A patient who underwent lymphangiography the day before asks the licensed practical nurse (LPN), “Why does my urine look blue?” What should the LPN respond to this patient's concern?

Correct Answer: D

Rationale: The correct answer is D because the dye used in lymphangiography can cause bluish skin and urine for up to 2 days. This is a known side effect of the procedure and is not a cause for concern. Choice A is incorrect because dismissing the patient's concern without explanation is not appropriate. Choice B is incorrect because there is no need to notify the RN and physician immediately for this known side effect. Choice C is incorrect because the blue urine does not necessarily indicate abnormal results, but rather a normal reaction to the dye used.

Correct Answer: C

Rationale: The correct answer is C: Numbness of the extremities. Pernicious anemia is caused by a deficiency in vitamin B12, leading to nerve damage. Numbness in the extremities is a common symptom due to neurological complications. Yellow-tinged sclerae (A) are seen in jaundice, not pernicious anemia. A shiny smooth tongue (B) is characteristic of glossitis, not pernicious anemia. Gum bleeding and tenderness (D) are more indicative of periodontal disease or vitamin C deficiency, not pernicious anemia.

Correct Answer: A

Rationale: The correct answer is A: It inhibits thrombin. Rivaroxaban is a direct factor Xa inhibitor, which works by specifically inhibiting the activity of factor Xa, a key enzyme in the coagulation cascade. By inhibiting factor Xa, rivaroxaban prevents the formation of thrombin, a crucial enzyme in the blood clotting process. Thrombin is responsible for converting fibrinogen to fibrin, which forms the meshwork of a blood clot. Therefore, by inhibiting thrombin formation, rivaroxaban effectively prevents blood clots from forming. Choice B is incorrect because rivaroxaban does not directly inhibit fibrinogen; it acts upstream by inhibiting factor Xa. Choice C is incorrect because rivaroxaban does not actually "thin" the blood like warfarin or heparin; it specifically targets factor Xa. Choice D is incorrect because rivaroxaban does not work against vitamin K like warfarin

Correct Answer: A

Rationale: The correct answer is A. Assessing client fears and coping mechanisms is the best action because it allows the nurse to understand the client's specific concerns and provide individualized support. This helps address the root cause of anxiety and establish trust. Reassuring the client (B) may not address the underlying fears. Sedating the client (C) without addressing the anxiety may lead to dependency on sedatives. Telling the client they will be asleep (D) may create false expectations and not address the client's emotional needs. Assessing fears and coping mechanisms enables tailored support, promoting trust and comfort.

Correct Answer: A

Rationale: The correct answer is A: Time to marrow relapse since initial diagnosis. This is because the time to marrow relapse indicates the aggressiveness of the leukemia and how quickly it has returned post-treatment. Quicker relapse indicates more aggressive disease, impacting survival. Choice B, sex, is not a significant factor in survival post-relapse. Choice C, central nervous system involvement, affects treatment but is not the primary factor for survival. Choice D, response to induction therapy, is crucial for initial treatment success but not the most important factor post-relapse survival. Therefore, choice A is the most critical factor for survival after relapse of acute lymphoblastic leukemia.