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An infant is born with a firm mass over the chest with a central area of purpura and a 'halo' around it. An ultrasound reveals a high-flow lesion. What is the most likely diagnosis?
- A. Fibrosarcoma
- B. Infantile hemangioma
- C. Congenital hemangioma
- D. Capillary malformation
Correct Answer: C
Rationale: The correct answer is C: Congenital hemangioma. A congenital hemangioma presents as a firm mass with purpura and a 'halo' due to rapid growth of blood vessels. The central area of purpura indicates thrombosis. The high-flow lesion on ultrasound suggests an increased blood flow. Fibrosarcoma (A) is a malignant tumor of fibrous tissue and does not present with these characteristic features. Infantile hemangioma (B) typically appears after birth and has a different clinical presentation. Capillary malformation (D) is a vascular malformation that does not typically show the same features as described in the question.
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You are discussing prognosis with the mother of a patient with stage 3, group III rhabdomyosarcoma. Which of the following is the most unfavorable primary site?
- A. Extremity
- B. Prostate
- C. Infratemporal fossa
- D. Neck
Correct Answer: A
Rationale: The correct answer is A: Extremity. Rhabdomyosarcoma in extremities has a worse prognosis due to difficulties in achieving complete surgical resection and higher risk of metastasis. Extremity tumors are often larger and more challenging to remove completely, leading to a higher chance of recurrence and poor outcomes. Prostate (B) and neck (D) sites are more favorable as they are easier to access for surgery and have lower rates of metastasis. Infratemporal fossa (C) is also a difficult site, but extremity tumors generally have a worse prognosis due to their anatomical and surgical challenges.
When assessing a newly admitted patient, the nurse notes pallor of the skin and nail beds. The nurse should ensure that which laboratory test has been ordered?
- A. Platelet count
- B. Neutrophil count
- C. White blood cell count
- D. Hemoglobin (Hgb) level
Correct Answer: D
Rationale: The correct answer is D: Hemoglobin (Hgb) level. Pallor of the skin and nail beds indicates possible anemia, which is a condition characterized by low levels of hemoglobin. Thus, checking the hemoglobin level is crucial to confirm the suspicion of anemia. Platelet count (choice A) assesses for clotting ability, neutrophil count (choice B) and white blood cell count (choice C) are indicators of infection or inflammation, which are not directly related to pallor. Hemoglobin level directly correlates with the observed symptom of pallor, making it the most appropriate laboratory test to order.
In iron deficiency anemia there is characteristically
- A. An atrophic gastritis
- B. A low mean corpuscular volume
- C. A reduced total iron binding capacity
- D. Megaloblastic changes in the bone marrow
Correct Answer: B
Rationale: The correct answer is B: A low mean corpuscular volume. In iron deficiency anemia, there is a decreased amount of iron available for hemoglobin synthesis, leading to smaller and paler red blood cells. This results in a low mean corpuscular volume (MCV). Atrophic gastritis (choice A) is associated with vitamin B12 deficiency anemia, not iron deficiency anemia. Choice C (reduced total iron binding capacity) is incorrect because in iron deficiency anemia, there is an increased total iron binding capacity due to the body's attempt to capture more iron. Megaloblastic changes in the bone marrow (choice D) are seen in megaloblastic anemia, not iron deficiency anemia.
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.
A nurse is caring for a client who is scheduled for an outpatient surgical procedure and reports taking aspirin 81 mg daily, including this morning. The nurse should identify that this places the client at risk for which of the following complications?
- A. Uncontrolled bleeding
- B. Myocardial infarction
- C. Respiratory depression
- D. Decreased renal perfusion
Correct Answer: A
Rationale: Rationale: Aspirin is an antiplatelet medication that inhibits platelet aggregation, increasing the risk of uncontrolled bleeding during surgical procedures. By taking aspirin, the client's blood clotting ability is impaired, leading to potential excessive bleeding during and after surgery. This can result in complications such as prolonged bleeding, hematoma formation, and delayed wound healing. Therefore, the correct answer is A: Uncontrolled bleeding.
Summary:
- B: Myocardial infarction is not directly related to taking aspirin; it is actually used to prevent heart attacks.
- C: Respiratory depression is not a common complication associated with aspirin use.
- D: Decreased renal perfusion is not a typical risk of taking aspirin; it primarily affects the cardiovascular system.