A female client with lymphedema expresses her anxiety about the abnormal enlargement of an arm. Which of the following suggestions should a nurse give to support the client's self-image?

Correct Answer: B

Rationale: The correct answer is B) Introduce variations in styles of clothing. This option supports the client's self-image by offering a practical and empowering solution to address the abnormal enlargement of the arm due to lymphedema. By suggesting different clothing styles, the nurse helps the client feel more comfortable and confident in their appearance, despite the physical changes caused by the condition. Option A) Place the arm in a sling is incorrect because it does not address the client's concerns about self-image but rather focuses on immobilizing the arm, which may not be necessary for lymphedema. Option C) Apply cold soaks to the affected arm is incorrect as it is a treatment for acute inflammation or injury, not for managing lymphedema-related arm enlargement. Option D) Tie a tight bandage to the arm is also incorrect as tight bandages can exacerbate lymphedema by restricting lymph flow and causing discomfort. In an educational context, it is essential for nurses to understand the psychosocial aspects of caring for clients with chronic conditions like lymphedema. By providing supportive and practical advice, nurses can help clients maintain their self-esteem and quality of life while managing their health challenges. Empowering clients to make choices that enhance their self-image is a crucial aspect of holistic nursing care.

Correct Answer: A

Rationale: In the context of a client with non-Hodgkin's lymphoma undergoing radiation and chemotherapy, the correct instruction for a nurse to give is to increase fluid intake (Option A). The rationale behind this is that radiation and chemotherapy can lead to various side effects such as nausea, vomiting, and diarrhea. Increasing fluid intake helps in preventing dehydration, flushing out toxins from the body, and maintaining hydration levels during treatment. It also supports kidney function and overall well-being. Regarding why the other options are incorrect: - Intake soft, bland foods (Option B) may be beneficial for some gastrointestinal side effects, but it is not as essential as maintaining proper hydration. - Intake low-fat meals (Option C) does not address the specific needs of a client undergoing cancer treatment. - Intake food rich in folic acid (Option D) is not the priority in this scenario; while folic acid is important for cell growth, increasing fluid intake takes precedence due to the potential side effects of treatment. From an educational standpoint, understanding the rationale behind the need to increase fluid intake for clients undergoing cancer treatments like radiation and chemotherapy is crucial for nurses. It helps them provide holistic care, manage side effects effectively, and support the overall well-being and treatment outcomes of their patients. By prioritizing hydration, nurses can contribute to better symptom management and improved quality of life for individuals battling cancer.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Infectious Mononucleosis. The nurse suspects this diagnosis because the client presents with classic symptoms of sore throat, fatigue, headache, and enlarged cervical lymph nodes, which are indicative of infectious mononucleosis, commonly caused by the Epstein-Barr virus. Option A) Lymphomas are a group of blood cancers that can also present with enlarged lymph nodes, but typically do not manifest with the acute symptoms described in the client's presentation. Option B) Lymphedema is swelling due to a blockage in the lymphatic system and is not associated with the acute symptoms mentioned. Option C) Lymphangitis is an infection of the lymphatic channels, which would present with red streaks on the skin and fever, rather than the sore throat and fatigue described in the client. This question is crucial in a Hematology Oncology exam as it tests the student's ability to differentiate between various conditions presenting with similar symptoms, enhancing their clinical reasoning skills in diagnosing hematologic and oncologic disorders based on patient presentations. Understanding the distinguishing features of each condition is vital for accurate diagnosis and appropriate patient management.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Graft versus host disease. Graft versus host disease (GVHD) occurs when the transplanted donor cells recognize the recipient's body as foreign and attack it. This immune response can manifest as various symptoms, including skin rash, gastrointestinal issues, and liver problems. Option A) Lymphoma relapse is incorrect because it refers to the return of cancer cells after a period of remission, not rejection of the transplant. Option B) Short remission is incorrect as it does not relate to the immune response following a bone marrow transplant. Option C) Bone marrow transplant rejection is also incorrect because rejection typically involves the recipient's immune system attacking the donor cells, not vice versa. Educationally, understanding GVHD is crucial for healthcare providers managing patients post-bone marrow transplant. Recognizing the signs and symptoms early can lead to prompt intervention and better outcomes for the patient. It highlights the complex interplay between the donor and recipient immune systems in transplantation, emphasizing the importance of monitoring and managing immune responses in these patients.

Correct Answer: C

Rationale: In this scenario, the most important action before defibrillation in a patient with a temporary pacemaker is to turn the pacemaker off and disconnect both wires. This is crucial to avoid interference between the pacemaker and the defibrillator, which could potentially lead to ineffective defibrillation or harm to the patient. Option A, giving pain medication before defibrillation, is not the priority in this case as the immediate concern is ensuring the safety and effectiveness of the defibrillation process. Option B, defibrillating the patient immediately while the pacemaker is still on, can lead to interference with the pacemaker's function and may not deliver the necessary shock to restore the heart's normal rhythm. Option D, calling the physician before defibrillation, may cause a delay in the life-saving intervention needed in an emergency situation like ventricular fibrillation. Immediate action to turn off the pacemaker and disconnect its wires is crucial to ensure successful defibrillation. Educationally, this question highlights the importance of understanding the potential interactions between medical devices in emergency situations. It emphasizes the need for healthcare providers to have the knowledge and skills to prioritize actions to maximize patient safety and outcomes during critical events.