Oncology Certified Nurse (OCN) Nursing Practice Test

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What laboratory finding indicates an unfavorable prognosis for a patient diagnosed with Hodgkin lymphoma?

Hemoglobin 11 g/dL
Involvement of two lymph nodes
Absolute lymphocyte count 400/mm3
Presence of A symptoms

The correct answer is: Absolute lymphocyte count 400/mm3

An absolute lymphocyte count of 400/mm3 is recognized as an unfavorable prognostic indicator in patients diagnosed with Hodgkin lymphoma. A low absolute lymphocyte count at diagnosis has been associated with a poorer overall survival rate and less favorable response to treatment. Lymphocytes play a crucial role in the immune response, and a low count may suggest a compromised immune system or higher tumor burden, both of which can negatively impact patient outcomes. In contrast, hemoglobin levels, while important, do not universally correlate with prognosis in Hodgkin lymphoma. Although anemia can suggest a more advanced disease state, it is not as definitive a factor as lymphocyte count when evaluating prognosis. The involvement of two lymph nodes represents early stage involvement and is less significant in terms of prognostic value compared to the lymphocyte count. Lastly, the presence of "A symptoms" (such as fever, night sweats, and weight loss) are related to a patient's symptomatology and can be present in various stages of the disease, but they do not directly indicate a poor prognosis as the absolute lymphocyte count does.