Nokea
The nurse is monitoring a patient receiving a blood product and is concerned that the blood is going to deteriorate before it is complete infused. What is the maximum time that blood can hang during infusion before it begins to deteriorate?
- A. 1 hour
- B. 2 hours
- C. 3 hours
- D. 4 hours
Correct Answer: D
Rationale: The correct answer is D: 4 hours. Blood products typically have a maximum hang time of 4 hours to reduce the risk of bacterial contamination and ensure the integrity of the product. Beyond this time, there is an increased risk of bacterial growth, which can lead to serious infections in the patient. It is crucial to adhere to the recommended hang time to maintain the safety and efficacy of the blood product.
Summary of other choices:
A: 1 hour - Too short of a time frame for a blood product to be infused, as it would not allow for the complete administration.
B: 2 hours - While closer to the correct answer, it still falls short of the recommended 4-hour maximum hang time for blood products.
C: 3 hours - Again, this is not the optimal choice as it exceeds the safe hang time for blood products, increasing the risk of contamination and deterioration.
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A 60-year-old patient with chronic myeloid leukemia will be treated in the home setting and the nurse is preparing appropriate health education. What topic should the nurse emphasize?
- A. The importance of adhering to the prescribed drug regimen
- B. The need to ensure that vaccinations are up to date
- C. The importance of daily physical activity
- D. The need to avoid shellfish and raw foods
Correct Answer: A
Rationale: The correct answer is A: The importance of adhering to the prescribed drug regimen. This is crucial for managing chronic myeloid leukemia effectively. Non-adherence can lead to disease progression and treatment failure. Option B is important but not as critical as medication adherence. Option C is generally good for overall health but not specific to managing the disease. Option D is irrelevant to the management of chronic myeloid leukemia.
A 35-year-old male is admitted to the hospital complaining of severe headaches, vomiting, and testicular pain. His blood work shows reduced numbers of platelets, leukocytes, and erythrocytes, with a high proportion of immature cells. The nurse caring for this patient suspects a diagnosis of what?
- A. AML
- B. CML
- C. MDS
- D. ALL
Correct Answer: D
Rationale: The correct answer is D: ALL (Acute Lymphoblastic Leukemia). In this case, the patient's symptoms of severe headaches, vomiting, testicular pain, reduced blood cell counts, and high proportion of immature cells indicate a rapidly progressing hematologic malignancy affecting lymphoid cells. AML (Choice A) primarily affects myeloid cells, not lymphoid cells. CML (Choice B) is a chronic myeloid disorder and presents differently with elevated leukocyte count and mature cells. MDS (Choice C) is a group of disorders characterized by abnormal blood cell production, but the presentation in this patient is more indicative of an acute leukemia.
A young child with consanguineous parents has developmental delay and a history of multiple recurrent bacterial infections and short stature. He presents to the emergency department following trauma and requires a blood transfusion. Blood work identifies leukocytosis, neutrophilia, and the Bombay blood group (absent H antigen as well as absent A and B antigens). What is this patient's diagnosis?
- A. Chediak-Higashi syndrome
- B. Leukocyte adhesion deficiency (LAD) Type II
- C. CD18 deficiency
- D. Griscelli syndrome
Correct Answer: B
Rationale: The correct answer is B: Leukocyte adhesion deficiency (LAD) Type II. This diagnosis is supported by the patient's history of recurrent bacterial infections, leukocytosis, neutrophilia, and the Bombay blood group. LAD Type II is characterized by a defect in the CD18 integrin molecules, leading to impaired leukocyte adhesion and migration to sites of infection. The Bombay blood group is due to the absence of H antigen, which is also seen in LAD Type II.
A: Chediak-Higashi syndrome is characterized by recurrent infections, albinism, and peripheral neuropathy, not leukocyte adhesion deficiency.
C: CD18 deficiency is actually another term for LAD Type I, not LAD Type II.
D: Griscelli syndrome presents with silvery hair and immunodeficiency, but does not involve leukocyte adhesion deficiency.
A nurse is caring for a client who is experiencing an acute ischemic cerebrovascular event due to a thrombus in a cerebral vessel. Which of the following drugs should the nurse expect to administer?
- A. Alteplase
- B. Aspirin
- C. Clopidogrel
- D. Heparin
Correct Answer: A
Rationale: The correct answer is A: Alteplase. Alteplase is a thrombolytic agent used to dissolve blood clots and restore blood flow in acute ischemic stroke. It is crucial to administer within a specific time frame for the best outcome. Aspirin (B) and Clopidogrel (C) are antiplatelet agents that prevent further clot formation but are not used for immediate clot dissolution in acute ischemic stroke. Heparin (D) is an anticoagulant that prevents clot formation and is not typically used as the initial treatment for acute ischemic stroke.
A study is designed to investigate the rates of central line–associated blood stream infections (CLABSI) among pediatric hematology/oncology patients. Investigators wish to compare the length of stay (LOS) between subjects receiving three common central line types (totally implanted catheter [port], peripherally inserted central catheter [PICC], and tunneled externalized catheter [TEC]). It is discovered that LOS is not normally distributed. What is the appropriate test for comparing the LOS between patients receiving the three central line types?
- A. Student's t test
- B. ANOVA
- C. Wilcoxon-Mann-Whitney test
- D. Kruskal-Wallis test
Correct Answer: D
Rationale: The correct answer is D: Kruskal-Wallis test. This non-parametric test is used to compare the medians of three or more independent groups when the data is not normally distributed, as in this case with LOS. It is an extension of the Wilcoxon-Mann-Whitney test, which compares two groups. The Kruskal-Wallis test assesses whether the medians of the groups are equal or different by ranking all observations, calculating the sum of ranks for each group, and then comparing these sums. It is appropriate here because it allows for comparison of central line types without assuming normality. The other choices (A: Student's t test and B: ANOVA) require the data to be normally distributed, which is not the case in this scenario. Choice C: Wilcoxon-Mann-Whitney test is for comparing two groups, not three or more.