A 62-year-old woman with fever, night sweats, weight loss, large cell lymphoma. Prognosis?

Correct Answer: C

Rationale: The correct answer is C: Aggressive, may be cured with chemo. In large cell lymphoma, aggressive treatment with chemotherapy has shown potential for cure. This is supported by studies showing high response rates and long-term survival in patients receiving appropriate chemo regimens. Indolent lymphomas (choice A) are slow-growing and typically do not require aggressive treatment. Aggressive lymphomas with poor chemo response (choice B) have a worse prognosis compared to large cell lymphomas. Responding but relapsing (choice D) indicates a temporary response followed by disease recurrence, which is less favorable than potential cure with chemo.

Correct Answer: B

Rationale: The correct answer is B: Transfuse factor VIII concentrate. In hemophilia A, deficiency of factor VIII leads to impaired blood clotting. Therefore, administering factor VIII concentrate is crucial to control bleeding in this patient. This step takes priority over other options as it addresses the underlying issue of hemophilia A. Choice A is not the priority as stabilizing the patient's bleeding takes precedence over radiography. Choice C is unnecessary until the patient's bleeding is controlled. Choice D, infusing normal saline, does not address the primary concern of bleeding in a hemophiliac patient.

Correct Answer: C

Rationale: Correct Answer: C - LPN with 2 years oncology experience Rationale: An LPN with 2 years of oncology experience is the best choice as they have specific knowledge and skills in oncology care, which is crucial when managing a patient with a low ANC. They can provide appropriate care under the supervision of an oncology RN. Incorrect Choices: A: LPN from same-day surgery - Lacks oncology-specific experience. B: RN from agency on orientation - Limited experience in oncology care. D: RN new from ED - Limited oncology knowledge and experience.

Correct Answer: B

Rationale: The correct answer is B: Valine for glutamic acid. This substitution occurs in sickle hemoglobin, where a single nucleotide change leads to the replacement of glutamic acid by valine at the sixth position of the beta chain. This change results in the characteristic sickling of red blood cells. Choices A, C, and D do not correspond to the specific substitution seen in sickle hemoglobin and are therefore incorrect. It is crucial to understand the molecular basis of the disease to differentiate the correct answer from the distractors.

Correct Answer: C

Rationale: The correct answer is C: Surgical lymph node excision. This is the most appropriate diagnostic test for lymphadenopathy with suspected lymphoma as it provides an adequate tissue sample for definitive diagnosis through histopathological examination. Fine-needle aspirate (B) may not yield enough tissue for accurate diagnosis. Abdominal x-ray (A) and bone scan (D) are not specific for assessing lymphoma and do not provide tissue for histological examination. Surgical excision allows for comprehensive evaluation of the lymph node architecture and cellular characteristics, aiding in accurate diagnosis and treatment planning.