The nurse is assessing a patient in a family practice clinic. The patient had extensive testing to rule out Hodgkin disease. Which of the following characteristics would indicate Hodgkin disease?
Results indicate the presence of Reed Sternberg cells
The patient is cyanotic
The patient is complaining of excessive thirst and hunger
Results indicate the presence of the Philadelphia chromosome
The Correct Answer is A
A. Results indicate the presence of Reed Sternberg cells: Reed-Sternberg cells are a defining characteristic of Hodgkin disease, a type of lymphoma. Their presence in biopsy samples confirms the diagnosis, distinguishing Hodgkin disease from other types of lymphomas and leukemias.
B. The patient is cyanotic: Cyanosis, or bluish skin discoloration due to low oxygen levels, is not a common sign of Hodgkin disease. It may occur in advanced disease due to respiratory compromise but is not a defining characteristic.
C. The patient is complaining of excessive thirst and hunger: Excessive thirst and hunger are more characteristic of diabetes mellitus, not Hodgkin disease. These symptoms are unrelated to the lymphatic involvement seen in Hodgkin disease.
D. Results indicate the presence of the Philadelphia chromosome: The Philadelphia chromosome is a genetic abnormality associated with chronic myelogenous leukemia (CML), not Hodgkin disease. Its presence suggests a different hematologic malignancy.
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Correct Answer is A
Explanation
A. Activity intolerance related to tissue hypoxia: Pernicious anemia leads to a decrease in the body’s ability to carry oxygen due to a lack of intrinsic factor and subsequent vitamin B12 deficiency, resulting in tissue hypoxia. This can cause fatigue and activity intolerance as the body struggles to meet its oxygen demands.
B. Ineffective airway clearance related to dyspnea: Dyspnea may occur, but ineffective airway clearance is not directly related to pernicious anemia, as this condition primarily affects oxygen transport, not the airway.
C. Risk for infection related to reduction in white blood cells (WBCs): Pernicious anemia primarily affects red blood cells due to vitamin B12 deficiency; it does not typically lead to a reduction in white blood cells.
D. Chronic pain related to bone marrow dysfunction: While bone marrow may be affected in some anemias, chronic pain is not a typical symptom of pernicious anemia, and bone marrow dysfunction is not usually present.
Correct Answer is A
Explanation
A. The spleen is the primary site for platelet destruction. In ITP, the spleen often sequesters and destroys platelets, leading to low platelet levels. Removing the spleen reduces platelet destruction and can help increase platelet counts in affected patients.
B. The spleen is at risk for infection due to the critical loss of WBCs. While infection risk increases after splenectomy, this is not the rationale for the procedure. The spleen does play a role in immune function, but splenectomy is indicated for reducing platelet destruction, not infection prevention.
C. Your spleen is making too many platelets. The spleen does not produce platelets; rather, it filters and sometimes destroys them, particularly in ITP. This choice does not accurately reflect the pathophysiology of ITP.
D. The spleen causes an overabundance of immature platelets. The spleen does not cause an increase in immature platelets. In ITP, platelets are destroyed, not overproduced.