Nokea
Children with ALL who carry poor outcome include all the following EXCEPT
- A. age younger than 1 year and older than 10 year
- B. T-cell immunophenotype
- C. hyperdiploidy chromosomal abnormality
- D. initial leukocyte count of > 50,000
Correct Answer: C
Rationale: Hyperdiploidy is generally associated with a favorable prognosis in ALL, unlike other listed factors.
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Mrs. Baker was instructed by the nurse on foods to encourage her child's diet concerning the latter's iron deficiency anemia; which of the following if stated by the mother would indicate the need for further instruction?
- A. Fish
- B. Lean meats
- C. Whole-grain breads
- D. Yellow vegetables
Correct Answer: D
Rationale: Yellow vegetables do not contain a significant amount of iron compared to the other options provided (fish, lean meats, and whole-grain breads). Therefore, if Mrs. Baker indicates that she plans to focus on yellow vegetables to address her child's iron deficiency anemia, further instruction would be necessary to help her choose more iron-rich sources of food to improve her child's condition.
A patient has hand-foot syndrome related to his sickle cell anemia. What findings does the nurse expect to see as the patient is assessed?
- A. Unequal growth of fingers and toes.
- B. Purplish discoloration of hands and feet.
- C. Webbing between fingers and toes.
- D. Deformities of the wrists and ankles.
Correct Answer: B
Rationale: Hand-foot syndrome, also known as dactylitis, is a common manifestation of sickle cell anemia. It is characterized by painful swelling and inflammation of the hands and feet, often resulting in a purplish discoloration due to decreased blood flow and oxygen delivery to the affected areas. This condition typically affects the soft tissues and joints of the hands and feet, leading to pain, swelling, and limited mobility. Unequal growth of fingers and toes, webbing between fingers and toes, and deformities of the wrists and ankles are not typically associated with hand-foot syndrome in sickle cell anemia.
Which of the following organisms is responsible for the development of rheumatic fever?
- A. Streptococcal pneumonia
- B. Haemophilus influenza
- C. Group Aß-hemolytic streptococcus
- D. Staphylococcus aureus
Correct Answer: C
Rationale: Rheumatic fever is an inflammatory disease that can develop after an untreated or inadequately treated infection with group Aß-hemolytic streptococcus bacteria, particularly Streptococcus pyogenes. This bacteria causes strep throat, which if left untreated, can lead to complications such as rheumatic fever. Rheumatic fever primarily affects the heart, joints, skin, and brain. It is important to promptly treat streptococcal infections with antibiotics to prevent the development of rheumatic fever.
The nurse is working in a support group for client with acquired immunodeficiency syndrome (AIDS). Which point is most important for the nurse to stress?
- A. Avoiding the use of recreational drugs and alcohol
- B. Refraining from telling anyone about the diagnosis
- C. Following safer-sex practices
- D. Telling potential sex partners about the diagnosis, as required by the law
Correct Answer: C
Rationale: Following safer sex practices is the most important point for the nurse to stress when working in a support group for clients with acquired immunodeficiency syndrome (AIDS). Safer sex practices, such as using condoms consistently and correctly, can help reduce the risk of transmitting the virus to others or acquiring other sexually transmitted infections. While avoiding the use of recreational drugs and alcohol is beneficial for overall health, it is not as crucial as practicing safer sex. Refraining from telling anyone about the diagnosis is not recommended, as social support is important for individuals living with AIDS. Telling potential sex partners about the diagnosis is also essential, not only for ethical reasons but also to prevent the transmission of the virus.
With severe diarrhea, electrolytes as well as fluids are lost. What electrolyte imbalance is indicated in Ms. CC's decreased muscle tone and deep tendon reflexes?
- A. Hypernatremia
- B. Hyperchoremia
- C. Hypokalemia
- D. Hypocalcemia
Correct Answer: C
Rationale: Hypokalemia is indicated in Ms. CC's decreased muscle tone and deep tendon reflexes. Potassium is an essential electrolyte for muscle function, including maintaining muscle tone and supporting proper nerve conduction for reflexes. When potassium levels are low, it can lead to muscle weakness, decreased muscle tone, and reduced deep tendon reflexes. With severe diarrhea, potassium is often lost along with fluids, leading to a potential electrolyte imbalance such as hypokalemia. Additionally, hypokalemia can cause cardiac arrhythmias, muscle cramps, and fatigue, further supporting the presence of this electrolyte imbalance in Ms. CC.