Nokea
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: The different leukemias all involve unregulated proliferation of WBC. Leukemia is a type of cancer that affects the blood and bone marrow, leading to the uncontrolled growth of white blood cells. This abnormal proliferation of white blood cells is a common feature across all subtypes of leukemia.
Explanation:
1. Leukemia is a cancer of the blood and bone marrow.
2. In leukemia, there is uncontrolled proliferation of white blood cells.
3. Different subtypes of leukemia may have specific characteristics, but they all involve the abnormal growth of white blood cells.
Summary:
Choice B is incorrect because leukemias do not involve unregulated proliferation of red blood cells. Choice C is incorrect because leukemias do not always result in a decrease in white blood cell production. Choice D is incorrect because leukemia is not specifically related to the lymphatic system; it affects the blood and bone marrow.
You may also like to solve these questions
A patient is scheduled for upcoming surgery. He is on nonsteroidal anti-inflammatory drugs (NSAIDs) for rheumatoid arthritis. You are being asked what to do with his medications for the surgery. What is the mechanism of action of NSAIDS?
- A. Irreversible inhibition of cyclooxygenase 1
- B. Irreversible inhibition of cyclooxygenase 2
- C. Reversible inhibition of cyclooxygenase 1
- D. Reversible inhibition of cyclooxygenase 2
Correct Answer: C
Rationale: The correct answer is C: Reversible inhibition of cyclooxygenase 1. NSAIDs work by reversibly inhibiting cyclooxygenase enzymes, particularly COX-1 and COX-2, which are involved in the synthesis of prostaglandins. In this case, reversible inhibition is crucial because it allows for the temporary suppression of prostaglandin production, leading to pain relief and anti-inflammatory effects.
Explanation of other choices:
A: Irreversible inhibition of cyclooxygenase 1 - This is incorrect because NSAIDs typically do not irreversibly inhibit COX-1.
B: Irreversible inhibition of cyclooxygenase 2 - This is incorrect because NSAIDs do not irreversibly inhibit COX-2.
D: Reversible inhibition of cyclooxygenase 2 - This is incorrect because while NSAIDs can inhibit COX-2, the primary target is COX-1 for their therapeutic effects.
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.
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.
A 7-year-old boy presents with recent onset of vomiting and lethargy. Blood smear shows increased neutrophils with a left shift and 8% abnormal cells. Bone marrow contains 60% of the same cells. Flow cytometry shows that the cells are TdT–, CD10+, CD19+, CD20+, sIg+. What is the most likely diagnosis?
- A. Burkitt leukemia/lymphoma
- B. B-cell acute lymphoblastic leukemia (ALL)
- C. T-cell ALL
- D. Hematogones
Correct Answer: A
Rationale: The correct answer is A: Burkitt leukemia/lymphoma. The key features in the case are increased neutrophils with a left shift, presence of abnormal cells in blood and bone marrow, and flow cytometry showing TdT–, CD10+, CD19+, CD20+, sIg+. These findings are consistent with Burkitt leukemia/lymphoma, a highly aggressive B-cell neoplasm. The presence of CD10, CD19, and CD20, along with sIg positivity, points towards a B-cell origin. Additionally, the characteristic translocation t(8;14) involving c-Myc oncogene is commonly seen in Burkitt lymphoma. The absence of TdT expression rules out T-cell ALL (Choice C). Hematogones (Choice D) are normal precursor B-cells found in bone marrow, but they do not typically present with the clinical features described. B-cell ALL (Choice B) lacks the specific features seen in this case
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.