The patient presents with fever for the last few days, sore throat and enlarged lymph nodes under the jaw. What is the appropriate response of the nurse when the patient asks about the cause of the enlarged lymph nodes?
Enlarged lymph nodes are associated with hypertensive heart disease."
"They are most likely enlarged as a result of the throat infection.
"You should probably see an oncologist to rule out lymphedema.
You probably have a blockage in the thoracic lymph duct"
The Correct Answer is B
A. Enlarged lymph nodes are associated with hypertensive heart disease is not a correct association. Hypertension does not directly cause lymph node enlargement.
B. They are most likely enlarged as a result of the throat infection is the correct answer. Enlarged lymph nodes, especially under the jaw, are commonly seen in response to infections, particularly in the throat (such as a viral or bacterial infection like pharyngitis).
C. You should probably see an oncologist to rule out lymphedema is an unnecessary response at this time. Lymphedema usually presents with other symptoms, and the patient's symptoms (fever, sore throat, and localized lymph node enlargement) suggest an infection rather than cancer.
D. You probably have a blockage in the thoracic lymph duct is not a common cause of localized lymph node enlargement. Blockages in the thoracic duct would affect lymphatic flow more generally and would present with more systemic symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Providing presence by sitting down, making eye contact, and offering a comforting presence is a key aspect of caring practice. It helps Mrs. Miller feel heard and supported, showing empathy.
B. Avoiding touch may not be necessary unless the patient expresses discomfort with physical contact. Offering a caring presence, including appropriate touch, can help build rapport and show compassion.
C. Telling Mrs. Miller that everything is alright may dismiss her feelings, even if the nurse means well. Acknowledge the patient's emotions and offer emotional support instead of minimizing her experience.
D. Telling Mrs. Miller that the nurse is busy and will return later may seem dismissive of her current emotional state, rather than offering immediate emotional support.
Correct Answer is A
Explanation
A. The cognitive domain involves the acquisition of knowledge and understanding, such as learning facts or concepts. The patient has learned the normal adult heartbeat range, which falls under cognitive learning.
B. The kinesthetic domain involves physical movement or hands-on skills, such as learning a physical technique, which is not applicable here.
C. The psychomotor domain focuses on physical skills and coordination, not the understanding of facts.
D. The affective domain involves emotions, attitudes, or values, which does not apply to learning a fact about heart rate
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