A client has just received an allogenic bone marrow transplant as treatment for non-Hodgkin's lymphoma. The client is showing signs of rejection. What is this term called?

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Graft versus host disease. Graft versus host disease (GVHD) occurs when the transplanted donor cells recognize the recipient's body as foreign and attack it. This immune response can manifest as various symptoms, including skin rash, gastrointestinal issues, and liver problems. Option A) Lymphoma relapse is incorrect because it refers to the return of cancer cells after a period of remission, not rejection of the transplant. Option B) Short remission is incorrect as it does not relate to the immune response following a bone marrow transplant. Option C) Bone marrow transplant rejection is also incorrect because rejection typically involves the recipient's immune system attacking the donor cells, not vice versa. Educationally, understanding GVHD is crucial for healthcare providers managing patients post-bone marrow transplant. Recognizing the signs and symptoms early can lead to prompt intervention and better outcomes for the patient. It highlights the complex interplay between the donor and recipient immune systems in transplantation, emphasizing the importance of monitoring and managing immune responses in these patients.

Correct Answer: C

Rationale: In this scenario, the correct answer is option C) 50 gtt./min. To understand why this is the correct flow rate, we need to consider the components of the question. Mr. Kirby is receiving 250 ml of D5W with 1 mg of isoproterenol every 5 hours. The administration set delivers 60 gtt./ml. To calculate the flow rate in drops per minute, we need to consider the total volume to be infused over 5 hours and the drip factor of the administration set. First, we need to calculate the total volume to be infused in 5 hours: 250 ml every 5 hours = 50 ml/hour Next, we convert ml/hour to drops per minute using the drip factor: 1 ml = 60 gtt. 50 ml = 50 * 60 gtt. = 3000 gtt. Since the total volume is to be infused over 5 hours, and we need to find the flow rate in drops per minute: 3000 gtt. / 300 minutes = 10 gtt./min Therefore, the correct flow rate is 50 gtt./min, as option C states. Option A) 5 gtt./min, Option B) 10 gtt./min, and Option D) 1 gtt./min are incorrect because they do not accurately calculate the flow rate based on the information provided in the question. In an educational context, understanding how to calculate intravenous flow rates is crucial for nurses and healthcare professionals to ensure accurate medication administration and patient safety. This question challenges learners to apply their knowledge of drip factors, volume calculations, and time conversions to determine the appropriate flow rate for intravenous therapy. Mastering these calculations is essential in providing quality patient care and preventing medication errors.

Correct Answer: B

Rationale: In early pregnancy, simple anemia can develop due to increased blood volume and demands for iron by the growing fetus. The correct advice for the nurse to give the woman in this scenario is to increase dietary protein, iron, and vitamins (Option B). This recommendation is crucial as it helps to address the underlying cause of anemia and supports the woman and her developing baby's nutritional needs. Option A, checking the pulse three times a day, is incorrect as it does not directly address the nutritional deficiency that is causing the anemia. Monitoring the pulse may be important in certain situations but is not the priority in this case. Option C, restricting rest, is also incorrect. Rest is important during pregnancy, especially when anemia is present, but it is not the primary intervention needed to address the nutritional deficiencies causing the anemia. Option D, avoiding overeating, is not the correct advice either. While maintaining a healthy diet is important, simply avoiding overeating does not specifically address the need for increased intake of essential nutrients like iron, protein, and vitamins that are necessary to combat anemia. Educationally, this question highlights the importance of understanding the nutritional needs of pregnant women, especially when complications like anemia arise. It reinforces the significance of providing appropriate dietary advice to support both the mother and the developing fetus during pregnancy. By choosing the correct answer, nurses can help prevent and manage anemia effectively, promoting better maternal and fetal outcomes.

Correct Answer: B

Rationale: In the acute phase of pernicious anemia, nursing care should focus on addressing the symptoms and complications of the condition. Bed rest with range-of-motion exercises is the correct option because it helps prevent complications like deep vein thrombosis and promotes circulation without exerting excessive energy that the patient may lack due to anemia. Option A is incorrect as placing limits on food, fluids, and activity can worsen the patient's condition by restricting essential nutrients and preventing necessary movement. Option C, preparation for blood transfusion, is incorrect because pernicious anemia is primarily due to vitamin B12 deficiency, not necessarily a lack of blood that would require a transfusion. Option D, providing a heating pad, is incorrect as warmth does not address the underlying cause or symptoms of pernicious anemia. Educationally, understanding the rationale behind the correct answer emphasizes the importance of tailored nursing care for patients with pernicious anemia. It highlights the need for interventions that address the specific needs and symptoms of the condition to promote optimal patient outcomes. This question also reinforces the significance of knowledge in providing evidence-based care to individuals with hematologic disorders.

Correct Answer: A

Rationale: In understanding why option A is the correct answer in this question about hemophilia A, it is crucial to grasp the pathophysiology of the condition. Hemophilia A is a genetic disorder characterized by a deficiency in clotting factor VIII, leading to impaired blood clotting. Due to this deficiency, bleeding in individuals with hemophilia A is often delayed after trauma because the clotting process is disrupted. This delayed bleeding is a hallmark feature of hemophilia A and distinguishes it from other bleeding disorders. Regarding why the other options are incorrect: - Option B: Hemarthrosis, or bleeding into joint spaces, is actually a common and significant complication in individuals with hemophilia A due to their impaired clotting mechanism. - Option C: In hemophilia A, coagulation and bleeding time are prolonged, not severely prolonged, due to the deficiency in factor VIII. - Option D: Client education plays a crucial role in managing hemophilia A by empowering individuals to recognize symptoms early, seek appropriate care, and prevent complications. Therefore, stating that client education is ineffective is inaccurate. Educational context: Understanding the key clinical manifestations and complications of hemophilia A is essential for healthcare professionals working in hematology and oncology. By grasping the nuances of this condition, clinicians can provide optimal care and support to individuals with hemophilia A, emphasizing the importance of early recognition, prompt treatment, and ongoing education to prevent complications and improve outcomes.