Which cells are classified as granulocytes (select one that doesn't apply)?

Correct Answer: B

Rationale: In the context of hematology and the classification of white blood cells, it is essential to understand the different types of leukocytes based on their characteristics and functions. Granulocytes are a category of white blood cells characterized by the presence of granules in their cytoplasm. In this question, the correct answer is B) Monocyte, which is not classified as a granulocyte. A) Basophils, C) Eosinophils, and D) Neutrophils are all examples of granulocytes. Basophils are involved in allergic reactions and the inflammatory response. Eosinophils play a role in combating parasitic infections and modulating allergic responses. Neutrophils are the most abundant type of white blood cell and are essential for fighting bacterial infections through phagocytosis. Monocytes, on the other hand, are classified as agranulocytes because they lack visible granules in their cytoplasm. Monocytes are crucial for immune responses as they can differentiate into macrophages and dendritic cells, which are involved in phagocytosis, antigen presentation, and regulation of the immune system. Understanding the classification of white blood cells, such as granulocytes and agranulocytes, is fundamental in hematology as it helps healthcare professionals diagnose and treat various conditions related to immune function and infection. By knowing the distinguishing features of each type of white blood cell, healthcare providers can better interpret lab results, assess a patient's immune status, and provide appropriate care.

Correct Answer: C

Rationale: In this scenario, the correct answer is option C: Partial thromboplastin time (PTT) 60 seconds. The reason this finding would be of most concern to the nurse when reviewing the blood tests of an 83-year-old patient is that PTT measures the effectiveness of the intrinsic pathway of the coagulation cascade. An elevated PTT could indicate a potential risk of bleeding disorders or clotting abnormalities, which are critical concerns in an elderly patient due to their increased susceptibility to these conditions. Option A: Platelets 150,000/µL is within the normal range (150,000-400,000/µL), so it would not be the most concerning finding. Option B: Serum iron 50 mcg/dL being low could indicate anemia, but in the absence of other symptoms or abnormal results, it is less urgent compared to a potential clotting issue indicated by an abnormal PTT. Option D: Erythrocyte sedimentation rate (ESR) 35 mm in 1 hour is a non-specific marker of inflammation and is influenced by various factors. While an elevated ESR could indicate underlying conditions, it is not as directly linked to the risk of immediate complications related to clotting abnormalities as an abnormal PTT. In an educational context, understanding the significance of different blood test results is crucial for nurses to provide safe and effective care. Nurses must be able to interpret lab values accurately to identify potential health concerns promptly and collaborate with healthcare providers to intervene appropriately. This question highlights the importance of recognizing abnormal values in the elderly population, where age-related changes and comorbidities can complicate health assessments.

Correct Answer: A

Rationale: The correct answer to the question is A) Record this finding as normal. In hematology, the assessment of lymph nodes is an essential part of a physical examination to evaluate for any signs of infection, inflammation, or malignancy. When using light pressure with the index and middle fingers, it is not uncommon to not palpate superficial lymph nodes. Lymph nodes can be small and not always easily palpable, especially if they are not enlarged due to any pathology. Therefore, it is important for the nurse to be aware that the absence of palpable lymph nodes does not necessarily indicate a problem. Option B) Reassess the lymph nodes using deeper pressure is incorrect because applying deeper pressure can potentially lead to discomfort for the patient and may not yield any different results. It is not recommended to use excessive force during lymph node palpation as it may cause unnecessary pain or injury. Option C) Asking the patient about any history of radiation therapy is incorrect in this context as there is no indication in the question stem that suggests a history of radiation therapy is relevant to the current assessment of the lymph nodes. Option D) Notifying the health care provider that x-rays of the nodes will be necessary is also incorrect as routine x-rays are not typically indicated for assessing superficial lymph nodes in a physical examination. Imaging studies like x-rays are usually ordered when there is a specific concern for deeper lymph nodes or structures, or when there are other clinical indications to do so. In an educational context, it is important for nurses to understand the normal variations in lymph node palpation and not to jump to unnecessary interventions based on a lack of palpable lymph nodes. Documenting findings accurately and knowing when to investigate further based on clinical indications are essential skills in nursing practice.

Correct Answer: B

Rationale: In this case, the correct answer is B) Hgb 9.6 g/dL (96 g/L). A smooth, shiny, red tongue is a classic symptom of iron deficiency anemia, which is characterized by low hemoglobin levels. Hemoglobin is a protein found in red blood cells that carries oxygen throughout the body. When hemoglobin levels are low, the body may not be getting enough oxygen, leading to symptoms like a smooth, shiny, red tongue. Option A) Neutrophils 45% is not directly related to the symptom described in the question. Neutrophils are a type of white blood cell involved in fighting infection. Option C) WBC count 13,500/µL indicates an elevated white blood cell count, which is not typically associated with the described symptom. Option D) Red blood cell count 6.4 × 10^6/µL is within the normal range and does not explain the smooth, shiny, red tongue observed in the patient. From an educational perspective, understanding the connection between hematologic disorders and physical symptoms is crucial for nurses to provide quality care. Recognizing the correlation between a smooth, shiny, red tongue and iron deficiency anemia can prompt appropriate interventions such as iron supplementation and dietary modifications. This case highlights the importance of comprehensive assessment skills and knowledge of hematologic conditions in nursing practice.

Correct Answer: B

Rationale: In this scenario, the correct answer is option B: The anti-A and anti-B antibodies in the patient's blood will hemolyze the donor blood. This is because blood type O individuals have both anti-A and anti-B antibodies in their plasma. When a person with blood type O receives blood from a donor with blood type AB, which has both A and B antigens on the red blood cells (RBCs), the recipient's anti-A and anti-B antibodies will recognize the A and B antigens on the donor RBCs as foreign and initiate a hemolytic reaction, causing the donor blood cells to be destroyed. Option A is incorrect because the patient's Rh factor being positive does not directly relate to the hemolytic reaction in ABO blood group incompatibility. Option C is incorrect because the antibodies causing the hemolysis come from the recipient, not the donor. Option D is incorrect because blood type O individuals do have antibodies against the A and B antigens present in the donor blood. Educationally, understanding blood compatibility is crucial in healthcare settings to prevent adverse transfusion reactions. Nurses must ensure proper blood typing and cross-matching to match donor blood with the recipient's blood type to prevent hemolytic reactions. This knowledge is essential for safe transfusion practices and patient care.