Nokea
A 60-year-old patient with chronic myeloid leukemia will be treated in the home setting and the nurse is preparing appropriate health education. What topic should the nurse emphasize?
- A. The importance of adhering to the prescribed drug regimen
- B. The need to ensure that vaccinations are up to date
- C. The importance of daily physical activity
- D. The need to avoid shellfish and raw foods
Correct Answer: A
Rationale: The correct answer is A: The importance of adhering to the prescribed drug regimen. This is crucial in managing chronic myeloid leukemia effectively. Medication adherence is essential to control the disease and prevent complications. Skipping doses can lead to treatment failure or drug resistance.
B: While vaccinations are important, they are not the top priority in managing chronic myeloid leukemia.
C: Daily physical activity is beneficial for overall health but is not the primary concern in this case.
D: Avoiding shellfish and raw foods is not a key aspect of managing chronic myeloid leukemia.
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Plummer Vinson syndrome is not associated with:
- A. angular stomatitis
- B. splenomegaly
- C. clubbing
- D. post cricoid web
Correct Answer: C
Rationale: The correct answer is C: clubbing. Plummer Vinson syndrome is characterized by the triad of iron deficiency anemia, dysphagia, and esophageal webs. Clubbing is not a typical feature of Plummer Vinson syndrome. Angular stomatitis (A), splenomegaly (B), and post cricoid web (D) are commonly associated with Plummer Vinson syndrome due to chronic iron deficiency anemia. Clubbing is more commonly seen in conditions such as chronic respiratory or cardiac diseases, not in Plummer Vinson syndrome.
A 10-year-old girl is a long-term survivor of type II pleuropulmonary blastoma (PPB). You suspect she has a cancer predisposition syndrome and perform genetic testing, which confirms she has DICER1 syndrome. Which other cancer is she predisposed to?
- A. Papillary thyroid cancer
- B. Medullary thyroid cancer
- C. Pheochromocytoma
- D. Renal cell carcinoma
Correct Answer: A
Rationale: The correct answer is A: Papillary thyroid cancer. Individuals with DICER1 syndrome are at increased risk for developing various tumors, including papillary thyroid cancer. This is due to the role of DICER1 gene in regulating cell growth and division. The other choices, B (medullary thyroid cancer), C (pheochromocytoma), and D (renal cell carcinoma), are not typically associated with DICER1 syndrome. Medullary thyroid cancer is commonly linked to RET gene mutations, pheochromocytoma to genes such as SDHB, SDHD, and VHL, and renal cell carcinoma to mutations in genes like VHL and MET.
Which of the following is false regarding Burkitt's lymphoma?
- A. Associated with translocation of c-myc gene on chromosome 18
- B. Usually presents with abdominal involvement in HIV patients
- C. Common in Africa children due to Epstein Barr infection after malaria exposure.
- D. Histologically characterized by a 'starry sky' appearance
Correct Answer: A
Rationale: The correct answer is A because Burkitt's lymphoma is associated with the translocation of the c-myc gene on chromosome 8, not chromosome 18. This translocation results in the overexpression of c-myc, leading to uncontrolled cell proliferation. Choice B is incorrect as Burkitt's lymphoma commonly presents with jaw or facial bone involvement in HIV patients. Choice C is incorrect as Burkitt's lymphoma is commonly seen in African children due to Epstein-Barr virus infection, not necessarily after malaria exposure. Choice D is incorrect as Burkitt's lymphoma is histologically characterized by a "starry sky" appearance due to the presence of numerous macrophages engulfing debris from apoptotic cells.
The nurse is monitoring a patient receiving a blood product and is concerned that the blood is going to deteriorate before it is complete infused. What is the maximum time that blood can hang during infusion before it begins to deteriorate?
- A. 1 hour
- B. 2 hours
- C. 3 hours
- D. 4 hours
Correct Answer: D
Rationale: The correct answer is D: 4 hours. Blood products typically have a maximum hang time of 4 hours to reduce the risk of bacterial contamination and ensure the integrity of the product. Beyond this time, there is an increased risk of bacterial growth, which can lead to serious infections in the patient. It is crucial to adhere to the recommended hang time to maintain the safety and efficacy of the blood product.
Summary of other choices:
A: 1 hour - Too short of a time frame for a blood product to be infused, as it would not allow for the complete administration.
B: 2 hours - While closer to the correct answer, it still falls short of the recommended 4-hour maximum hang time for blood products.
C: 3 hours - Again, this is not the optimal choice as it exceeds the safe hang time for blood products, increasing the risk of contamination and deterioration.
The nurse examines the lymph nodes of a patient during a physical assessment. Which assessment finding would be of most concern to the nurse?
- A. A 2-cm nontender supraclavicular node
- B. A 1-cm mobile and nontender axillary node
- C. An inability to palpate any superficial lymph nodes
- D. Firm inguinal nodes in a patient with an infected foot
Correct Answer: A
Rationale: The correct answer is A: A 2-cm nontender supraclavicular node. This finding is concerning because supraclavicular nodes are not normally palpable. Enlarged supraclavicular nodes can indicate metastatic cancer. B is incorrect because mobile and nontender axillary nodes are usually benign. C is incorrect as the inability to palpate superficial nodes may be normal. D is incorrect as firm inguinal nodes could indicate a localized infection or inflammation.