Nokea
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.
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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.
A nurse is caring for a patient with Hodgkin lymphoma at the oncology clinic. The nurse should be aware of what main goal of care?
- A. Cure of the disease
- B. Enhancing quality of life
- C. Controlling symptoms
- D. Palliation
Correct Answer: A
Rationale: The correct answer is A: Cure of the disease. The main goal of care for a patient with Hodgkin lymphoma is to achieve a cure whenever possible. This is because Hodgkin lymphoma is a potentially curable cancer with appropriate treatment. Achieving a cure means eradicating the cancer cells completely and preventing its recurrence in the future. This is the most desirable outcome for the patient's long-term health and well-being.
Incorrect choices:
B: Enhancing quality of life - While improving the patient's quality of life is important, the primary goal in treating Hodgkin lymphoma is to cure the disease.
C: Controlling symptoms - Symptom management is important in providing comfort to the patient, but the main goal is to cure the disease.
D: Palliation - Palliative care focuses on relieving symptoms and improving quality of life in patients with advanced or incurable diseases. For Hodgkin lymphoma, the main goal is to aim for a cure rather than palliation.
You are discussing prognosis with the mother of a patient with stage 3, group III rhabdomyosarcoma. Which of the following is the most unfavorable primary site?
- A. Extremity
- B. Prostate
- C. Infratemporal fossa
- D. Neck
Correct Answer: A
Rationale: The correct answer is A: Extremity. Rhabdomyosarcoma has a better prognosis when located in the extremities compared to other sites due to easier surgical resection and less risk of metastasis. Prostate (B) is less common in children and has a poorer prognosis. Infratemporal fossa (C) and neck (D) sites have a higher risk of local invasion and metastasis, leading to a worse prognosis compared to extremity sites.
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: Step-by-step rationale:
1. Iron deficiency leads to decreased hemoglobin synthesis, resulting in smaller red blood cells.
2. Mean corpuscular volume (MCV) measures the average size of red blood cells.
3. In iron deficiency anemia, MCV is low due to the smaller red blood cells.
4. Therefore, choice B is correct as it reflects the characteristic feature of iron deficiency anemia.
Summary:
A: Atrophic gastritis is seen in pernicious anemia, not iron deficiency anemia.
C: Total iron binding capacity is increased, not reduced, in iron deficiency anemia.
D: Megaloblastic changes in the bone marrow are seen in megaloblastic anemias, not iron deficiency anemia.
Which of the following requires IL-2 and IL-4 in the conversion of unilineage progenitor cell into mature circulating cell?
- A. Neutrophil
- B. Eosinophil
- C. Basophil
- D. B lymphocyte
Correct Answer: D
Rationale: The correct answer is D: B lymphocyte. IL-2 and IL-4 are crucial for the differentiation of B lymphocytes from unilineage progenitor cells. IL-2 supports proliferation and survival of B cells, while IL-4 promotes their differentiation into mature circulating cells. Neutrophils, eosinophils, and basophils develop independently of IL-2 and IL-4. Neutrophils mainly require granulocyte colony-stimulating factor (G-CSF), eosinophils require IL-5, and basophils are influenced by IL-3 and IL-5. Therefore, the correct answer is D as B lymphocytes specifically rely on IL-2 and IL-4 for their maturation.