40-year-old with palpebral edema, lymphadenopathy, megaesophagus. Vector?

Correct Answer: C

Rationale: The correct answer is C: Rhodnius prolixus. This insect is a vector for Trypanosoma cruzi, causing Chagas disease. Palpebral edema, lymphadenopathy, and megaesophagus are common manifestations. Glossina morsitans transmits African Trypanosomiasis (sleeping sickness) with different symptoms. Ixodes scapularis transmits Lyme disease. Simulium damnosum transmits Onchocerciasis (river blindness). Thus, Rhodnius prolixus is the correct vector based on the provided symptoms.

Correct Answer: C

Rationale: Schistocytes are fragmented red blood cells formed due to mechanical trauma in the circulation. In the context of microangiopathic hemolytic anemia (MAHA), such as in thrombotic thrombocytopenic purpura or hemolytic uremic syndrome, schistocytes are commonly seen due to the presence of microthrombi in small vessels. This mechanical destruction of red blood cells leads to the characteristic appearance of schistocytes on peripheral blood smear. Therefore, the correct answer is C. Sickle cell trait (choice A) and thalassemia (choice B) do not typically present with schistocytes. In immune thrombocytopenic purpura (ITP) (choice D), the destruction of platelets by autoantibodies does not typically cause schistocytes formation.

Correct Answer: A

Rationale: The correct answer is A: Phlebotomus species. Visceral leishmaniasis is transmitted by sandflies of the genus Phlebotomus in Asia. These sandflies are the main vectors for the parasite that causes the disease. Phlebotomus species are known to transmit Leishmania donovani, the causative agent of visceral leishmaniasis. Lutzomyia species (B) are primarily found in the Americas and are more commonly associated with cutaneous leishmaniasis. Anopheles species (C) are known vectors for malaria, not visceral leishmaniasis. Mansonia species (D) are associated with transmitting various viruses, not Leishmania parasites. Therefore, the correct answer is A as Phlebotomus species are the main vectors of visceral leishmaniasis in Asia.

Correct Answer: C

Rationale: The correct answer is C: IgG. IgG is the major immunoglobulin in human serum, comprising about 80% of the pool. IgA is mainly found in mucosal secretions, IgD is involved in B cell activation, and IgM is the first antibody produced in response to an infection. IgG is the most abundant and versatile immunoglobulin, providing long-term immunity through neutralization, opsonization, and complement activation. Its high concentration in serum makes it crucial for defending against various pathogens.

Correct Answer: D

Rationale: The correct answer is D: Place on safety precautions. With a platelet count of 58,000/mm³, the client is at risk for bleeding due to thrombocytopenia. Safety precautions include measures to prevent injury and bleeding, such as using soft-bristled toothbrushes, avoiding sharp objects, and maintaining a safe environment. Encouraging high-protein foods (choice A) is not directly related to managing low platelet count. Neutropenic precautions (choice B) are for clients with low white blood cell counts, not platelet issues. Limiting visitors (choice C) may reduce infection risk but does not address the bleeding risk associated with low platelet count.