Through a bone marrow aspirate:

Correct Answer: C

Rationale: The correct answer is C because a bone marrow aspirate allows for the examination of cells to assess their level of maturation. This is crucial in diagnosing various hematologic conditions like leukemia and anemia. Choice A is incorrect as cellularity is better assessed through a bone marrow biopsy. Choice B is incorrect as myelofibrosis is better visualized through a bone marrow biopsy as well. Choice D is incorrect as tumor infiltration is typically seen through imaging studies rather than a bone marrow aspirate.

Correct Answer: A

Rationale: The correct answer is A because protecting the client from infection is the priority for someone with immunodeficiency. By minimizing exposure to pathogens, the nurse helps prevent potential serious complications. Providing emotional support (B) is important but not the priority. Encouraging discussion about lifestyle changes (C) and identifying factors that decreased immune function (D) are also important but not as critical as preventing infections in this case.

Correct Answer: D

Rationale: Step 1: The client has acquired immunodeficiency syndrome, which impairs the immune system. Step 2: Pneumocystis jiroveci infection is an opportunistic infection common in immunocompromised individuals. Step 3: Pentamidine is used to treat Pneumocystis jiroveci infection but can cause leukopenia (decreased white blood cells). Step 4: Leukopenia increases the risk of developing other infections. Step 5: Fever (temperature of 101°F) is a common sign of infection. Step 6: Therefore, the most likely condition indicated by the fever is another infection due to leukopenic effects of the medication, making choice D the correct answer. Summary: A: Incorrect. Temperature elevation is not typically related to a low dose of medication. B: Incorrect. Toxic effects of pentamidine would likely present with different symptoms. C: Incorrect. Inadequacy of thermore

Correct Answer: C

Rationale: The correct answer is C, peripheral blood smear. A peripheral blood smear is the best next diagnostic test in this case to evaluate the red blood cell morphology for signs of hemolysis, such as spherocytes or schistocytes, which could indicate hemolytic anemia. This is important given the patient's symptoms, anemia (Hb 9.0 g/dL), elevated MCV (110 fL), and icteric appearance, suggestive of hemolysis. Serum protein electrophoresis (choice A) is not indicated for the evaluation of anemia. Flow cytometry (choice B) is not typically used in the initial workup of hemolytic anemia. Glucose-6-PD level (choice D) may be useful in diagnosing certain types of hemolytic anemia but is not the best initial test in this case.

Correct Answer: D

Rationale: The correct answer is D: Renal cell carcinoma. In this case, the presentation of flank pain, hematuria, high hemoglobin, and high calcium levels is classic for renal cell carcinoma. The flank pain suggests tumor involvement, hematuria is a common symptom, high Hb can be due to erythropoietin production by the tumor, and high Ca can be from paraneoplastic syndrome. Polycystic kidney disease (A) typically presents with enlarged kidneys but not with these symptoms. Pheochromocytoma (B) usually presents with hypertension and palpitations. Adrenal carcinoma (C) is less likely given the presentation of flank pain and hematuria, which are more indicative of renal involvement.