A 24-year-old pregnant woman asks the nurse if it is safe to drink alcohol during pregnancy. Which of the following is the most appropriate response?

A. Promote bed rest without additional pain interventions to allow natural resolution of the crisis is incorrect. While rest can help conserve energy, pain management is a priority in vaso-occlusive crises. Unmanaged pain can lead to stress-induced complications, prolonged hospital stays, and decreased oxygenation, which may worsen sickling.

B. Limit fluid intake to prevent fluid overload and minimize risk of pulmonary edema during the crisis is incorrect. Hydration is critical during a vaso-occlusive crisis because dehydration increases blood viscosity and promotes further sickling. Limiting fluids can exacerbate the crisis rather than help it.

C. Administer prescribed opioids promptly and encourage oral hydration as tolerated to manage pain and reduce sickling episodes is correct. Prompt administration of opioids (e.g., morphine or hydromorphone) addresses the severe pain associated with vaso-occlusive crises, while hydration helps maintain blood volume and decreases the likelihood of additional sickling. These interventions are central to reducing morbidity and preventing complications such as organ damage or prolonged hypoxia.

D. Delay opioid administration to assess the child's pain threshold and avoid potential opioid dependence is incorrect. Pain should be treated promptly in vaso-occlusive crises. Delaying analgesia increases suffering, can worsen hypoxia, and may lead to more severe complications. Concerns about long-term opioid dependence are secondary to immediate pain control and patient safety.

A. Non-Hodgkin's lymphoma is more commonly associated with painless, enlarged lymph nodes than Hodgkin's lymphoma is incorrect because both HL and NHL can present with painless lymphadenopathy, so this is not a distinguishing feature.

B. Hodgkin's lymphoma presents with a more aggressive course than Non-Hodgkin's lymphoma is incorrect because, in children, Non-Hodgkin’s lymphoma generally has a more aggressive and rapid course compared with Hodgkin’s lymphoma, which usually progresses more slowly.

C. Non-Hodgkin's lymphoma typically involves the Reed-Sternberg cells is incorrect because Reed-Sternberg cells are characteristic of Hodgkin’s lymphoma, not Non-Hodgkin’s lymphoma. Their presence is a key diagnostic feature of HL.

D. Hodgkin's lymphoma usually has a more predictable and localized spread than Non-Hodgkin's lymphoma is correct. Hodgkin’s lymphoma tends to spread in a contiguous, orderly fashion from one lymph node group to another, often starting in cervical or supraclavicular nodes. Non-Hodgkin’s lymphoma, in contrast, tends to spread more diffusely and rapidly, involving extranodal sites such as the gastrointestinal tract, mediastinum, and bone marrow.