A 43-year-old woman with fatigue, heavy periods, low iron, ferritin. Anemia?

Correct Answer: B

Rationale: The correct answer is B: Iron deficiency anemia. This woman presents with fatigue, heavy periods, low iron, and ferritin levels, which are classic symptoms of iron deficiency anemia. Iron is essential for red blood cell production, and a deficiency leads to decreased oxygen-carrying capacity causing fatigue. Thalassemia (choice A) would show microcytic anemia with normal iron studies. Sideroblastic anemia (choice C) presents with ringed sideroblasts on bone marrow biopsy. Anemia of chronic disease (choice D) is typically normocytic or microcytic and occurs in chronic inflammatory conditions.

Correct Answer: D

Rationale: The correct answer is D because neutropenia (low neutrophil count) from chemotherapy puts the patient at high risk for infections. This information is crucial for the LTC nurse to monitor the patient closely, implement infection control measures, and promptly recognize and manage any signs of infection to prevent complications. Choices A, B, and C are less relevant in the context of patient safety and immediate care needs compared to neutropenia. A: Philadelphia chromosome is important for diagnosis but does not impact immediate care in LTC. B: Elevated glucose may require monitoring but is not as urgent as neutropenia. C: Weight loss is concerning but not as immediately life-threatening as neutropenia.

Correct Answer: D

Rationale: The principal goal of hydroxyurea therapy is to increase circulating fetal hemoglobin (HbF), which has anti-sickling properties and reduces the frequency of sickle cell crises. Hydroxyurea stimulates HbF production by inducing the expression of gamma-globin genes. This helps to inhibit the polymerization of sickle hemoglobin (HbS) and decrease the proportion of sickled cells in circulation. Choices A and B are incorrect because the goal is not to decrease circulating HbS or increase its polymerization. Choice C is incorrect as hydroxyurea does not directly affect the water content of red cells. The correct answer, choice D, aligns with the therapeutic mechanism of hydroxyurea in increasing levels of HbF to improve clinical outcomes in sickle cell disease.

Correct Answer: D

Rationale: The correct answer is D, Rituximab + CHOP, for advanced diffuse large B-cell lymphoma due to proven efficacy in clinical trials. Rituximab targets CD20 on B-cells, enhancing CHOP's effectiveness. A: m-BACOD and B: PROMACE-CytaBOM are outdated regimens. C: CHOP alone lacks the benefit of rituximab's targeted therapy.

Correct Answer: A

Rationale: The correct answer is A: Chronic atrophic gastritis. This condition leads to vitamin B12 deficiency, causing macrocytic anemia, weakness, and tingling. Chronic atrophic gastritis affects the stomach's ability to produce intrinsic factor needed for B12 absorption. Ileal resection impairs B12 absorption, tapeworm infestation competes for B12, and alcoholism can lead to poor diet and malabsorption, all contributing to macrocytic anemia.