Nokea
A child is diagnosed with sickle cell disease. The parents are unsure of how their child contracted the disease. What is the most appropriate explanation by the nurse?
- A. The mother has the trait, but the father does not.
- B. The father has the trait, but the mother does not.
- C. The mother has the disease, but the father has neither the trait nor the disease.
- D. The mother and father have the trait; therefore the child has a 25% chance for having the disease.
Correct Answer: D
Rationale: Rationale:
1. Sickle cell disease is an autosomal recessive genetic disorder.
2. Both parents must be carriers (have the trait) to pass on the disease.
3. If both parents have the trait, each child has a 25% chance of inheriting the disease.
4. Therefore, choice D is correct as it explains the genetic basis of sickle cell disease transmission.
Summary of Incorrect Choices:
A. Incorrect - Both parents need to be carriers for the child to inherit the disease.
B. Incorrect - Both parents need to be carriers for the child to inherit the disease.
C. Incorrect - If the mother has the disease, the child would have a 50% chance of inheriting it, not 25%.
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A 66-year-old woman with 3-cm breast cancer, 4/13 nodes positive, ER/PR+. Next treatment?
- A. No further treatment
- B. Radiation to mammary nodes
- C. Platinum chemotherapy
- D. Adjuvant hormonal therapy
Correct Answer: D
Rationale: The correct answer is D: Adjuvant hormonal therapy. For ER/PR+ breast cancer, hormonal therapy is the standard treatment to reduce the risk of recurrence. This patient has a high-risk tumor with positive lymph nodes, making hormonal therapy crucial to target any remaining cancer cells. No further treatment (A) is not appropriate given the high-risk features. Radiation to mammary nodes (B) is not the standard of care for ER/PR+ breast cancer. Platinum chemotherapy (C) is not indicated for ER/PR+ breast cancer and is reserved for other subtypes.
In which of the following conditions is percent transferrin iron saturation highest?
- A. Anemia of chronic disease
- B. Iron deficiency
- C. Pernicious anemia
- D. Hemachromatosis
Correct Answer: D
Rationale: The correct answer is D: Hemachromatosis. In hemachromatosis, the body absorbs and stores too much iron, leading to high transferrin iron saturation.
Rationale:
1. In hemachromatosis, the body absorbs excess iron from the diet, causing high iron levels in the blood.
2. Transferrin is a protein that transports iron in the blood. In hemachromatosis, the high iron levels saturate the transferrin, leading to high percent transferrin iron saturation.
3. Anemia of chronic disease (A) is characterized by low iron levels and low transferrin iron saturation.
4. Iron deficiency (B) results in low iron levels and low transferrin iron saturation.
5. Pernicious anemia (C) is caused by vitamin B12 deficiency, not iron overload, leading to normal to low transferrin iron saturation.
Summary: Hemachromatosis leads to high
Which is the priority concern in developing a teaching plan for the parents of a 15-month-old child?
- A. Toilet training guidelines
- B. Guidelines for weaning children from bottles
- C. Instructions on preschool readiness
- D. Instructions on a home safety assessment
Correct Answer: D
Rationale: The correct answer is D, instructions on a home safety assessment. This is the priority concern because at 15 months, children are curious and mobile, making them prone to accidents. Conducting a home safety assessment helps identify potential hazards and allows parents to make necessary changes to create a safe environment for the child. Toilet training (A) and weaning from bottles (B) are important developmental milestones but are not as critical as ensuring the child's safety. Preschool readiness (C) is also important but can be addressed later, whereas immediate attention to home safety is crucial to prevent accidents.
A nurse is assessing a client who has pericarditis. Which of the following manifestations should the nurse expect?
- A. Dyspnea with hiccups
- B. Chest pain relieved by sitting upright
- C. Fever with chills
- D. Tachycardia alone
Correct Answer: A
Rationale: The correct answer is A: Dyspnea with hiccups. Pericarditis is inflammation of the pericardium, leading to chest pain worsened by lying flat and relieved by sitting upright. Dyspnea (shortness of breath) may occur due to compression of the heart by fluid or inflammation. Hiccups can result from irritation of the diaphragm. Fever with chills (choice C) is more indicative of an infectious process. Tachycardia alone (choice D) is a nonspecific symptom and can occur in various conditions, but pericarditis typically presents with a combination of symptoms including chest pain and dyspnea.
Most common type of lymphoma?
- A. Hodgkin lymphoma
- B. Follicular lymphoma
- C. Diffuse large B-cell lymphoma
- D. Mantle-cell lymphoma
Correct Answer: C
Rationale: The correct answer is C: Diffuse large B-cell lymphoma. This is the most common type of lymphoma due to its aggressive nature and frequent occurrence in adults. It accounts for about 30% of all non-Hodgkin lymphomas. Hodgkin lymphoma (A) is less common and has distinct diagnostic features. Follicular lymphoma (B) is indolent and typically affects older adults. Mantle-cell lymphoma (D) is rarer and characterized by a specific genetic abnormality. Therefore, based on prevalence and characteristics, diffuse large B-cell lymphoma is the most common type.