Incorrect about pernicious an:

Correct Answer: A

Rationale: The correct answer is A, hyperchlorhydria. Pernicious anemia is characterized by vitamin B12 deficiency due to lack of intrinsic factor. Hyperchlorhydria refers to high stomach acid production, not a symptom of pernicious anemia. Premature graying of hair and gastric polyp are potential features of pernicious anemia. Anti intrinsic factor antibody presence in 60% of patients is a characteristic finding in pernicious anemia.

Correct Answer: D

Rationale: The correct answer is D: CML. Peripheral blood picture is most useful in diagnosing CML due to the characteristic presence of increased mature and immature granulocytes, especially neutrophils, in the blood smear. This finding is known as a "left-shift" and is a hallmark of CML. In contrast, NHL (choice A) primarily involves lymphocytes, multiple myeloma (choice B) is characterized by abnormal plasma cells, and myelodysplastic syndrome (choice C) typically presents with dysplastic changes in blood cell precursors. Therefore, based on the specific blood cell findings, CML is the most likely diagnosis when observing a peripheral blood picture.

Correct Answer: C

Rationale: The correct answer is C: Ask if he would like you to sit with him while he collects his thoughts. This is the most appropriate action because it shows empathy and support for the patient's emotional distress. By offering to sit with the patient, the nurse acknowledges the patient's feelings and provides a comforting presence. This can help the patient feel understood and supported during a difficult time. Choices A and D are incorrect because they do not actively offer emotional support or show empathy towards the patient. Choice A may make the patient feel abandoned, and choice D may come across as insincere or dismissive of the patient's emotions. Choice B, offering to call pastoral care, is also not the most appropriate action in this scenario because the patient may need immediate emotional support from the nurse. Pastoral care can be considered later if the patient expresses a desire for spiritual or religious support.

Correct Answer: C

Rationale: The correct answer is C: Multiple Myeloma. This condition commonly presents with symptoms such as fatigue, back pain, and rib pain due to bone involvement. In older adults, these symptoms should raise suspicion for multiple myeloma, a type of cancer that affects plasma cells in the bone marrow. The nurse should assess for further signs such as anemia, hypercalcemia, renal impairment, and bone lesions. Hodgkin and Non-Hodgkin Lymphoma usually present with lymphadenopathy rather than bone pain. Acute Thrombocytopenia would present with symptoms related to low platelet count, such as bruising or bleeding, not fatigue and bone pain.

Correct Answer: D

Rationale: The correct answer is D: An aggressive course of chemotherapy. For AML, induction therapy typically involves aggressive chemotherapy to achieve remission. This approach aims to rapidly reduce the number of leukemia cells in the body. Targeted treatment medications are not the standard first-line therapy for AML. Radiation therapy is not commonly used as a primary treatment for AML. Hematopoietic stem cell transplantation is usually considered after achieving remission with chemotherapy as a consolidation therapy. Therefore, preparing the patient for an aggressive course of chemotherapy aligns with the standard treatment approach for AML.