Nokea
Which of the following is the most suitable anti malarial drug for pregnant women?
- A. Atovaquone and proguanil
- B. Quinine and doxycycline
- C. Quinine and clindamycin
- D. Primaquine
Correct Answer: C
Rationale: The correct answer is C: Quinine and clindamycin. Quinine is recommended for pregnant women due to its safety profile in pregnancy. Clindamycin is often used in combination with quinine to treat malaria during pregnancy.
A: Atovaquone and proguanil are not recommended for pregnant women due to limited safety data.
B: Quinine and doxycycline should be avoided in pregnancy as doxycycline can harm the fetus.
D: Primaquine is not recommended during pregnancy due to potential risks to the fetus.
In summary, the combination of quinine and clindamycin is the most suitable anti-malarial drug for pregnant women due to their safety profiles and efficacy in treating malaria without harming the fetus.
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Which of the following characteristics are similar with respect to Factor VIII and von Willebrand factor (vWF)?
- A. Both are made in endothelial cells and megakaryocytes.
- B. Both are activated by thrombin.
- C. They are present in normal to high relative amounts in newborns.
- D. They are stored in Weibel-Palade bodies in endothelial cells.
Correct Answer: C
Rationale: Step-by-step rationale:
1. Factor VIII and vWF are present in normal to high relative amounts in newborns due to the physiological adaptation to the low levels at birth.
2. Both Factor VIII and vWF play crucial roles in the coagulation cascade, but their levels decrease after birth.
3. The other choices are incorrect because:
- A: Factor VIII is primarily made in endothelial cells and vWF is made in endothelial cells and platelets, not megakaryocytes.
- B: Thrombin activates Factor VIII but not vWF, which is activated by shear stress.
- D: Factor VIII is stored in Weibel-Palade bodies, but vWF is stored in platelets and endothelial cells, not in the Weibel-Palade bodies.
In microcytic hypochromic anaemia
- A. Red cells are larger with normal staining
- B. Red blood cell count is increased
- C. Haemtocrit and mean corpuscular haemoglobin are normal
- D. Red cells are smaller with a pale large central pallor
Correct Answer: D
Rationale: In microcytic hypochromic anemia, the correct answer is D because red cells are smaller (microcytic) and have a pale large central pallor (hypochromic). This is due to decreased hemoglobin content and iron deficiency. Choice A is incorrect as red cells are smaller, not larger. Choice B is incorrect as the red blood cell count is typically decreased in this type of anemia. Choice C is incorrect as both hematocrit and mean corpuscular hemoglobin are decreased in microcytic hypochromic anemia, not normal. Therefore, the correct answer is D based on the characteristic features of microcytic hypochromic anemia.
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.
Splenectomy is contraindicated in:
- A. pyruvate kinase def.
- B. ITP
- C. BM failure
- D. angiogenic myeloid metaplasia
Correct Answer: C
Rationale: The correct answer is C: BM failure. Splenectomy is contraindicated in patients with bone marrow failure due to conditions such as aplastic anemia or myelodysplastic syndromes. The spleen plays a role in removing abnormal blood cells, and removing it can worsen cytopenias in these patients. Choices A, B, and D are not contraindications for splenectomy as they do not directly involve the bone marrow function. Pyruvate kinase deficiency (A) does not affect bone marrow function, ITP (B) is a platelet disorder, and angiogenic myeloid metaplasia (D) is a condition related to abnormal blood cell production, not bone marrow failure.
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.