The nurse is preparing a group of Cub Scouts for an overnight camping trip and instructs the Scouts about the methods to prevent Lyme disease. Which statement by one of the Scouts indicates a need for further instruction?

Correct Answer: C

Rationale: The correct answer is C because using insect repellents is actually recommended to prevent tick bites, not attract them. Ticks are repelled by certain chemicals in insect repellents, so using repellents can help reduce the risk of getting Lyme disease. Therefore, the Scout's statement about not using insect repellents shows a misunderstanding and indicates a need for further instruction. In contrast, choices A, B, and D are all correct preventive measures for Lyme disease. Wearing a hat, long-sleeved tops, long pants, closed shoes, and socks that can be pulled up over pants all help to minimize skin exposure to ticks and reduce the chances of getting bitten.

Correct Answer: C

Rationale: The correct answer is C: Refer for chemotherapy. Chemotherapy is the best next step for bronchioalveolar adenocarcinoma to target and shrink the tumor, control metastasis, and improve symptoms. It is a standard treatment for advanced-stage lung cancer. Option A (Refer to hospice) is premature as chemotherapy can improve quality of life and survival. Option B (Refer for lobectomy) is not suitable for advanced-stage cancer. Option D (Refer for radiation therapy) may be used in combination with chemotherapy but is not the initial treatment of choice.

Correct Answer: D

Rationale: The correct answer is D: GnRH analogue. In a 75-year-old man with prostate cancer and elevated PSA levels, GnRH analogues are the treatment of choice to suppress testosterone production and inhibit tumor growth. Observation (A) is not recommended due to the aggressive nature of prostate cancer. Radiation therapy (B) may be used as adjuvant therapy but is not the primary treatment for advanced disease. Estrogen therapy (C) is not recommended in men due to its side effects. Choosing GnRH analogues (D) is supported by guidelines for advanced prostate cancer management.

Correct Answer: C

Rationale: The correct answer is C: Acute myeloid leukemia. The clinical presentation of fever, bone pain, ecchymoses, and presence of Auer rods on smear is highly suggestive of acute myeloid leukemia. AML is characterized by the rapid proliferation of abnormal myeloid cells in the bone marrow, leading to symptoms such as fever, bone pain, and easy bruising. The presence of Auer rods on smear is a hallmark finding in AML. Multiple myeloma (A) presents with lytic bone lesions, hypercalcemia, and monoclonal gammopathy. Myelofibrosis (B) is characterized by bone marrow fibrosis, splenomegaly, and teardrop-shaped red blood cells. Chronic myelogenous leukemia (D) typically presents with an elevated white blood cell count, splenomegaly, and the presence of the Philadelphia chromosome.

Correct Answer: C

Rationale: The correct answer is C, Anemia of renal disease. In this case, the patient's chronic kidney disease is causing decreased erythropoietin production, leading to anemia. Dialysis can also contribute to anemia. Thalassemia (choice A) and iron deficiency (choice B) can be ruled out by normal indices. Anemia of chronic disease (choice D) is typically associated with chronic inflammatory conditions, not specifically renal disease.