What is the nurse's priority when caring for a client who just completed a bone marrow aspiration and biopsy?

Correct Answer: C

Rationale: The correct answer is C: Check the pressure dressing frequently for signs of excessive or active bleeding. After a bone marrow aspiration and biopsy, the priority is to monitor for bleeding, as these procedures can cause bleeding complications. Checking the pressure dressing helps to detect any signs of excessive bleeding early, allowing for prompt intervention. This is crucial to prevent complications such as hematoma or hemorrhage. Incorrect choices: A: Teaching the client to avoid activity is important but not the priority immediately post-procedure. B: Administering NSAIDs may not be appropriate as they can increase the risk of bleeding. D: Reporting laboratory results is important but not the priority in this immediate post-procedure scenario.

Correct Answer: C

Rationale: The correct answer is C: Aplastic anemia. Aplastic anemia is characterized by a low reticulocyte production index due to bone marrow failure, leading to decreased red blood cell production and subsequently causing anemia. Thalassemia (choice A) is a genetic disorder resulting in abnormal hemoglobin production, not bone marrow failure. Vitamin B12 deficiency (choice B) can lead to macrocytic anemia, not a low reticulocyte production index. Sideroblastic anemia (choice D) is characterized by abnormal iron metabolism in the bone marrow, not bone marrow failure.

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 characteristic of vitamin K deficiency. Vitamin K is essential for synthesizing clotting factors II, VII, IX, and X. Hemophilia A (choice A) is a genetic disorder resulting in deficiency of clotting factor VIII, not vitamin K-dependent factors. Thrombocytopenia (choice B) is a condition characterized by low platelet count, not affecting clotting factor synthesis. Von Willebrand factor disease (choice C) involves a deficiency or dysfunction of von Willebrand factor, not related to vitamin K deficiency.

Correct Answer: A

Rationale: The correct answer is A because Burkitt's lymphoma is associated with translocation of c-myc gene on chromosome 8, not chromosome 18. This translocation leads to uncontrolled cell proliferation. Choice B is incorrect because Burkitt's lymphoma commonly presents with jaw or facial bone involvement in HIV patients. Choice C is incorrect as the association between Epstein Barr infection and malaria exposure in African children increases the risk of Burkitt's lymphoma. Choice D is incorrect because Burkitt's lymphoma is histologically characterized by a 'starry sky' appearance due to macrophages engulfing apoptotic tumor cells, not due to the presence of the c-myc translocation.

Correct Answer: D

Rationale: Step-by-step rationale for why the correct answer is D (Iron deficiency anemia): 1. Koilonychias is characterized by spoon-shaped nails, a classic sign of iron deficiency anemia due to changes in nail structure. 2. Iron deficiency leads to decreased production of keratin, causing nail deformities like koilonychias. 3. Hemolytic anemia (choice A) and Sickle cell disease (choice B) are not typically associated with koilonychias. 4. Thalassemia major (choice C) can cause nail changes, but koilonychias is more commonly seen in iron deficiency anemia.