The nurse is assessing a client experiencing anemia. Which laboratory findings will the nurse expect for this client? (Select all that apply.)

Correct Answer: b

Rationale: Correct Answer: B - Decreased red blood cell count Rationale: 1. Anemia is defined by a decrease in red blood cells, causing decreased oxygen-carrying capacity. 2. A decreased red blood cell count is a key indicator of anemia. 3. Other choices are incorrect: A. Increased hematocrit is not expected in anemia, as it indicates a higher concentration of red blood cells. C. Decreased serum iron may be seen in iron-deficiency anemia but is not a universal finding in all types of anemia. D. Decreased hemoglobin is a common finding in anemia but is not as specific as a decreased red blood cell count.

Correct Answer: D

Rationale: The correct answer is D: Vitamin K deficiency. Prolonged prothrombin time and activated partial thromboplastin time indicate impaired blood clotting, which is a characteristic of Vitamin K deficiency. Vitamin K is essential for the synthesis of clotting factors II, VII, IX, and X. Hemophilia A (Choice A) is a genetic disorder resulting in a deficiency of clotting factor VIII, leading to prolonged activated partial thromboplastin time only. Thrombocytopenia (Choice B) is a condition characterized by low platelet count, which can lead to bleeding but does not affect clotting factors. Von Willebrand disease (Choice C) is a genetic disorder affecting von Willebrand factor and platelet function, not clotting factors.

Correct Answer: A

Rationale: The correct answer is A because Burkitt's lymphoma is associated with the translocation of the c-myc gene on chromosome 8, not chromosome 18. This translocation results in the overexpression of c-myc, leading to uncontrolled cell proliferation. Choice B is incorrect as Burkitt's lymphoma commonly presents with jaw or facial bone involvement in HIV patients. Choice C is incorrect as Burkitt's lymphoma is commonly seen in African children due to Epstein-Barr virus infection, not necessarily after malaria exposure. Choice D is incorrect as Burkitt's lymphoma is histologically characterized by a "starry sky" appearance due to the presence of numerous macrophages engulfing debris from apoptotic cells.

Correct Answer: D

Rationale: Step-by-step rationale for why D is correct: 1. Koilonychias is characterized by spoon-shaped nails, a common symptom of iron deficiency anemia due to decreased hemoglobin levels. 2. Iron is essential for normal nail growth, and its deficiency can lead to changes in nail shape. 3. Hemolytic anemia (A) is characterized by the premature destruction of red blood cells, not typically associated with koilonychias. 4. Sickle cell disease (B) causes abnormal hemoglobin, leading to sickle-shaped red blood cells, not related to koilonychias. 5. Thalassemia major (C) is a genetic disorder affecting hemoglobin production, but it does not directly cause koilonychias.

Correct Answer: B

Rationale: The correct answer is B: Irradiating the blood components before transfusion. Graft versus host disease occurs when donor immune cells attack the recipient's tissues. Irradiating blood components helps to eliminate donor T cells, reducing the risk of this complication. Choice A (Transfusion of packed cells) does not address the issue of donor T cells. Choice C (Transfusing fresh whole blood) may actually increase the risk as it contains more viable donor immune cells. Choice D (Replacement by crystalloids) is not a suitable alternative for blood transfusion.