A patient with thalassemia has been found to have high iron levels. Which of the following agents would be appropriate for management of this patient?

Correct Answer: C

Rationale: The correct answer is C: Deferoxamine. Thalassemia patients often require blood transfusions, leading to iron overload. Deferoxamine is an iron-chelating agent that helps remove excess iron from the body. Ferrous sulphate (A) is an iron supplement and would worsen iron overload. Hydroxycobalamin (B) is a form of vitamin B12 and is not indicated for iron overload. Iron dextran (D) is another form of iron supplement and would also exacerbate the iron overload in this patient. Therefore, the appropriate choice is C as it directly addresses the issue of high iron levels in thalassemia patients.

Correct Answer: B

Rationale: The correct answer is B: Inform the client to plan to have a blood test 4 to 6 weeks after a bite to detect the presence of the disease. Rationale: 1. Lyme disease testing is most accurate 4-6 weeks post-bite due to the time required for antibodies to develop. 2. Testing too early may result in false negatives. 3. Waiting allows for accurate detection and timely treatment if needed. Summary of Other Choices: A: Incorrect. Arthralgia is just one symptom; testing is needed for accurate diagnosis. C: Incorrect. While prevention is important, this does not address the immediate need for testing. D: Incorrect. Antibiotics should not be started without proper diagnosis to avoid unnecessary medication.

Correct Answer: C

Rationale: The correct answer is C: Hearing loss. Amikacin, an aminoglycoside antibiotic, is known to cause ototoxicity, which can manifest as hearing loss. The client should contact the PHCP immediately if hearing loss occurs as it may be a sign of irreversible damage. Nausea (A), lethargy (B), and muscle aches (D) are common side effects of Amikacin but are not urgent or indicative of a serious adverse reaction requiring immediate medical attention.

Correct Answer: C

Rationale: The correct answer is C: Desmopressin (DDAVP). This patient likely has von Willebrand disease, a common bleeding disorder. Desmopressin releases von Willebrand factor and factor VIII from endothelial cells, aiding in hemostasis. Factor VIII concentrate (A) is used for hemophilia A, not von Willebrand disease. Fresh frozen plasma (B) contains various clotting factors but is not specific for von Willebrand disease. Whole blood transfusion (D) is not necessary in this case and does not address the underlying issue.

Correct Answer: A

Rationale: The correct answer is A: CT scan of abdomen. In a 69-year-old man with weight loss, back pain, and hyperglycemia, a CT scan of the abdomen is the most likely diagnostic study to identify potential underlying causes such as pancreatic cancer or other abdominal malignancies. This imaging modality can provide detailed information on the pancreas, surrounding structures, and possible metastases. Summary: B: Glucose tolerance test is not the most appropriate initial study for a patient presenting with these symptoms. C: Colonoscopy is indicated for evaluating lower gastrointestinal symptoms, not typically for weight loss, back pain, and hyperglycemia. D: Whole-body PET scan may be used for cancer staging, but a CT scan of the abdomen is more specific for identifying abdominal malignancies.