Nokea
The nurse is reviewing laboratory results and notes an aPTT level of 28 seconds. The nurse should notify the health care provider in anticipation of adjusting which medication?
- A. Aspirin
- B. Heparin
- C. Warfarin
- D. Erythropoietin
Correct Answer: B
Rationale: The correct answer is B: Heparin. An aPTT level of 28 seconds indicates a shorter clotting time than normal, suggesting that the patient may be at risk for bleeding due to excessive anticoagulation with heparin. The nurse should notify the healthcare provider to adjust the heparin dosage to prevent bleeding complications.
A: Aspirin is an antiplatelet medication and does not affect aPTT levels.
C: Warfarin is a vitamin K antagonist and primarily affects the PT/INR levels, not aPTT.
D: Erythropoietin is a hormone that stimulates red blood cell production and does not affect clotting parameters such as aPTT.
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While taking a client history, which factor(s) that place the client at risk for a hematologic health problem will the nurse document? (Select all that apply.)
- A. Family history of military excellence
- B. Diet low in iron and protein
- C. Excessive alcohol consumption
- D. Family history of allergies
Correct Answer: C
Rationale: The correct answer is C: Excessive alcohol consumption. Alcohol can lead to various hematologic health problems such as anemia, bleeding disorders, and impaired immune function. Excessive alcohol intake can disrupt the production of red blood cells and platelets, leading to an increased risk of hematologic issues. Family history of military excellence (A) and family history of allergies (D) are not directly related to hematologic health problems. A diet low in iron and protein (B) can contribute to hematologic issues, but it is not as direct a risk factor as excessive alcohol consumption.
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 transplantation (BMT) because it offers the potential for cure by replacing the abnormal cells with healthy donor cells. This is the only option that can provide long-term disease control and potential cure for CML. Hydroxyurea (choice A) is a cytotoxic drug used for symptom control but does not target the underlying cause. Interferon alpha (choice C) can help control the disease but is less effective in achieving long-term remission compared to BMT. Radiotherapy (choice D) is not a standard treatment for CML and is not curative.
Which of the following is associated with normocytic normochromic anaemia?
- A. Iron deficiency
- B. Primaquine
- C. Pregnancy
- D. Sickle cell disease
Correct Answer: C
Rationale: Normocytic normochromic anemia is characterized by normal-sized red blood cells with normal hemoglobin content. Pregnancy is associated with this type of anemia due to increased blood volume and iron demands. Iron deficiency anemia (choice A) is typically microcytic hypochromic. Primaquine (choice B) is not known to cause normocytic normochromic anemia. Sickle cell disease (choice D) results in hemolytic anemia with abnormal red blood cell morphology. Thus, the correct answer is C as it aligns with the characteristics of normocytic normochromic anemia.
A patient with a diagnosis of acute myeloid leukemia (AML) is being treated with induction therapy on the oncology unit. What nursing action should be prioritized in the patient's care plan?
- A. Protective isolation and vigilant use of standard precautions
- B. Provision of a high-calorie, low-texture diet and appropriate oral hygiene
- C. Including the family in planning the patient's activities of daily living
- D. Monitoring and treating the patient's pain
Correct Answer: A
Rationale: The correct answer is A: Protective isolation and vigilant use of standard precautions. This is the priority because patients with AML are at high risk for infections due to compromised immune systems. Isolation and strict infection control measures help prevent exposure to pathogens. B is incorrect as the main priority is infection prevention, not diet. C is incorrect as involving the family is important but not the priority. D is incorrect as pain monitoring is important but not the priority in this case.
A home health nurse is caring for a patient with multiple myeloma. Which of the following interventions should the nurse prioritize when addressing the patient's severe bone pain?
- A. Implementing distraction techniques
- B. Educating the patient about the effective use of hot and cold packs
- C. Teaching the patient to use NSAIDs effectively
- D. Helping the patient manage the opioid analgesic regimen
Correct Answer: D
Rationale: The correct answer is D: Helping the patient manage the opioid analgesic regimen. This is the priority intervention for severe bone pain in multiple myeloma because opioids are the most effective for managing severe pain. Opioids target the central nervous system to reduce pain perception, providing significant relief. Implementing distraction techniques (A) may offer temporary relief but will not address the underlying pain. Educating about hot and cold packs (B) may be helpful for mild pain but is not sufficient for severe bone pain. Teaching NSAIDs (C) is not recommended for multiple myeloma pain management due to potential kidney issues.