Nokea
According to the FAB classification, the L2 stage is characterized by:
- A. Large heterogenous blasts with prominent nucleoli
- B. Small homogenous blasts with scanty nucleoli and higher nucleus to cytoplasm ratio
- C. Large homogenous blasts with scanty nucleoli and higher nucleus to cytoplasm ratio
- D. Large blasts with basophilic vacuolated cytoplasm
Correct Answer: C
Rationale: The correct answer is C because according to the FAB classification, the L2 stage is characterized by large homogenous blasts with scanty nucleoli and a higher nucleus to cytoplasm ratio. This stage represents acute lymphoblastic leukemia with a high risk of relapse. Choice A is incorrect as it describes the L1 stage. Choice B is incorrect as it describes the L3 stage. Choice D is incorrect as it does not accurately describe the characteristics of the L2 stage.
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A patient's complete blood count (CBC) shows a hemoglobin of 19 g/dL and a hematocrit of 54%. Which question should the nurse ask to determine possible causes of this finding?
- A. Have you had a recent weight loss?
- B. Do you have any history of lung disease?
- C. Have you noticed any dark or bloody stools?
- D. What is your dietary intake of meats and protein?
Correct Answer: B
Rationale: The correct answer is B: Do you have any history of lung disease? A high hemoglobin and hematocrit could indicate polycythemia, which can be secondary to chronic hypoxia from lung disease. Asking about lung disease helps determine if there is an underlying cause of the elevated levels.
Incorrect Choices:
A: Recent weight loss is more relevant for anemia.
C: Dark or bloody stools are more indicative of gastrointestinal bleeding and iron deficiency anemia.
D: Dietary intake of meats and protein is not directly related to the elevated hemoglobin and hematocrit levels.
Incorrect about pernicious an:
- A. hyperchlorhydria
- B. premature graying of hair
- C. anti intrinsic factor antibody in 60% of pts.
- D. gastric polyp may occur
Correct Answer: A
Rationale: The correct answer is A: hyperchlorhydria. Pernicious anemia is characterized by vitamin B12 deficiency due to impaired absorption, not excess stomach acid. Premature graying of hair is unrelated. Presence of anti-intrinsic factor antibody and risk of gastric polyps are associated with pernicious anemia, but not hyperchlorhydria. Therefore, choice A is the correct answer as it does not align with the typical symptoms and characteristics of pernicious anemia.
A patient is prescribed a transfusion of washed packed red blood cells. What should the nurse realize as being the rationale for the using this type of blood?
- A. Reduces the risk of hypothermia
- B. Cleans the blood cells of impurities
- C. Reduces the risk of a febrile reaction
- D. Removes potential harmful particles from the blood
Correct Answer: C
Rationale: The correct answer is C because washing packed red blood cells reduces the risk of a febrile reaction by removing white blood cells, plasma proteins, and other substances that could lead to an immune response. Choice A is incorrect as hypothermia is not a primary concern with washed packed red blood cells. Choice B is incorrect as the process does not cleanse blood cells of impurities. Choice D is incorrect as the main purpose of washing blood cells is to reduce the risk of adverse reactions, not to remove harmful particles.
A nurse is assessing a dark-skinned client for pallor. What nursing assessment is best to assess for pallor in this client?
- A. Assess the conjunctiva of the eye.
- B. Have the patient open the hand widely.
- C. Look at the roof of the patient's mouth.
- D. Palpate for areas of mild swelling.
Correct Answer: A
Rationale: The correct answer is A: Assess the conjunctiva of the eye. The conjunctiva is a thin, transparent layer covering the white part of the eye. Pallor, which is paleness of the skin or mucous membranes, is more easily observed in the conjunctiva of the eye in dark-skinned individuals. This area provides a contrast to the skin tone, making it easier to detect subtle changes in color. Assessing the conjunctiva allows for a more accurate evaluation of pallor in dark-skinned clients compared to other areas like the palm, mouth, or palpation for swelling, which may not provide as clear of an indication of pallor.
A client is having a radioisotopic imaging scan. What action by the nurse is most important?
- A. Assess the client for shellfish allergies.
- B. Place the client on radiation precautions.
- C. Sedate the client before the scan.
- D. Teach the client about the procedure.
Correct Answer: D
Rationale: The correct answer is D because educating the client about the procedure is crucial for informed consent, cooperation, and reducing anxiety. This empowers the client to participate actively in their care. Assessing for shellfish allergies (A) is irrelevant unless a specific contrast agent is used. Placing the client on radiation precautions (B) is unnecessary for radioisotopic imaging. Sedating the client (C) may not be indicated and should be avoided if possible. Teaching the client about the procedure (D) addresses the immediate need and supports client safety and understanding.