The nurse is teaching the parent of a child with hemophilia. Which of the following statements by the parent demonstrates understanding about preventing bleeding episodes?
"My son will have to grow a beard."
"My son will have to avoid contact sports."
"My son will have to avoid fresh foods such as fruit in his diet."
"My son will always have to live near a major hospital."
The Correct Answer is B
A. "My son will have to grow a beard." Growing a beard is irrelevant to managing hemophilia and preventing bleeding.
B. "My son will have to avoid contact sports." Avoiding contact sports is essential for children with hemophilia to reduce the risk of trauma and bleeding episodes due to their clotting factor deficiency.
C. "My son will have to avoid fresh foods such as fruit in his diet." Fresh foods like fruits do not pose a bleeding risk for hemophilia; dietary restrictions are generally unnecessary in managing this condition.
D. "My son will always have to live near a major hospital."While proximity to a healthcare facility can be helpful in emergencies, this is not a requirement for managing hemophilia, nor does it directly prevent bleeding episodes.
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Correct Answer is A
Explanation
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.
Correct Answer is D
Explanation
A. Hematocrit 35% (F 37%–47%; M 42%–52%): Although the hematocrit is slightly low, it is not as concerning as a low platelet count, which poses an immediate risk for bleeding.
B. Bone pain: Bone pain is common in leukemia due to bone marrow expansion, but it does not take priority over the risk of bleeding from thrombocytopenia.
C. Weight loss: Weight loss may be a symptom of leukemia, but it is not immediately life-threatening and does not take priority over a low platelet count that increases bleeding risk.
D. Platelet count 125,000/mm³ (150,000–400,000): A low platelet count is concerning in leukemia patients because it increases the risk of bleeding. Monitoring for and preventing bleeding is a high priority due to thrombocytopenia associated with leukemia.