Folate deficiency is likely to develop in one of the following groups of people:

Correct Answer: B

Rationale: The correct answer is B: Alcoholic persons. Alcohol interferes with folate absorption and metabolism, leading to folate deficiency. Alcoholic persons often have poor dietary intake and impaired absorption of nutrients, including folate. Folate deficiency can result in megaloblastic anemia and other health issues. A: Strict vegetarians generally have a higher risk of vitamin B12 deficiency rather than folate deficiency. C: Patients who have undergone stomach surgery may have reduced absorption of nutrients, but the question specifically focuses on folate deficiency, which is more associated with alcohol consumption. D: Persons who take a low fiber diet may have inadequate nutrient intake, but this choice does not directly relate to folate deficiency caused by alcohol consumption.

Correct Answer: C

Rationale: The correct answer is C: Positive punch biopsy of the cutaneous lesions. A definitive diagnosis of Kaposi's sarcoma is confirmed by the presence of spindle cells and red blood cell extravasation in cutaneous lesions, which can be identified through a punch biopsy. This procedure allows for a histological examination to accurately diagnose Kaposi's sarcoma. Incorrect choices: A: Swelling in the genital area - Kaposi's sarcoma does not typically present with swelling in the genital area. B: Swelling in the lower extremities - Swelling in the lower extremities is not a specific indicator of Kaposi's sarcoma. D: Appearance of reddish-blue lesions noted on the skin - While reddish-blue lesions are characteristic of Kaposi's sarcoma, a punch biopsy is required to confirm the diagnosis definitively.

Correct Answer: A

Rationale: The correct answer is A: Gait. Stavudine has been associated with peripheral neuropathy, which can lead to gait disturbances. Monitoring the client's gait closely is crucial to detect any signs of peripheral neuropathy early on. Other choices (B) Appetite, (C) Level of consciousness, and (D) Gastrointestinal function are not directly associated with stavudine use. Peripheral neuropathy is a known side effect of stavudine, making monitoring gait the priority in this scenario.

Correct Answer: C

Rationale: The correct approach is a bone marrow biopsy. The patient presents with pancytopenia (low Hb, WBC, platelets) which suggests a bone marrow issue. Bone marrow biopsy can reveal the cause of pancytopenia such as aplastic anemia, myelodysplastic syndrome, or leukemia. Erythropoietin level (A) is not indicated as low levels are expected in anemia. Serum B12 (B) is used for diagnosing B12 deficiency anemia, not pancytopenia. Liver spleen scan (D) is not helpful in this scenario. Bone marrow biopsy is the most direct and appropriate diagnostic test in this case.

Correct Answer: C

Rationale: The correct answer is C: Keep in hospital, discontinue heparin, start lepirudin. In this scenario, the patient has heparin-induced thrombocytopenia (HIT) with a platelet drop and is at risk for thrombosis. Lepirudin, a direct thrombin inhibitor, is the preferred anticoagulant in HIT. Dismissing on heparin and warfarin (choice A) is not appropriate due to HIT. Discontinuing heparin and adding aspirin (choice B) is not sufficient in managing HIT. Adding low-molecular-weight heparin (choice D) may worsen the thrombocytopenia.