A client is having a bone marrow aspiration and biopsy and is extremely anxious. What action by the nurse is the most appropriate?

Correct Answer: A

Rationale: The correct answer is A because assessing the client's fears and coping mechanisms allows the nurse to provide individualized support and interventions to address the client's anxiety effectively. By understanding the client's specific concerns, the nurse can provide tailored information, emotional support, and coping strategies to help the client feel more comfortable during the procedure. Option B is incorrect as simply reassuring the client may not address the underlying anxieties and fears. Option C is inappropriate as sedation should only be used if absolutely necessary and after other non-pharmacological interventions have been exhausted. Option D is incorrect because bone marrow aspiration and biopsy are typically performed with local anesthesia, so the client will not be asleep during the procedure.

Correct Answer: A

Rationale: The correct answer is A. Immunophenotype of mature B cell is not a good prognostic factor in acute lymphoblastic leukemia (ALL) because it indicates a more aggressive subtype. B: Gender being female is a good prognostic factor in ALL as females generally have better outcomes. C: Chromosomal number hyperploidy is a good prognostic factor as it is associated with a favorable prognosis. D: Age 4 to 10 years old is also a good prognostic factor as children in this age group tend to have better outcomes in ALL.

Correct Answer: A

Rationale: The correct answer is A: Nodular sclerosis subtype of Hodgkin's lymphoma. It is common in young women due to its peak incidence in the 20s-30s. This subtype has a good prognosis as it is the most indolent with a high cure rate. It is characterized by fibrotic bands dividing the lymph node into nodules, containing lacunar (Reed-Sternberg) cells. The other choices (B: Mixed cellularity, C: Lymphocyte predominance, D: Lymphocyte depletion) are incorrect: B: Mixed cellularity is more common in older adults and has a less favorable prognosis. C: Lymphocyte predominance is rare and has a favorable prognosis, but it is more common in young males, not young women. D: Lymphocyte depletion is rare, aggressive, and associated with a poor prognosis, not common in young women.

Correct Answer: A

Rationale: Step 1: The patient presents with symptoms of iron deficiency anemia. Step 2: Koilonychias and angular cheilitis are characteristic of iron deficiency anemia. Step 3: Low total iron binding capacity (TIBC) is expected in iron deficiency anemia due to decreased iron stores. Step 4: High serum transferrin and low iron:TIBC ratio are also expected in iron deficiency anemia. Step 5: Therefore, the correct answer is A, as low TIBC is expected in iron deficiency anemia. Summary: B: High serum transferrin and C: Low iron:TIBC ratio are expected in iron deficiency anemia. D: Low serum ferritin is expected in iron deficiency anemia as it is a marker of decreased iron stores.

Correct Answer: B

Rationale: The correct answer is B: Defects in the peripheral proteins. Spherocytosis is characterized by spherical-shaped red blood cells due to defects in the peripheral proteins of the cell membrane, such as spectrin or ankyrin. This results in decreased membrane stability and fragility, leading to hemolysis. Choices A, C, and D are incorrect. Choice A is not the most likely cause as spherocytosis is primarily due to defects in peripheral proteins, not integral proteins. Choice C is incorrect as "ropalux" is not a known factor in spherocytosis. Choice D is incorrect as sickle-shaped cells are characteristic of sickle cell anemia, not spherocytosis.