You are caring for a patient with a large localized Ewing sarcoma of the soft tissues of the arm. The surgeon believes that the tumor can be resected without amputation but asks whether you can give some chemotherapy to shrink the tumor before surgery. Which of the following would you tell the surgeon?

Correct Answer: B

Rationale: The correct answer is B because starting chemotherapy before resection at week 12 can help shrink the tumor, making it more manageable for surgery. A is incorrect because preoperative chemotherapy can improve outcomes. C is incorrect because radiotherapy may not be necessary if the tumor is completely resected. D is incorrect because radiotherapy may still be necessary even if the tumor is resected before chemotherapy.

Correct Answer: D

Rationale: The correct answer is D because educating the client about the procedure is crucial for informed consent, cooperation, and reducing anxiety. This empowers the client to participate actively in their care. Assessing for shellfish allergies (A) is irrelevant unless a specific contrast agent is used. Placing the client on radiation precautions (B) is unnecessary for radioisotopic imaging. Sedating the client (C) may not be indicated and should be avoided if possible. Teaching the client about the procedure (D) addresses the immediate need and supports client safety and understanding.

Correct Answer: C

Rationale: The correct answer is C: Crimean Congo virus. This is the most likely causative agent of acute viral hemorrhagic fever following a tick bite due to its association with tick transmission. Crimean Congo virus is a tick-borne virus that causes severe hemorrhagic fever in humans. The other options, Hantavirus, Rift Valley virus, and Marburg virus, are not typically transmitted by ticks. Hantavirus is spread through rodent feces, Rift Valley virus is transmitted by mosquitoes, and Marburg virus is transmitted through direct contact with infected animals or their bodily fluids. Therefore, based on the history of tick bite, Crimean Congo virus is the most probable causative agent.

Correct Answer: C

Rationale: The correct answer is C, Factor VIII. Vitamin K is crucial for the activation of Factors II, VII, IX, and X in the coagulation cascade. Factor VIII is not dependent on vitamin K for its synthesis or activation, so it will not be affected by vitamin K deficiency. Factors II, VII, and IX will be affected as they require vitamin K for their activation. Therefore, Factor VIII is the only factor that will not be impacted by vitamin K deficiency.

Correct Answer: C

Rationale: The correct answer is C: Lymphocyte count. The International Prognostic Index (IPI) for non-Hodgkin's lymphoma includes factors such as age, number of extranodal sites, LDH level, performance status, and stage. Lymphocyte count is not a specific criteria in the IPI. This index is used to predict the outcome of patients with aggressive lymphomas. A higher score indicates a worse prognosis. A low lymphocyte count is not a consistent prognostic factor for non-Hodgkin's lymphoma, unlike the other factors listed. Therefore, choice C is not a criteria in the IPI, making it the correct answer.