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A hospitalized client has a platelet count of 58,000/mm³. What action by the nurse is best?
- A. Encourage high-protein foods.
- B. Institute neutropenic precautions.
- C. Limit visitors to healthy adults.
- D. Place the client on safety precautions.
Correct Answer: D
Rationale: The correct answer is D: Place the client on safety precautions. A platelet count of 58,000/mm³ indicates thrombocytopenia, increasing the risk of bleeding. Safety precautions aim to prevent injury and minimize bleeding risks. Encouraging high-protein foods (choice A) is not directly related to managing thrombocytopenia. Instituting neutropenic precautions (choice B) is for clients with low white blood cell counts, not platelet counts. Limiting visitors to healthy adults (choice C) is important for infection control, not specifically for thrombocytopenia. In summary, placing the client on safety precautions is the best action to prevent bleeding complications.
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An oncology nurse is providing health education for a patient who has recently been diagnosed with leukemia. What should the nurse explain about commonalities between all of the different subtypes of leukemia?
- A. The different leukemias all involve unregulated proliferation of WBC
- B. The different leukemias all have unregulated proliferation of red blood cells and decreased bone marrow function.
- C. The different leukemias all result in a decrease in the production of white blood cells.
- D. The different leukemias all involve the development of cancer in the lymphatic system.
Correct Answer: A
Rationale: The correct answer is A because all subtypes of leukemia involve unregulated proliferation of white blood cells (WBC). Leukemia is a type of cancer that starts in the blood-forming tissues, leading to the production of abnormal WBCs in the bone marrow. This uncontrolled growth of WBCs interferes with the production of normal blood cells.
Choice B is incorrect because leukemia does not involve unregulated proliferation of red blood cells, but rather white blood cells. It also does not necessarily result in decreased bone marrow function as stated in the choice.
Choice C is incorrect because while some subtypes of leukemia may result in a decrease in the production of normal white blood cells, the primary issue is the unregulated proliferation of abnormal WBCs.
Choice D is incorrect because leukemia is not specifically related to cancer development in the lymphatic system. Leukemia primarily affects the bone marrow and blood.
A 40 year old patient is presented with unilateral palpebral edema and ipsilateral lymphadenopathy. He later develops megaesophagus and megacolon as complications. Which of the following vector is responsible for this parasitic infection?
- A. Glossina morsitans
- B. Ixodes scapularis
- C. Rhodnius prolixus
- D. Simulium damnosum
Correct Answer: C
Rationale: The correct answer is C: Rhodnius prolixus. This vector is responsible for transmitting Trypanosoma cruzi, causing Chagas disease. The initial symptoms of unilateral palpebral edema and lymphadenopathy are characteristic of Chagas disease. The complications of megaesophagus and megacolon are also common manifestations of chronic Chagas disease. Glossina morsitans (A) transmits African trypanosomiasis (sleeping sickness), Ixodes scapularis (B) transmits Lyme disease, and Simulium damnosum (D) transmits onchocerciasis (river blindness), so they are not associated with the symptoms described.
Which of the following best characterizes the function of ferroportin in iron metabolism?
- A. A form of storage iron in intestinal mucosal cells
- B. A transport protein in the plasma
- C. A receptor protein on the surface of erythroid progenitors
- D. Transmembrane iron exporter
Correct Answer: D
Rationale: Ferroportin is a transmembrane iron exporter responsible for releasing iron from cells into the bloodstream. It is crucial in regulating systemic iron levels. Choice A is incorrect as storage iron is typically stored as ferritin. Choice B is incorrect as ferroportin is not found in the plasma but on cell membranes. Choice C is incorrect as erythroid progenitors do not directly interact with ferroportin. Therefore, the correct answer is D as it accurately describes the function of ferroportin in iron metabolism.
The nurse is caring for a patient who has a white blood cell (WBC) count of 8000/mm³. What concern should the nurse have about this finding?
- A. The patient has an infection.
- B. The patient is at risk for infection.
- C. The patient has a hematological disorder.
- D. There is no concern; this is a normal finding.
Correct Answer: D
Rationale: The correct answer is D because a WBC count of 8000/mm³ falls within the normal range of 4000-11000/mm³. The normal WBC count indicates the body's ability to fight infections and maintain immunity. The other choices are incorrect because:
A: The patient does not necessarily have an infection based solely on the WBC count.
B: The patient is not necessarily at risk for infection with a normal WBC count.
C: There is no indication of a hematological disorder based on the WBC count within the normal range.
A study is designed to investigate the rates of central line–associated blood stream infections among pediatric hematology/oncology patients. Three common central line types (totally implanted catheter [port], peripherally inserted central catheter [PICC], and tunneled externalized catheter [TEC]) were included in the study. What data structure is central line type?
- A. Continuous
- B. Dichotomous
- C. Nominal
- D. Ordinal
Correct Answer: C
Rationale: The correct answer is C: Nominal. Central line type is a nominal data structure because it represents categories without any inherent order or ranking. In this study, the central line types (port, PICC, TEC) are distinct categories with no numerical value or order. It's important to distinguish between the different types of central lines, but they cannot be ordered in a meaningful sequence, making them nominal.
Incorrect answers:
A: Continuous - Central line type does not have a continuous range of values, it is categorical.
B: Dichotomous - Dichotomous data structure has only two categories, while central line type has more than two distinct categories.
D: Ordinal - Ordinal data structure involves categories with a clear order or ranking, which is not applicable to central line types as they do not have a natural order.