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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Waldeyer's ring does not include:
- A. faucal tonsils
- B. submandibular glands
- C. adenoids
- D. lingual tonsils
Correct Answer: B
Rationale: The correct answer is B: submandibular glands. Waldeyer's ring consists of the pharyngeal tonsil (adenoids), tubal tonsils, palatine tonsils (faucal tonsils), and lingual tonsils. The submandibular glands are salivary glands located outside of Waldeyer's ring. The other choices are incorrect because they are all part of Waldeyer's ring, which is a ring of lymphoid tissue located in the pharynx.
A nurse is caring for a client who is experiencing an acute ischemic cerebrovascular event due to a thrombus in a cerebral vessel. Which of the following drugs should the nurse expect to administer?
- A. Alteplase
- B. Aspirin
- C. Clopidogrel
- D. Heparin
Correct Answer: A
Rationale: The correct answer is A: Alteplase. Alteplase is a thrombolytic agent used to dissolve blood clots and restore blood flow in acute ischemic stroke. It is crucial to administer within a specific time frame for the best outcome. Aspirin (B) and Clopidogrel (C) are antiplatelet agents that prevent further clot formation but are not used for immediate clot dissolution in acute ischemic stroke. Heparin (D) is an anticoagulant that prevents clot formation and is not typically used as the initial treatment for acute ischemic stroke.
A 13-year-old boy presents to the emergency department with complaints of headache and visual changes. History reveals progressive dyspnea on exertion, generalized fatigue, and increased bruising. His labs are significant for a WBC of 350,000/mcL, of which 80% are reported to be blasts and appear to be myeloblasts without the presence of Auer rods. His hemoglobin is 7.2 g/dL, and his platelets are 18,000/mcL. A CT scan of the head shows a small intracerebral hemorrhage. His coags are normal. Which of the following is the most appropriate therapy?
- A. Start induction chemotherapy.
- B. Perform emergent leukapheresis followed the next day by induction chemotherapy.
- C. Perform emergent leukapheresis plus hydroxyurea.
- D. Provide emergent cranial radiation plus hydroxyurea followed the next day by induction chemotherapy.
Correct Answer: C
Rationale: The most appropriate therapy in this scenario is emergent leukapheresis plus hydroxyurea (Choice C). Leukapheresis is needed to rapidly reduce the high white blood cell count, preventing further complications such as leukostasis and hyperviscosity syndrome. Hydroxyurea can help further control the rapid proliferation of blasts. Induction chemotherapy (Choice A) may lead to tumor lysis syndrome due to the high tumor burden. Performing leukapheresis alone without a subsequent therapy (Choice B) may not adequately address the underlying disease. Providing cranial radiation (Choice D) is not the initial management for acute myeloid leukemia.
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.
Koilonychias is a specific feature of
- A. Hemolytic anemia
- B. Sickle cell disease
- C. Thalassemia major
- D. Iron deficiency anemia
Correct Answer: D
Rationale: Step-by-step rationale for why D is correct:
1. Koilonychias is characterized by spoon-shaped nails, a common symptom of iron deficiency anemia due to decreased hemoglobin levels.
2. Iron is essential for normal nail growth, and its deficiency can lead to changes in nail shape.
3. Hemolytic anemia (A) is characterized by the premature destruction of red blood cells, not typically associated with koilonychias.
4. Sickle cell disease (B) causes abnormal hemoglobin, leading to sickle-shaped red blood cells, not related to koilonychias.
5. Thalassemia major (C) is a genetic disorder affecting hemoglobin production, but it does not directly cause koilonychias.