A client is diagnosed with scleroderma. Which intervention should the nurse anticipate to be prescribed?

Correct Answer: B

Rationale: The correct answer is B: Administer corticosteroids as prescribed for inflammation. In scleroderma, corticosteroids are commonly prescribed to reduce inflammation and manage symptoms. Bed rest (A) is not typically recommended as it can lead to muscle weakness. Remaining supine after meals (C) is not necessary for scleroderma. Keeping the room temperature warm during the day and cool at night (D) may provide comfort but does not directly address the underlying condition of scleroderma.

Correct Answer: B

Rationale: The correct answer is B: Chronic Myelogenous Leukemia (CML). The presentation of a 60-year-old man with abdominal fullness, fatigue, leukocytosis, thrombocytosis, and the presence of the Philadelphia chromosome strongly suggests CML. The Philadelphia chromosome results from a reciprocal translocation between chromosomes 9 and 22, leading to the formation of the BCR-ABL fusion gene characteristic of CML. This gene encodes a constitutively active tyrosine kinase, driving uncontrolled proliferation of myeloid cells. Acute myeloid leukemia (A) typically presents with bone marrow failure, not leukocytosis and thrombocytosis. Chronic lymphocytic leukemia (C) is more common in older adults, but it is characterized by lymphocytosis, not leukocytosis. Acute lymphocytic leukemia (D) usually presents with pancytopenia and blast cells in the peripheral blood, not leuk

Correct Answer: D

Rationale: The correct answer is D: CT scan of chest, abdomen, pelvis. This is the best next step as it helps in staging the disease extent and planning treatment. A bone marrow biopsy (A) is not typically needed in Hodgkin lymphoma. Liver biopsy (B) is not the initial step in evaluation. Staging laparotomy (C) is an invasive procedure and not the first-line investigation. CT scan (D) is preferred for initial staging due to its ability to detect lymph node involvement and assess organ involvement.

Correct Answer: D

Rationale: Rationale for Answer D (No additional treatment): In this scenario, the patient likely has drug-induced hemolysis from the malaria prophylaxis. Since the hematocrit is not critically low and the patient is stable, the initial step is to discontinue the offending drug and monitor the patient closely. Additional treatment is not required unless the patient deteriorates or develops severe anemia. Summary of other choices: A: Splenectomy is not indicated in this case as the primary issue is drug-induced hemolysis, not a splenic disorder. B: Methylene blue is used for methemoglobinemia, not hemolysis caused by drug toxicity. C: Vitamin E is not the appropriate treatment for drug-induced hemolysis; it is more commonly used for conditions like vitamin E deficiency or antioxidant therapy.

Correct Answer: C

Rationale: The correct answer is C: Folate deficiency. In this case, the patient presents with macrocytic anemia (elevated MCV) and hypersegmented neutrophils, which are characteristic of folate deficiency. Folate is essential for DNA synthesis and red blood cell production. Alcoholism can lead to folate deficiency due to poor dietary intake and malabsorption. Sideroblastic anemia (A) presents with ringed sideroblasts in the bone marrow, thalassemia (B) shows microcytic anemia, and anemia of renal disease (D) is typically normocytic normochromic.