A patient has hypochromic microcytic red blood cells with some target cells. The spleen is somewhat enlarged. The reticulocyte count is 9%. The following procedure is most likely give the definitive diagnosis:

Correct Answer: C

Rationale: Hypochromic microcytic RBCs, target cells, splenomegaly, and 9% reticulocytes suggest thalassemia hemoglobin electrophoresis (C) confirms (e.g., HbAâ‚‚ >3.5%). Serum iron (A) differentiates iron deficiency (normal here). Marrow exam (B) shows erythroid hyperplasia, not specific. Fragility (D) fits spherocytosis. Serum electrophoresis is proteins, not Hb. Electrophoresis pinpoints Hb variants, key in nursing for genetic diagnosis and family screening.

Correct Answer: D

Rationale: Lymphocytes (D) are most radiation-sensitive rapidly dividing, they die at low doses (e.g., 1-2 Gy), dropping counts within days (e.g., <1000/μL). Erythrocytes (A) lack nuclei, resisting damage. Basophils (B), eosinophils (C), and granulocytes (E neutrophils) tolerate higher doses, declining later. Lymphocytes' vulnerability reflects marrow suppression, key in nursing for radiation exposure monitoring and infection prophylaxis.

Correct Answer: B

Rationale: Secondary polycythemia hypoxia-driven RBC rise occurs in hypernephroma (A erythropoietin), emphysema (C low Oâ‚‚), AV aneurysms (D shunting), and cyanotic heart disease (E chronic hypoxia), but not peptic ulcer (B) GI bleeding causes anemia, not polycythemia. Hypoxia's erythropoietic trigger is key, guiding nursing for underlying cause workup.

Correct Answer: B

Rationale: Hemophilia joint bleed (e.g., factor VIII <1%) fresh frozen plasma (B) replaces clotting factors (e.g., 15 mL/kg raises VIII to 30%), stopping hemarthrosis. Transfusion (A) lacks factors. Bed rest (C) aids, not treats. Vitamin K (D) is for liver factors. Protamine reverses heparin. FFP's factor delivery is key, guiding nursing for infusion and joint care.

Correct Answer: B

Rationale: Anemia of renal insufficiency low erythropoietin (B e.g., <100 mU/mL) from kidney failure slows RBC production, with reduced marrow transit (e.g., 5-7 days). Iron block (A) is chronic disease. Normocytic (C) describes, not causes. Blood loss (D) is unrelated. EPO deficiency is key, guiding nursing for EPO therapy.