and cortisol on target cells?

Nursing

Sarah is a nursing graduate of 5 years who is very confident in her clinical skills. She has taken some certificate courses in leadership and management and has considered beginning a graduate degree with this focus

She is excited about being able to use her knowledge and interest by be-ing hired as a nurse manager. Before beginning her new position, Sarah spends time with her nurse executive to clarify the executive's expectations of her and of the unit that she has been hired to manage. Sarah finds that she is comfortable with the expectations of staff and her super-visor regarding her management role and responsibilities and has been able to effect a strong commitment to quality clinical care on the unit. At this point, Sarah has likely attained this role: a. Development. b. Acceptance. c. Symmetry. d. Internalization.

Nursing