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 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.
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In a study to investigate the rates of central line–acquired bacterial infections, it is discovered that patient length of stay (LOS) is not normally distributed but is highly right-skewed. What is the correct relationship between the mean, median, and mode of LOS?
- A. The mean is less than the median but greater than the mode.
- B. The mean is equal to the median and the mode.
- C. The mean is greater than the median and mode.
- D. The mean and median will both be less than the mode.
Correct Answer: C
Rationale: The correct answer is C: The mean is greater than the median and mode. In a highly right-skewed distribution, the mean is pulled towards the higher end by the extreme values, making it greater than the median, which is the middle value. The mode is the most frequent value, which is typically lower than the mean in a right-skewed distribution. In summary, the mean is influenced by extreme values, causing it to be greater than both the median and the mode in a highly right-skewed distribution.
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 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 because assessing the conjunctiva of the eye is the best way to assess pallor in dark-skinned individuals. Pallor is difficult to detect on dark skin due to increased melanin. The conjunctiva is a mucous membrane that can show pallor regardless of skin tone. Choices B, C, and D are incorrect because examining the hand, mouth, or palpating for swelling are not reliable methods for assessing pallor in dark-skinned individuals.
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.
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, increasing the risk of infections. Priority is given to preventing infections to avoid complications. Activity Intolerance (A) may be a concern but is secondary to infection risk. Acute Confusion (C) may occur but is not as critical as preventing infections. Risk for Spiritual Distress (D) is important but addressing physical needs like infection prevention takes precedence for this patient population.