You are transferring a client with newly diagnosed chronic myeloid leukemia to a long-term-care (LTC) facility. Which information is most important to communicate to the LTC charge nurse prior to transferring the client?

Correct Answer: D

Rationale: The most important information to communicate to the LTC charge nurse prior to transferring a client with newly diagnosed chronic myeloid leukemia is option D) The client's chemotherapy has resulted in neutropenia. Neutropenia is a critical concern in leukemia patients as it indicates a decreased number of neutrophils, which are important in fighting infections. Leukemia and its treatment compromise the immune system, making patients more susceptible to infections. This information is crucial for the LTC charge nurse to be vigilant about signs of infection and to implement appropriate infection control measures. Option A) The presence of the Philadelphia chromosome in the blood smear is important for diagnosing chronic myeloid leukemia but does not impact immediate care or management at the LTC facility. Option B) Elevated glucose levels due to prednisone therapy may be relevant for managing diabetes but are not as urgent as addressing neutropenia in a leukemia patient. Option C) Weight loss is a common symptom in leukemia, but it does not pose an immediate threat as neutropenia does. Educationally, understanding the priority of communicating critical health information when transferring patients is vital for healthcare professionals to ensure continuity of care and patient safety. This scenario highlights the importance of recognizing and addressing complications of leukemia and its treatment to prevent life-threatening infections in vulnerable patients.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) A 20-year-old with possible acute myelogenous leukemia who has just arrived on the medical unit. This client should be assessed first because acute myelogenous leukemia is a potentially life-threatening condition that requires immediate intervention and close monitoring. Rapid assessment and initiation of appropriate treatment are crucial in managing this condition. Option B) A 38-year-old with aplastic anemia who needs teaching about decreasing infection risk prior to discharge is not the priority in this situation. While education is important, it is not as urgent as assessing and managing a potentially critical condition like acute myelogenous leukemia. Option C) A 40-year-old with lymphedema who requests help to put on compression stockings before getting out of bed is a lower priority compared to a client with a suspected serious hematological disorder like leukemia. Option D) A 60-year-old with non-Hodgkin's lymphoma who is refusing the ordered chemotherapy regimen, while important, is not the priority at this moment. The immediate focus should be on the client with possible acute myelogenous leukemia to ensure timely intervention and assessment. In an educational context, understanding the prioritization of patient care based on the urgency of conditions is crucial for nurses and healthcare providers. By prioritizing care effectively, they can ensure that critical conditions are addressed promptly, leading to better patient outcomes and safety. This question highlights the importance of quick decision-making and critical thinking in a clinical setting, especially in hematology where timely interventions can significantly impact patient health.

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: A

Rationale: In the context of hemostasis, the correct answer is A) Lysis of clot. This process involves the breakdown of a formed clot to prevent excessive clotting and maintain blood flow. Protein C and protein S are anticoagulant proteins that work to inhibit the clotting process, while plasminogen is a precursor to plasmin, an enzyme responsible for breaking down fibrin clots. Option B) Vascular response refers to the constriction and dilation of blood vessels in response to injury, but it is not directly related to the specific components mentioned in the question. Option C) Plasma clotting factors are involved in the initiation and propagation of the clotting cascade, not in the breakdown of clots as described in the question. Option D) Platelet plug formation is the initial step in hemostasis where platelets adhere to the site of injury and aggregate to form a temporary plug, but it is not directly related to the processes involving protein C, protein S, and plasminogen. Understanding the processes involved in normal hemostasis is crucial for healthcare professionals, particularly in fields like hematology and critical care. Knowing how these components work together helps in managing patients with bleeding disorders, thrombotic conditions, and during surgical procedures where hemostasis is critical for patient outcomes.

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.