Nokea
Which of the following is wrong concerning Philadelphia chromosome:
- A. shortening of long arm of chromosome 22
- B. Philadelphia:-ve cases have bad prognosis
- C. diagnostic of CML
- D. found in lymphocytes
Correct Answer: D
Rationale: The correct answer is D because the Philadelphia chromosome is found in myeloid (not lymphoid) cells in Chronic Myeloid Leukemia (CML). This is due to a reciprocal translocation between chromosomes 9 and 22, resulting in a shortened chromosome 22q, not chromosome 22 itself. Choice A is incorrect because the long arm of chromosome 22 is affected. Choice B is incorrect as Philadelphia chromosome-negative cases can have a favorable prognosis. Choice C is incorrect as the presence of the Philadelphia chromosome is diagnostic of CML.
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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, red cells are smaller with decreased hemoglobin content, leading to pale appearance. Choice D is correct as it describes the typical characteristics of microcytic hypochromic anemia. Choice A is incorrect as red cells are smaller, not larger. Choice B is incorrect as red blood cell count is usually decreased. Choice C is incorrect as both hematocrit and mean corpuscular hemoglobin are decreased in microcytic hypochromic anemia.
All produce microcytic anemia except:
- A. sideroblastic an.
- B. thalassemia
- C. pernicious anemia
- D. lead poisoning
Correct Answer: C
Rationale: The correct answer is C: pernicious anemia. Pernicious anemia is a macrocytic anemia caused by vitamin B12 deficiency, leading to large red blood cells. Sideroblastic anemia (A) is a type of microcytic anemia due to ineffective iron utilization. Thalassemia (B) causes microcytic anemia due to decreased production of hemoglobin. Lead poisoning (D) can also lead to microcytic anemia by disrupting heme synthesis. Therefore, pernicious anemia is the only choice that does not produce microcytic anemia.
A nurse is caring for a client who is taking filgrastim to treat neutropenia. The nurse should assess the client for which of the following adverse effects?
- A. Dusky nail beds
- B. Petechiae
- C. Enlarged spleen
- D. Swollen calf
Correct Answer: C
Rationale: Step-by-step rationale for why choice C is correct:
1. Filgrastim stimulates the production of neutrophils.
2. An enlarged spleen can indicate an increase in neutrophils.
3. Therefore, assessing the client for an enlarged spleen is crucial to monitor the drug's effectiveness and potential adverse effects.
Summary of why other choices are incorrect:
A: Dusky nail beds - Not directly related to filgrastim or neutropenia.
B: Petechiae - Typically associated with low platelet count, not neutrophil increase.
D: Swollen calf - Unlikely to be a direct adverse effect of filgrastim for neutropenia.
The nurse is caring for a patient who is being discharged after an emergency splenectomy following an automobile accident. Which instructions should the nurse include in the discharge teaching?
- A. Watch for excess bruising.
- B. Check for swollen lymph nodes.
- C. Take iron supplements to prevent anemia.
- D. Wash hands and avoid persons who are ill.
Correct Answer: D
Rationale: Step 1: Patient's immune system is compromised post-splenectomy.
Step 2: Washing hands and avoiding ill individuals reduce infection risk.
Step 3: Emphasizing infection prevention crucial for patient safety.
Summary: A - relates to clotting issues, B - not relevant, C - not immediate concern. Washing hands is most pertinent.
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 is below the therapeutic range for heparin, indicating a subtherapeutic dose. The nurse should notify the healthcare provider to adjust the heparin dosage to achieve the desired anticoagulant effect. Aspirin (choice A) does not affect aPTT levels. Warfarin (choice C) affects PT/INR, not aPTT. Erythropoietin (choice D) is not related to aPTT levels.