The nurse is assessing an older client for any potential hematologic health problem. Which assessment finding is the most significant and would be reported to the primary health care provider?

Correct Answer: B

Rationale: The correct answer is B - Multiple petechiae and large bruises. This finding indicates potential bleeding issues or clotting disorders, which are serious hematologic health problems. Petechiae and bruises may suggest thrombocytopenia or other underlying conditions. Reporting this to the primary health care provider is crucial for further evaluation and management. A: Poor skin turgor on both forearms - Indicates dehydration, not necessarily a hematologic issue. C: Dry, flaky skin on arms and legs - Suggests a skin condition, not directly related to hematologic problems. D: Decreased body hair distribution - More indicative of endocrine or nutritional issues, not specific to hematologic health problems.

Correct Answer: A

Rationale: The correct answer is A: Thrombosis. Thrombotic thrombocytopenic purpura (TTP) is characterized by microangiopathic hemolytic anemia and thrombocytopenia, not thrombosis. In TTP, there is excessive platelet aggregation leading to microthrombi formation in small blood vessels, causing hemolysis and thrombocytopenia. Neurologic deficits are also common due to microvascular ischemia. Thrombosis is not a typical feature of TTP and is more commonly associated with conditions like deep vein thrombosis or pulmonary embolism. Thrombosis is not a hallmark of TTP, making choice A the correct answer.

Correct Answer: A

Rationale: The correct answer is A: Immunophenotype - mature B cell. In acute lymphoblastic leukemia, a mature B cell immunophenotype is associated with a poor prognosis due to its resistance to treatment. Gender being female is a good prognostic factor as females tend to have better outcomes. Hyperploidy is favorable as it indicates a better response to treatment. Age 4 to 10 years old is also a good prognostic factor as younger age groups have better survival rates.

Correct Answer: A

Rationale: The correct answer is A: Nodular sclerosis. This subtype of Hodgkin's lymphoma is more common in young women and has a good prognosis due to its characteristic fibrotic bands dividing the lymph node into nodules. These nodules contain a mixture of inflammatory cells and Reed-Sternberg cells. Choice B: Mixed cellularity is more common in older patients and has a less favorable prognosis due to its heterogeneous cell population with abundant Reed-Sternberg cells. Choice C: Lymphocyte predominance typically affects young adults and has an indolent course with a good prognosis, but it is not as common in young women as nodular sclerosis. Choice D: Lymphocyte depletion is a rare subtype seen in older individuals with a poor prognosis due to the paucity of lymphocytes and an abundance of Reed-Sternberg cells.

Correct Answer: A

Rationale: The correct answer is A: Low total iron binding capacity. In this case, the patient is showing signs of iron deficiency anemia. Low total iron binding capacity is not expected because in iron deficiency anemia, the total iron binding capacity is typically elevated as the body tries to increase its capacity to bind and transport iron. High serum transferrin and low iron: total iron binding capacity ratio are expected findings in iron deficiency anemia, as the body increases the production of transferrin to compensate for low iron levels. Low serum ferritin is also expected as it is a marker of decreased iron stores in the body. Therefore, choice A is the correct answer as it contradicts the typical laboratory findings seen in iron deficiency anemia.