Nokea
All produce microcytic anemia except:
- A. sideroblastic an.
- B. thalassemia
- C. pernicious anemia
- D. lead poisoning
Correct Answer: C
Rationale: The correct answer is C, pernicious anemia. Pernicious anemia is a macrocytic anemia caused by vitamin B12 deficiency affecting red blood cell production. Sideroblastic anemia (A), thalassemia (B), and lead poisoning (D) can all lead to microcytic anemia due to different mechanisms such as impaired hemoglobin synthesis or red blood cell destruction. Pernicious anemia, on the other hand, is not associated with microcytosis.
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A nurse is assessing a dark-skinned client for pallor. What action is best?
- A. Assess the conjunctiva of the eye.
- B. Have the client open the hand widely.
- C. Look at the roof of the client's mouth.
- D. Palpate for areas of mild swelling.
Correct Answer: A
Rationale: The correct answer is A: Assess the conjunctiva of the eye. This is because pallor, which is paleness of the skin, can be difficult to detect on dark skin. The conjunctiva of the eye is a mucous membrane that is not pigmented and can provide a more accurate indication of pallor. Options B, C, and D are not ideal for assessing pallor in a dark-skinned client as they may not show paleness accurately. B is more related to checking for pallor in fair-skinned individuals. C and D are not reliable indicators of pallor in any skin type.
A patient receiving blood complains of dyspnea. The nurse auscultates the patient's lungs and finds crackles that were not present before the start of the transfusion. Which type of reaction should the nurse suspect?
- A. Urticarial
- B. Hemolytic
- C. Anaphylactic
- D. Circulatory overload
Correct Answer: D
Rationale: The correct answer is D: Circulatory overload. This type of reaction occurs when the patient receives blood too quickly, leading to fluid overload in the circulatory system. The dyspnea and crackles are indicative of pulmonary edema, a common symptom of circulatory overload. Urticarial reaction (choice A) presents with hives, not dyspnea. Hemolytic reaction (choice B) involves the destruction of red blood cells, not fluid overload. Anaphylactic reaction (choice C) is a severe allergic reaction that includes symptoms like hives, swelling, and hypotension, but not typically pulmonary edema.
A nurse is caring for a client who is taking filgrastim to treat neutropenia. The nurse should assess the client for which of the following adverse effects?
- A. Dusky nail beds
- B. Petechiae
- C. Enlarged spleen
- D. Swollen calf
Correct Answer: C
Rationale: Step-by-step rationale for why choice C is correct:
1. Filgrastim stimulates the production of neutrophils.
2. An enlarged spleen can indicate an increase in neutrophils.
3. Therefore, assessing the client for an enlarged spleen is crucial to monitor the drug's effectiveness and potential adverse effects.
Summary of why other choices are incorrect:
A: Dusky nail beds - Not directly related to filgrastim or neutropenia.
B: Petechiae - Typically associated with low platelet count, not neutrophil increase.
D: Swollen calf - Unlikely to be a direct adverse effect of filgrastim for neutropenia.
Which of the following is associated with normocytic normochromic anaemia?
- A. Iron deficiency
- B. Primaquine
- C. Pregnancy
- D. Sickle cell disease
Correct Answer: C
Rationale: Normocytic normochromic anemia is characterized by normal-sized red blood cells with normal hemoglobin content. Pregnancy is associated with increased blood volume and physiological hemodilution, leading to normocytic normochromic anemia. Iron deficiency (choice A) typically presents as microcytic hypochromic anemia. Primaquine (choice B) is associated with hemolytic anemia. Sickle cell disease (choice D) is characterized by sickle-shaped red blood cells and is associated with hemolytic anemia, making it different from normocytic normochromic anemia.
Best tit modality in CML is:
- A. hydroxyurea
- B. allogenic BMT
- C. interferon alpha
- D. radiotherapy
Correct Answer: B
Rationale: The best treatment modality for Chronic Myeloid Leukemia (CML) is allogenic Bone Marrow Transplant (BMT) due to its potential for cure by replacing abnormal cells with healthy donor cells. Hydroxyurea only controls symptoms, interferon alpha has limited efficacy, and radiotherapy is not a standard treatment for CML. BMT offers a curative potential by replacing cancerous cells with healthy donor cells, making it the most effective option for treating CML.