A 26-year-old man with testicular mass, periaortic lymphadenopathy. Next diagnostic study?

Correct Answer: C

Rationale: The correct next diagnostic study for a 26-year-old man with testicular mass and periaortic lymphadenopathy is to measure α-fetoprotein, β-hCG, and LDH levels (Choice C). This is because these tumor markers (α-fetoprotein, β-hCG, LDH) are essential in the evaluation of testicular cancer. Elevated levels of these markers can indicate the presence of germ cell tumors. Needle biopsy of a retroperitoneal mass (Choice A) would not be the initial step as it does not directly evaluate the testicular mass. Needle aspiration of the testicular mass (Choice B) may yield limited information compared to tumor marker levels. PET scan (Choice D) is typically not the first-line investigation for testicular cancer evaluation.

Correct Answer: C

Rationale: The correct answer is C because the patient post-colonoscopy with chronic GI bleeding requires close monitoring and immediate intervention if any complications arise. The float nurse from PACU is experienced in handling post-operative patients and can provide appropriate care for this patient's needs. Choice A is incorrect because a patient with thalassemia major receiving deferoxamine does not require immediate post-operative care. Choice B is incorrect as the patient with multiple myeloma needing discharge teaching can be managed by a regular floor nurse. Choice D is incorrect as the patient with pernicious anemia does not have urgent post-operative care needs.

Correct Answer: A

Rationale: The correct answer is A because a 30-year-old with renal failure needing epoetin alfa would benefit from a Licensed Practical Nurse (LPN) due to the need for ongoing medication administration and monitoring. Renal failure and epoetin alfa therapy require regular assessment of vital signs, medication side effects, and patient response, tasks well within an LPN's scope of practice. Summary: - Choice B is incorrect as managing hemophilia B for PRBCs requires specialized knowledge and skills beyond an LPN's scope. - Choice C is incorrect as managing polycythemia vera for phlebotomy involves more complex care that is typically outside an LPN's scope. - Choice D is incorrect as post-stem cell transplant care, including bone marrow aspiration, requires a higher level of nursing expertise typically provided by a Registered Nurse or Nurse Practitioner.

Correct Answer: B

Rationale: The correct answer is B: Hemoglobin 7.1 g/dL. In ITP, low platelet count is common but does not typically require immediate reporting unless there are signs of significant bleeding. Hemoglobin of 7.1 g/dL indicates severe anemia, which requires prompt evaluation to assess the need for transfusion and determine the underlying cause. Increased eosinophils (A) are not typically concerning in ITP. Platelet count of 40,000/mm³ (C) is expected in ITP. Elevated reticulocyte count (D) may indicate compensatory response to anemia but does not warrant immediate reporting.

Correct Answer: C

Rationale: The correct answer is C because bleeding time evaluates platelet function in vivo by measuring the time it takes for a small, standardized skin incision to stop bleeding. This test directly assesses the primary hemostasis process mediated by platelets. Choice A is incorrect because bleeding time can be influenced by various factors, making it less reliable and reproducible. Choice B is incorrect because bleeding time is typically evaluated using a stopwatch, not an optical densitometer. Choice D is incorrect because bleeding time is not a commonly ordered test due to its limitations and variability in results.