Nokea
Haemolytic anemia is not produced by:
- A. penicillin
- B. lithium
- C. Quinidine
- D. methyldopa
Correct Answer: B
Rationale: The correct answer is B: lithium. Lithium is not known to cause haemolytic anemia. Penicillin (A), Quinidine (C), and methyldopa (D) are associated with causing haemolytic anemia due to various mechanisms, such as immune-mediated destruction of red blood cells. In contrast, lithium is primarily used to treat mood disorders and does not have a direct link to causing haemolytic anemia. Therefore, by process of elimination and understanding the pharmacological effects of these drugs, we can determine that lithium is the correct answer.
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Presence of an --jaundice --splenomegaly with increase MCH is seen in:
- A. liver cirrhosis
- B. th.major
- C. PNH
- D. herditary spherocytosis
Correct Answer: D
Rationale: The correct answer is D, hereditary spherocytosis. In this condition, the presence of jaundice and splenomegaly is due to the destruction of red blood cells by the spleen, leading to increased MCH. In liver cirrhosis (choice A), jaundice is due to impaired liver function. Thalassemia major (choice B) presents with severe anemia, not jaundice. Paroxysmal nocturnal hemoglobinuria (choice C) is characterized by hemolytic anemia and not typically associated with splenomegaly and jaundice. Therefore, the presence of jaundice, splenomegaly, and increased MCH points towards hereditary spherocytosis.
A nurse is monitoring a client who is undergoing anticoagulant therapy with heparin. Which of the following findings should the nurse identify as a possible indication of hemorrhage?
- A. Rapid pulse
- B. Yellowing of the sclera
- C. Elevated blood pressure
- D. Pale-colored stools
Correct Answer: A
Rationale: The correct answer is A: Rapid pulse. Hemorrhage is a potential complication of anticoagulant therapy with heparin due to the increased risk of bleeding. A rapid pulse can indicate hypovolemia from blood loss, a common sign of hemorrhage. Yellowing of the sclera (choice B) is a sign of jaundice, not directly related to hemorrhage. Elevated blood pressure (choice C) is not typically associated with hemorrhage. Pale-colored stools (choice D) can be indicative of liver or gallbladder issues, but not specifically hemorrhage. Overall, a rapid pulse is the most relevant finding to indicate possible hemorrhage in a client on heparin therapy.
A study is designed to investigate the rates of central line–associated blood stream infections among pediatric hematology/oncology patients. Three common central line types (totally implanted catheter [port], peripherally inserted central catheter [PICC], and tunneled externalized catheter [TEC]) were included in the study. What data structure is central line type?
- A. Continuous
- B. Dichotomous
- C. Nominal
- D. Ordinal
Correct Answer: C
Rationale: The correct answer is C: Nominal. Central line type is a nominal data structure because it represents categories without any inherent order or ranking. In this study, the central line types (port, PICC, TEC) are distinct categories with no numerical significance or order. They are simply different types of central lines used for medical purposes. Continuous (A) data involves numerical values with infinite possibilities, which is not the case here. Dichotomous (B) data consists of only two categories, while in this study there are three central line types. Ordinal (D) data involves categories with a specific order or ranking, which is not applicable to central line types as they do not have a natural order.
Assuming that adherence has been excellent, which of the following should have returned to normal 6 weeks following appropriate oral iron treatment for a child with severe dietary iron deficiency (hemoglobin [Hgb] 5.0 g/dL and mean corpuscular volume [MCV] 48 fL at the beginning of therapy)?
- A. Hgb concentration
- B. MCV
- C. Red cell distribution width
- D. Peripheral blood smear
Correct Answer: A
Rationale: Rationale:
1. Hemoglobin (Hgb) reflects the oxygen-carrying capacity of red blood cells.
2. Severe dietary iron deficiency causes low Hgb levels.
3. Adequate iron treatment should lead to increased Hgb levels.
4. MCV and other parameters may take longer to normalize.
Summary:
B, C, and D are incorrect because MCV and red cell distribution width may take longer to normalize, and peripheral blood smear changes may persist even after Hgb has returned to normal.
A patient with leukemia has developed stomatitis and is experiencing a nutritional deficit. An oral anesthetic has consequently been prescribed. What health education should the nurse provide to the patient?
- A. Chew with care to avoid inadvertently biting the tongue.
- B. Use the oral anesthetic 1 hour prior to meal time.
- C. Brush teeth before and after eating.
- D. Swallow slowly and deliberately.
Correct Answer: A
Rationale: The correct answer is A: Chew with care to avoid inadvertently biting the tongue. Stomatitis causes inflammation in the mouth, making it painful to eat. By chewing carefully, the patient can prevent accidentally biting the tongue or cheek, which can worsen the pain. Using the oral anesthetic before meals (choice B) may provide some relief, but the key is to prevent further injury. Brushing teeth before and after eating (choice C) and swallowing slowly (choice D) do not directly address the issue of preventing accidental bites and are not as essential for managing stomatitis.