Regarding myelodysplastic syndromes:

Correct Answer: C

Rationale: The correct answer is C because myelodysplastic syndromes result from ineffective proliferation of cells of myeloid origin. This leads to abnormal development and functioning of blood cells. Choice A is incorrect as the disorders actually involve ineffective rather than increased proliferation. Choice B is incorrect as polycythemia vera is a separate disorder characterized by an overproduction of red blood cells. Choice D is incorrect as myelodysplastic syndromes specifically involve myeloid cells, not lymphoid cells.

Correct Answer: A

Rationale: The correct answer is A because recording the site, date, and time of the test is crucial for documentation and tracking purposes. This information helps monitor for any delayed reactions and ensures proper follow-up. Choice B is incorrect as clients should be educated to report any reaction immediately, not just return for inspection. Choice C is incorrect because monitoring the client for an allergic reaction should occur for at least 15-30 minutes, not 1 to 2 hours. Choice D is incorrect as estimating the size of the wheal is not necessary for postprocedure interventions.

Correct Answer: C

Rationale: The correct answer is C: Colonoscopy. This is the best next step in evaluation for this patient because the presentation suggests iron deficiency anemia. The low serum iron, high iron-binding capacity, and low ferritin levels are consistent with this diagnosis. Colonoscopy is indicated to rule out gastrointestinal bleeding as the cause of iron deficiency anemia in a middle-aged man with no other obvious etiology. Red blood cell folate (choice A) and serum lead levels (choice B) are not indicated based on the clinical presentation. Bone marrow examination (choice D) is not needed at this point as the likely cause of anemia is iron deficiency related to possible gastrointestinal bleeding.

Correct Answer: A

Rationale: Rationale for Choice A (Pelvic ultrasound): - Pelvic ultrasound is the most appropriate initial step for evaluating a 50-year-old woman with abdominal and adnexal fullness to assess for gynecologic issues like ovarian cysts, fibroids, or tumors. - It is non-invasive, cost-effective, and can provide valuable information about the structures in the pelvis. - It helps to visualize the ovaries and uterus, guiding further management decisions based on the findings. Summary of other choices: - Choice B (CA-125 antigen levels): While CA-125 is a tumor marker often elevated in ovarian cancer, it is not specific and can be elevated in other conditions. It is not the initial step in this case. - Choice C (Surgery): Surgery should not be the first step without proper diagnostic evaluation with imaging studies. - Choice D (CT scan of abdomen): CT scan may provide detailed information but is not the initial diagnostic modality for evaluating adnexal full

Correct Answer: C

Rationale: The correct answer is C: APC. This gene mutation is associated with familial adenomatous polyposis (FAP), a condition characterized by hundreds to thousands of colorectal polyps and a high risk of developing colon cancer. FAP is an autosomal dominant disorder, so individuals with a family history of colon cancer are at highest risk for having an APC mutation. MEN1 (choice A) is associated with multiple endocrine neoplasia type 1, RET (choice B) with multiple endocrine neoplasia type 2, and MSH (choice D) with Lynch syndrome - all of which are not specifically linked to colon cancer in the context of this question.