Nokea
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 transplantation (BMT) because it offers the potential for cure by replacing the abnormal cells with healthy donor cells. This is the only option that can provide long-term disease control and potential cure for CML. Hydroxyurea (choice A) is a cytotoxic drug used for symptom control but does not target the underlying cause. Interferon alpha (choice C) can help control the disease but is less effective in achieving long-term remission compared to BMT. Radiotherapy (choice D) is not a standard treatment for CML and is not curative.
You may also like to solve these questions
Busulfan therapy lead to all except:
- A. hyperpigmentation
- B. pulm .Fibrosis
- C. optic neuritis
- D. BM suppression
Correct Answer: C
Rationale: The correct answer is C: Optic neuritis. Busulfan therapy is known to cause adverse effects like hyperpigmentation, pulmonary fibrosis, and bone marrow suppression due to its cytotoxic nature. However, optic neuritis is not a common side effect associated with busulfan. Optic neuritis typically occurs due to inflammation of the optic nerve and is more commonly linked to conditions like multiple sclerosis. Therefore, in the context of busulfan therapy, optic neuritis is not a expected side effect, making it the correct answer.
A nurse is preparing to administer a prescribed dose of desmopressin to a client who has hemophilia A. The client's laboratory results indicate that the client has a sodium level of 130 mEq/L. Which of the following actions should the nurse take?
- A. Clarify the prescription with the provider.
- B. Administer the drug with an analgesic.
- C. Administer the required dose orally.
- D. Assess factor IX levels.
Correct Answer: A
Rationale: The correct answer is A: Clarify the prescription with the provider. Desmopressin is a medication that can cause hyponatremia, especially in patients with low sodium levels like this client. Before administering desmopressin, the nurse should consult with the provider to ensure it is safe to administer the medication given the client's sodium level. Administering the drug without clarifying may worsen the hyponatremia.
Choice B is incorrect because administering the drug with an analgesic is not necessary or relevant in this situation. Choice C is incorrect because desmopressin is typically administered via injection, not orally. Choice D is incorrect because assessing factor IX levels is not directly related to the administration of desmopressin in this scenario.
A nursing student is caring for a patient with acute myeloid leukemia who is preparing to undergo induction therapy. In preparing a plan of care for this patient, the student should assign the highest priority to which nursing diagnoses?
- A. Activity Intolerance
- B. Risk for Infection
- C. Acute Confusion
- D. Risk for Spiritual Distress
Correct Answer: B
Rationale: The correct answer is B: Risk for Infection. During induction therapy for acute myeloid leukemia, the patient's immune system is compromised, making them highly susceptible to infections. Therefore, the highest priority nursing diagnosis should be addressing and preventing infections. This includes monitoring for signs of infection, implementing proper infection control measures, educating the patient and family on infection prevention, and administering prophylactic antibiotics as needed.
Choice A (Activity Intolerance) may be a concern due to the patient's underlying condition and treatment, but preventing infections takes precedence as it can lead to life-threatening complications. Choice C (Acute Confusion) and Choice D (Risk for Spiritual Distress) are important considerations but do not pose an immediate threat to the patient's health and safety compared to the risk of infection.
A patient who is taking warfarin (Coumadin) 5 mg daily has an international normalized ratio (INR) of 2.5. It is time to administer the next dose of Coumadin. What should the nurse do?
- A. Notify the physician STAT.
- B. Hold the dose of Coumadin.
- C. Prepare to administer vitamin K.
- D. Administer the daily Coumadin as ordered.
Correct Answer: D
Rationale: The correct answer is D: Administer the daily Coumadin as ordered. A therapeutic INR range for patients on warfarin is typically between 2-3. A patient with an INR of 2.5 is within this range, indicating that their blood is adequately anticoagulated. Therefore, the next dose of Coumadin should be administered as prescribed to maintain the therapeutic effect. Holding the dose (B) may lead to subtherapeutic anticoagulation, and notifying the physician (A) is not necessary as the INR is within range. Administering vitamin K (C) is indicated for patients with a high INR and signs of bleeding, which is not the case here.
A 3-year-old boy is referred to you for evaluation of right leukocoria. Funduscopic examination under anesthesia reveals a large amelanotic mass occupying more than two-thirds of the vitreous space in his right eye, with massive retinal detachment, consistent with group E retinoblastoma. The left eye is normal. An MRI confirms the funduscopic findings and shows no extraocular disease. What is the most appropriate next step in the management of this child's disease?
- A. Enucleation
- B. Systemic chemotherapy
- C. Brachytherapy
- D. Needle biopsy
Correct Answer: A
Rationale: The correct answer is A: Enucleation. In this case, the child has a group E retinoblastoma in the right eye, with massive retinal detachment. Enucleation, or surgical removal of the eye, is the most appropriate next step as the tumor is extensive and poses a risk of metastasis. Enucleation helps prevent spread of the cancer to other parts of the body and provides the best chance for cure. Systemic chemotherapy (B) and brachytherapy (C) are not ideal for such advanced cases due to the high risk of metastasis. Needle biopsy (D) is not recommended as the diagnosis is already confirmed by funduscopic examination and MRI.