NR667 FNP Capstone Practicum & Intensive Exit Practice Exam

Weight loss and night sweats are B symptoms that, when combined with markedly enlarged hilar lymph nodes on chest imaging, point most strongly to lymphoma, particularly Hodgkin lymphoma. Hodgkin often involves the mediastinal and hilar lymph nodes and presents with systemic symptoms, especially in adults around this age. The presence of prominent hilar adenopathy fits the typical radiographic pattern seen with nodal lymphoma.

TB can also cause constitutional symptoms and lymphadenopathy, but it more commonly shows upper-lobar or apical lung involvement rather than such profound hilar enlargement alone. Sarcoidosis causes bilateral hilar lymphadenopathy as well, but it usually presents with respiratory symptoms like cough and dyspnea and fewer B symptoms. Metastatic cancer is possible, but the combination of B symptoms with mediastinal/hilar lymphadenopathy makes lymphoma the most fitting diagnosis to consider first. Confirmation would come from tissue biopsy, with staging guided by imaging and labs.