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A nurse is caring for a patient with Hodgkin lymphoma at the oncology clinic. The nurse should be aware of what main goal of care?
- A. Cure of the disease
- B. Enhancing quality of life
- C. Controlling symptoms
- D. Palliation
Correct Answer: A
Rationale: The correct answer is A: Cure of the disease. In Hodgkin lymphoma, the main goal of care is to achieve a cure whenever possible. This is because Hodgkin lymphoma is a potentially curable cancer with appropriate treatment. Curative intent focuses on eradicating the cancer completely, leading to long-term remission or cure. Enhancing quality of life (B) is important but not the main goal in Hodgkin lymphoma as the primary aim is to eliminate the disease. Controlling symptoms (C) is important for comfort but not the main goal in curable cases. Palliation (D) is more relevant in advanced or incurable cases, not the main goal in Hodgkin lymphoma.
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Dohle bodies are patches of dilated endoplasmic reticulum that appear as cerulean blue cytoplasmic puddles. These findings are mostly seen in
- A. Chronic myeloid leukemia
- B. Leukemoid reaction
- C. Chediak-Higashi syndrome
- D. Infectious mononucleosis
Correct Answer: D
Rationale: Step-by-step rationale for why choice D (Infectious mononucleosis) is correct:
1. Infectious mononucleosis is caused by the Epstein-Barr virus.
2. Dohle bodies are seen in the peripheral blood of patients with infectious mononucleosis.
3. These bodies represent aggregates of rough endoplasmic reticulum in neutrophils.
4. The appearance of Dohle bodies is attributed to the viral infection in infectious mononucleosis.
Summary:
A: Chronic myeloid leukemia - Dohle bodies are not typically seen in this condition.
B: Leukemoid reaction - Dohle bodies are not specific to a leukemoid reaction.
C: Chediak-Higashi syndrome - This syndrome is characterized by giant granules in neutrophils, not Dohle bodies.
C6PD reflect false normal report in:
- A. iron def .an.
- B. hypoplastic an.
- C. hairy cell leuk.
- D. shortly after haemolysis
Correct Answer: D
Rationale: The correct answer is D because individuals with G6PD deficiency can have normal enzyme levels shortly after a hemolytic episode due to the body replenishing the enzyme. Choice A, iron deficiency anemia, is unrelated to G6PD deficiency. Choice B, hypoplastic anemia, does not affect enzyme levels. Choice C, hairy cell leukemia, is not typically associated with false-normal G6PD levels. Therefore, the correct answer is D as it reflects the transient nature of G6PD levels post-hemolysis.
Which of the following alters the function of thrombin from a procoagulant protein to one that downregulates the formation of fibrinogen?
- A. Protein C
- B. Protein S
- C. Antithrombin
- D. Thrombomodulin
Correct Answer: D
Rationale: Thrombomodulin alters thrombin's function by binding to it and activating protein C. Activated protein C then inhibits factors Va and VIIIa, which are essential for the formation of fibrinogen. Protein C (choice A) also inhibits coagulation, but it doesn't directly alter thrombin's function. Protein S (choice B) enhances protein C's activity but doesn't directly affect thrombin. Antithrombin (choice C) inhibits thrombin and other coagulation factors, but it doesn't specifically alter thrombin's function to downregulate fibrinogen formation.
The nurse assesses a patient who has numerous petechiae on both arms. Which question should the nurse ask the patient?
- A. Do you take salicylates?
- B. Are you taking any oral contraceptives?
- C. Have you been prescribed antiseizure drugs?
- D. How long have you taken antihypertensive drugs?
Correct Answer: A
Rationale: The correct answer is A: Do you take salicylates? Petechiae can be a sign of salicylate use, which can cause bleeding disorders. By asking about salicylates, the nurse can determine if the petechiae are related to medication. Choice B is not directly related to petechiae. Choice C is more specific to antiseizure drugs and not commonly associated with petechiae. Choice D is unrelated to petechiae and focuses on hypertension management. Asking about salicylates is the most appropriate to assess potential medication-induced petechiae.
A patient with abdominal injuries from a motor vehicle crash is scheduled for surgery to remove the spleen. What bodily function will be affected by the removal of this organ?
- A. Filtration of waste products
- B. Removal of old red blood cells from circulation
- C. Clearance of mucous in the tracheobronchial tree
- D. Facilitation of glucose to be used by the cell for energy
Correct Answer: B
Rationale: The correct answer is B: Removal of old red blood cells from circulation. The spleen is responsible for filtering and removing old or damaged red blood cells from the bloodstream. When the spleen is removed, this function is compromised, leading to a decreased ability to clear out old red blood cells. This can result in an increased risk of anemia and other complications related to the breakdown of red blood cells.
Choices A, C, and D are incorrect:
A: Filtration of waste products - The spleen primarily filters blood cells, not waste products.
C: Clearance of mucous in the tracheobronchial tree - This function is mainly carried out by the respiratory system, not the spleen.
D: Facilitation of glucose to be used by the cell for energy - This is a function of the pancreas and insulin, not the spleen.