Home health patient on warfarin for DVT. Which statement indicates need for more teaching?

Correct Answer: A

Rationale: The correct answer is A because increasing intake of green salads and fruit will potentially increase the intake of Vitamin K, which can interfere with the effectiveness of warfarin. Warfarin works by inhibiting Vitamin K-dependent clotting factors, so a sudden increase in Vitamin K intake can reduce the medication's efficacy. Choice B is important as constipation can lead to unpredictable absorption of warfarin. Choice C is valid as warfarin should be taken with food to reduce nausea. Choice D is accurate as regular blood tests are necessary to monitor warfarin's effectiveness and adjust dosage accordingly.

Correct Answer: D

Rationale: The principal goal of hydroxyurea therapy is to increase circulating fetal hemoglobin (HbF), which has anti-sickling properties and reduces the frequency of sickle cell crises. Hydroxyurea stimulates HbF production by inducing the expression of gamma-globin genes. This helps to inhibit the polymerization of sickle hemoglobin (HbS) and decrease the proportion of sickled cells in circulation. Choices A and B are incorrect because the goal is not to decrease circulating HbS or increase its polymerization. Choice C is incorrect as hydroxyurea does not directly affect the water content of red cells. The correct answer, choice D, aligns with the therapeutic mechanism of hydroxyurea in increasing levels of HbF to improve clinical outcomes in sickle cell disease.

Correct Answer: D

Rationale: The correct answer is D, Rituximab + CHOP, for advanced diffuse large B-cell lymphoma due to proven efficacy in clinical trials. Rituximab targets CD20 on B-cells, enhancing CHOP's effectiveness. A: m-BACOD and B: PROMACE-CytaBOM are outdated regimens. C: CHOP alone lacks the benefit of rituximab's targeted therapy.

Correct Answer: A

Rationale: The correct answer is A: Chronic atrophic gastritis. This condition leads to vitamin B12 deficiency, causing macrocytic anemia, weakness, and tingling. Chronic atrophic gastritis affects the stomach's ability to produce intrinsic factor needed for B12 absorption. Ileal resection impairs B12 absorption, tapeworm infestation competes for B12, and alcoholism can lead to poor diet and malabsorption, all contributing to macrocytic anemia.

Correct Answer: A

Rationale: The correct answer is A because t(c-myc) in Burkitt's lymphoma is actually a translocation between chromosome 8 and 14 or less commonly 8 and 22. This translocation leads to the overexpression of c-myc oncogene. Choice B is correct as Burkitt's lymphoma often presents with abdominal involvement in HIV patients. Choice C is true as the characteristic "starry sky" appearance is due to the high number of macrophages engulfing apoptotic lymphoma cells. Choice D is also true, as cyclophosphamide is a common chemotherapy drug used to treat Burkitt's lymphoma.