Anatomy of Hematologic System

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Artemisinin and its derivatives are used in the treatment of severe forms of chloroquine-resistant falciparum because they have:

  • A. Rapid gametocidal activity
  • B. The ability to prevent further development of hypnozoites
  • C. Rapid sporontocidal activity
  • D. Rapid schizonticidal activity
Correct Answer: D

Rationale: The correct answer is D: Rapid schizonticidal activity. Artemisinin and its derivatives target the malaria parasite at the schizont stage, which is crucial for the parasite's replication and survival. By rapidly killing schizonts, these drugs help in controlling the infection and preventing severe complications.

Choice A (Rapid gametocidal activity) is incorrect because artemisinin and its derivatives primarily target asexual stages of the parasite, not gametocytes. Choice B (The ability to prevent further development of hypnozoites) is incorrect as these drugs do not target the liver stages where hypnozoites develop. Choice C (Rapid sporontocidal activity) is incorrect as artemisinin derivatives do not primarily target the sexual stages of the parasite.

In summary, the correct answer is D because of the drugs' effectiveness against the schizont stage, while the other choices are incorrect as they do not align with the mechanism of action of artemisinin

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The nurse is assessing a client experiencing anemia. Which laboratory findings will the nurse expect for this client? (Select all that apply.)

  • A. Increased hematocrit
  • B. Decreased red blood cell count
  • C. Decreased serum iron
  • D. Decreased hemoglobin
Correct Answer: b

Rationale: Correct Answer: B - Decreased red blood cell count

Rationale:
1. Anemia is defined by a decrease in red blood cells, causing decreased oxygen-carrying capacity.
2. A decreased red blood cell count is a key indicator of anemia.
3. Other choices are incorrect:
A. Increased hematocrit is not expected in anemia, as it indicates a higher concentration of red blood cells.
C. Decreased serum iron may be seen in iron-deficiency anemia but is not a universal finding in all types of anemia.
D. Decreased hemoglobin is a common finding in anemia but is not as specific as a decreased red blood cell count.

What is the nurse's priority when caring for a client who just completed a bone marrow aspiration and biopsy?

  • A. Teach the client to avoid activity for 24 to 48 hours to prevent infection.
  • B. Administer a nonsteroidal anti-inflammatory drug (NSAID) to promote comfort.
  • C. Check the pressure dressing frequently for signs of excessive or active bleeding.
  • D. Report the laboratory results to the primary health care provider.
Correct Answer: C

Rationale: The correct answer is C: Check the pressure dressing frequently for signs of excessive or active bleeding. This is the priority because post bone marrow aspiration and biopsy, there is a risk of bleeding due to the procedure. By checking the dressing, the nurse can assess for any signs of excessive bleeding or hematoma formation, which are crucial to prevent complications.

A: Teaching the client to avoid activity is important but not the priority immediately post-procedure.
B: Administering NSAIDs may not be appropriate as they can increase the risk of bleeding.
D: Reporting the lab results is important but not the priority over ensuring immediate post-procedure safety.

A 35-year-old male is admitted to the hospital complaining of severe headaches, vomiting, and testicular pain. His blood work shows reduced numbers of platelets, leukocytes, and erythrocytes, with a high proportion of immature cells. The nurse caring for this patient suspects a diagnosis of what?

  • A. AML
  • B. CML
  • C. MDS
  • D. ALL
Correct Answer: D

Rationale: The correct answer is D: ALL (Acute Lymphoblastic Leukemia). In this case, the patient's symptoms of severe headaches, vomiting, testicular pain, reduced blood cell counts, and high proportion of immature cells indicate a rapidly progressing hematologic malignancy affecting lymphoid cells. AML (Choice A) primarily affects myeloid cells, not lymphoid cells. CML (Choice B) is a chronic myeloid disorder and presents differently with elevated leukocyte count and mature cells. MDS (Choice C) is a group of disorders characterized by abnormal blood cell production, but the presentation in this patient is more indicative of an acute leukemia.

A peripheral blood smear showing increase in numbers of neutrophils, band cells, basophils, eosinophils, and platelets is most suggestive

  • A. Acute myeloid leukemia
  • B. Acute lymphoid leukemia
  • C. Chronic myelocytic leukemia
  • D. Chronic lymphocytic leukemia
Correct Answer: C

Rationale: Step-by-step rationale:
1. Increased neutrophils, band cells, basophils, and platelets suggest myeloproliferative disorder.
2. Presence of eosinophils indicates a chronic phase as seen in chronic myelocytic leukemia.
3. Chronic myelocytic leukemia commonly presents with increased granulocytes and platelets.

Summary:
- A: Acute myeloid leukemia is characterized by blast cells, not mature granulocytes.
- B: Acute lymphoid leukemia primarily affects lymphocytes, not myeloid cells.
- D: Chronic lymphocytic leukemia involves lymphocytes, not myeloid cells like in the given case.

The mean cell volume of the patient is 90 fl and the reticulocyte production index is low. Which of the following is the most possible cause of anemia in this patient?

  • A. Thalassemia
  • B. Vitamin B12 deficiency
  • C. Aplastic anemia
  • D. Sideroblastic anemia
Correct Answer: C

Rationale: Rationale: A low reticulocyte production index indicates decreased bone marrow response to anemia. Aplastic anemia is characterized by bone marrow failure leading to pancytopenia, causing anemia. Thalassemia results in microcytic anemia, not macrocytic. Vitamin B12 deficiency causes macrocytic anemia due to impaired DNA synthesis. Sideroblastic anemia leads to microcytic anemia due to defective heme synthesis. Therefore, the most likely cause of anemia in this patient with a low reticulocyte production index and normal mean cell volume is aplastic anemia.

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