The nurse is caring for a client with Mediastinal Lymphadenopathy who has developed a sudden onset of shortness of breath, head swelling, swelling of the eyes, neck and arms, and a severe headache.
The nurse should recognize that which is the presenting emergent condition?

Pulmonary hypertension.

Tumor lysis syndrome.

Pulmonary edema.

Superior vena cava syndrome.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Pulmonary hypertension is characterized by elevated pressures in the pulmonary arteries, leading to symptoms like dyspnea and fatigue, but typically not sudden onset of head, eye, neck, and arm swelling. The described symptoms are more indicative of venous obstruction rather than elevated arterial pressure.

Choice B rationale

Tumor lysis syndrome is a metabolic emergency resulting from rapid breakdown of malignant cells, releasing intracellular contents. It causes hyperkalemia, hyperphosphatemia, and hyperuricemia, leading to renal failure and cardiac arrhythmias, but not typically the localized swelling described.

Choice C rationale

Pulmonary edema involves fluid accumulation in the lung parenchyma, primarily causing severe dyspnea, orthopnea, and crackles. While it can lead to respiratory distress, it does not explain the specific constellation of head, eye, neck, and arm swelling, which points to a different obstructive process.

Choice D rationale

Superior vena cava syndrome (SVCS) is an emergent condition caused by obstruction of the superior vena cava, often by mediastinal tumors. The described symptoms—sudden shortness of breath, head swelling, swelling of the eyes, neck, and arms, and severe headache—are classic manifestations due to impaired venous return from the head, neck, and upper extremities.

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Correct Answer is B

Explanation

Choice A rationale

Nitroglycerin sublingual tablets are sensitive to light, moisture, and heat, which can degrade the active pharmaceutical ingredient, reducing its potency and effectiveness. Storing them in a bathroom medicine cabinet exposes them to significant fluctuations in humidity and temperature, compromising their stability and potentially rendering them ineffective when needed. They should be stored in a cool, dry, dark place in their original container.

Choice B rationale

Nitroglycerin is a potent vasodilator that acts primarily on the venous system, causing venodilation and reducing venous return to the heart (preload). This decreases myocardial workload and oxygen demand. Additionally, at higher doses, it can dilate coronary arteries, improving blood flow and oxygen supply to the ischemic myocardium, thereby alleviating angina.

Choice C rationale

The recommended dosing for nitroglycerin sublingual tablets to relieve acute angina is to take one tablet, and if pain is not relieved after 5 minutes, the client should call emergency services immediately while taking a second tablet. A third tablet can be taken after another 5 minutes if pain persists, but the critical action is seeking emergency medical attention if the first dose is ineffective after 5 minutes.

Choice D rationale

Nitroglycerin primarily works by vasodilation, reducing myocardial workload and increasing oxygen supply. It does not directly dissolve blood clots. Blood clots occluding coronary arteries are addressed by antiplatelet medications, anticoagulants, or thrombolytic agents, or through percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) procedures.

A. Pulmonary hypertension. B. Tumor lysis syndrome. C. Pulmonary edema. D. Superior vena cava syndrome.

Correct Answer is D

Explanation

Choice A rationale

Pulmonary hypertension involves elevated pressure in the pulmonary arteries. While it can cause shortness of breath, it typically develops more gradually and does not acutely present with head and upper extremity swelling, which is characteristic of venous obstruction.

Choice B rationale

Tumor lysis syndrome is a metabolic emergency caused by the rapid breakdown of tumor cells, releasing intracellular contents into the bloodstream, leading to hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia, with symptoms like nausea, vomiting, and cardiac arrhythmias, not acute swelling.

Choice C rationale

Pulmonary edema is characterized by fluid accumulation in the lung parenchyma, leading to severe dyspnea, orthopnea, and crackles on auscultation. While it causes shortness of breath, the constellation of head and upper extremity swelling is not its primary or characteristic presentation.

Choice D rationale

Superior vena cava syndrome (SVCS) is an emergent condition resulting from obstruction of blood flow through the superior vena cava, often by a mediastinal tumor. The classic symptoms include swelling of the face, neck, and upper extremities, dyspnea, and headache due to venous congestion.

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The nurse is caring for a client with Mediastinal Lymphadenopathy who has developed a sudden onset of shortness of breath, head swelling, swelling of the eyes, neck and arms, and a severe headache. The nurse should recognize that which is the presenting emergent condition?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has angina about nitroglycerin sublingual tablets. Which of the following statements should the nurse include in the teaching?

Correct Answer is B

Explanation

The nurse is caring for a client with Mediastinal Lymphadenopathy who has developed a sudden onset of shortness of breath, head swelling, headache, swelling of the eyes, neck and arms, and a severe sore neck. The nurse should recognize that which is the presenting emergent condition?

Correct Answer is D

Explanation

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The nurse is caring for a client with Mediastinal Lymphadenopathy who has developed a sudden onset of shortness of breath, head swelling, swelling of the eyes, neck and arms, and a severe headache.
The nurse should recognize that which is the presenting emergent condition?