Which of the following is not true in thrombasthenia:

Correct Answer: D

Rationale: In thrombasthenia, there is a deficiency or dysfunction of the glycoprotein IIb/IIIa receptor complex on platelets, leading to impaired platelet aggregation. This results in prolonged bleeding time due to ineffective platelet plug formation (choice A). Platelet count is typically normal (choice B). Platelet aggregation is defective (choice C). However, clotting time is not affected in thrombasthenia as it primarily involves platelet function, not the clotting factors involved in coagulation (choice D). Therefore, the correct answer is D.

Correct Answer: A

Rationale: The correct answer is A, hyperchlorhydria. Pernicious anemia is characterized by vitamin B12 deficiency due to lack of intrinsic factor. Hyperchlorhydria refers to high stomach acid production, not a symptom of pernicious anemia. Premature graying of hair and gastric polyp are potential features of pernicious anemia. Anti intrinsic factor antibody presence in 60% of patients is a characteristic finding in pernicious anemia.

Correct Answer: D

Rationale: The correct answer is D: immunogenic thrombocytopenia. Platelet transfusion is not indicated in immunogenic thrombocytopenia because it involves antibodies attacking platelets, which would render transfused platelets ineffective. Platelet transfusion is indicated in aplastic anemia (A) to increase platelet count, in uremia with bleeding (B) to replace dysfunctional platelets, and in DIC (C) to help manage severe bleeding. In summary, platelet transfusion is contraindicated in immunogenic thrombocytopenia due to ineffective platelet response.

Correct Answer: D

Rationale: The correct answer is D: CML. Peripheral blood picture is most useful in diagnosing CML due to the characteristic presence of increased mature and immature granulocytes, especially neutrophils, in the blood smear. This finding is known as a "left-shift" and is a hallmark of CML. In contrast, NHL (choice A) primarily involves lymphocytes, multiple myeloma (choice B) is characterized by abnormal plasma cells, and myelodysplastic syndrome (choice C) typically presents with dysplastic changes in blood cell precursors. Therefore, based on the specific blood cell findings, CML is the most likely diagnosis when observing a peripheral blood picture.

Correct Answer: C

Rationale: The correct answer is C: Ask if he would like you to sit with him while he collects his thoughts. This is the most appropriate action because it shows empathy and support for the patient's emotional distress. By offering to sit with the patient, the nurse acknowledges the patient's feelings and provides a comforting presence. This can help the patient feel understood and supported during a difficult time. Choices A and D are incorrect because they do not actively offer emotional support or show empathy towards the patient. Choice A may make the patient feel abandoned, and choice D may come across as insincere or dismissive of the patient's emotions. Choice B, offering to call pastoral care, is also not the most appropriate action in this scenario because the patient may need immediate emotional support from the nurse. Pastoral care can be considered later if the patient expresses a desire for spiritual or religious support.