diagnosis of chronic myelogenous leukemia

diagnosis of chronic myelogenous leukemia

diagnosis of chronic myelogenous leukemia

Question 1

A 70-year-old woman has received a diagnosis of chronic myelogenous leukemia (CML) after a clinical investigation sparked by the presence of leukocytosis in her routine blood work. What clinical course should her care provider tell her to expect?

Answers:

A. “It’s likely that this will give you chronic fatigue and malaise for the rest of your life, but that will probably be the extent of your symptoms.”

B. “Unfortunately, your leukemia will likely enter a crisis mode within a few weeks if we don’t treat it immediately.”

C. “You could remain the chronic stage of CML for several years before it accelerates and culminates in a crisis.”

D. “You can expect your blood results, fatigue, and susceptibility to infection to gradually worsen over a few years.”

Question 2

Following an injury resulting in a small cut from a knife, the first cells to go to the area of the cut would be the

Answers:

A. erythrocytes.

B. basophils.

C. neutrophils.

D. albumin.

Question 3

Which of the following diagnostic findings is likely to result in the most serious brain insult?

Answers:

A. Moderate decrease in brain tissue volume secondary to a brain tumor removal

B. High intracellular concentration of glutamate

C. Increased ICP accompanied by hyperventilation

D. Mean arterial pressure (MAP) that equals intracranial pressure (ICP)

Question 4

Which of the following patients would be most likely to be experiencing an increase in renal erythropoietin production?

Answers:

A. A 70-year-old woman admitted with dehydration secondary to an overdose of her potassium-wasting diuretic

B. A 21-year-old man with acute blood loss secondary to a motor vehicle accident 3 hours prior

C. A 68-year-old man with a long-standing diagnosis of polycythemia vera

D. A 71-year-old smoker admitted to hospital with exacerbation of his chronic obstructive pulmonary disease (COPD)

Question 5

A college student has been experiencing frequent headaches that he describes as throbbing and complaining of difficulty concentrating while studying. Upon cerebral angiography, he is found to have an arteriovenous malformation. Which of the following pathophysiological concepts is likely responsible for his symptoms?

Answers:

A. Localized ischemia with areas of necrosis noted on CT angiography

B. High pressure and local hemorrhage of the venous system

C. Hydrocephalus and protein in the cerebral spinal fluid

D. Increased tissue perfusion at the site of the malformation

Question 6

A group of nursing students were studying for their pathophysiology exam by quizzing each other about disorders of WBCs and lymphoid tissue. When asked what the first chromosomal abnormality that identified cancer was, one student correctly answered Answers:

A. interleukin cells.

B. Philadelphia.

C. PSA.

D. BRCA-1.

Question 7

A 47-year-old woman was diagnosed with amyotrophic lateral sclerosis 3 years ago and has experienced a progressive onset and severity of complications. She has been admitted to a palliative care unit due to her poor prognosis? What assessments and interventions should the nursing staff of the unit prioritize in their care?

Answers:

A. Regular pain assessment and administration of opioid analgesics as needed

B. Cardiac monitoring and administration of inotropic medications

C. Assessment and documentation of cognitive changes, including confusion and restlessness

D. Assessment of swallowing ability and respiratory status

Question 8

A 53-year-old man presents with inability to concentrate, itching in his fingers and toes, elevated blood pressure, and unexplained weight loss. He is diagnosed with primary polycythemia. What will be the primary goal of his treatment?

Answers:

A. To increase the amount of oxygen distributed by his red blood cells

B. To reduce the viscosity of his blood

C. To reduce the mean size of his red cells

D. To control his hypertension

Question 9

During a late night study session, a pathophysiology student reaches out to turn the page of her textbook. Which of the following components of her nervous system contains the highest level of control of her arm and hand action?

Answers:

A. Thalamus

B. Cerebellum

C. Frontal lobe

D. Basal ganglia

Question 10

The family members of an elderly patient are wondering why his “blood counts” are not rising after his last GI bleed. They state, “He has always bounced back after one of these episodes, but this time it isn’t happening. Do you know why?” The nurse will respond based on which of the following pathophysiological principles?

Answers:

A. “Don’t worry about it. We can always give him more blood.”

B. “Due to stress, the red blood cells of older adults are not replaced as promptly as younger people.”

C. “Everything slows down when you get older. You just have to wait and see what happens.”

D. “The doctor may start looking for another cause of his anemia, maybe cancer of the bone.”

Question 11

A 44-year-old female patient presents to the emergency department with abnormal bleeding and abdominal pain that is later attributed to gallbladder disease. Which of the following diagnoses would the medical team be most justified in suspecting as a cause of the patient’s bleeding?

Answers:

A. Hemophilia B

B. Vitamin K deficiency

C. Excess calcium

D. Idiopathic immune thrombocytopenic purpura (ITP)

Question 12

Your ESRD patient is receiving 2 units of packed red blood cells for anemia (Hgb of 8.2). Twenty minutes into the first transfusion, the nurse observes the patient has a flushed face, hives over upper body trunk, and is complaining of pain in lower back. His vital signs include pulse rate of 110 and BP drop to 95/56.What is the nurse’s priority action? Answers:

A. Recheck the type of blood infusing with the chart documentation of patient’s blood type. B. Discontinue the transfusion and begin an infusion of normal saline.

C. Slow the rate of the blood infusion to 50 mL/hour.

D. Document the assessment as the only action.

Question 13

A 5th grade elementary student asks the school nurse how much blood is in an entire body. The nurse should respond that the average grown-up adult has

Answers:

A. 2 to 4 cups of blood in his or her body.

B. 5 to 6 L of blood throughout his or her body.

C. 3 pints of blood in total.

D. 3 to 4 quarts of blood in his or her body.

Question 14

The geriatrician providing care for a 74-year-old man with diagnosis of Parkinson disease has recently changed the client’s medication regimen. What is the most likely focus of the pharmacologic treatment of the man’s health problem?

Answers:

A. Preventing demyelination of the efferent cerebellar pathways

B. Preventing axonal degradation of motor neurons

C. Maximizing acetylcholine release from synaptic vesicles at neuromuscular junctions

D. Increasing the functional ability of the underactive dopaminergic system

Question 15

A student makes the statement to a colleague, “Blood plasma is essentially just a carrier for the formed elements like red blood cells and white blood cells.”What would be the most accurate response to this statement?

Answers:

A. “Not really. Plasma also contributes to the processes of protein synthesis and hematopoiesis.”

B. “Actually, plasma plays a significant role in nutrient and waste transport.”

C. “Actually, plasma is integral to the proper function of the liver and maintenance of acid–base balance.”

D. “That’s not really true. Plasma is crucial in the immune and inflammatory responses.”

Question 16

Several months ago, a 20-year-old male suffered a spinal cord injury brought about by a snowboard trick gone wrong. The lasting effects of his injury include a flaccid bowel and bladder and the inability to obtain an erection. While sensation has been completely preserved in his legs and feet, his motor function is significantly impaired. What type of incomplete spinal cord injury has the man most likely experienced?

Answers:

A. Central cord syndrome

B. Conus medullaris syndrome

C. Brown-Séquard syndrome

D. Anterior cord syndrome

Question 17

A client with a gastrointestinal bleed secondary to alcohol abuse and a hemoglobin level of 5.8 g/dL has been ordered a transfusion of packed red blood cells. The client possesses type B antibodies but lacks type D antigens on his red cells. Transfusion of which of the following blood types would be least likely to produce a transfusion reaction?

Answers:

A. A–

B. A

C. B–

D. B

Question 18

Which of the following clients’ signs and symptoms would allow a clinician to be most justified in ruling out stroke as a cause? An adult

Answers:

A. has vomited and complained of a severe headache.

B. states that his left arm and leg are numb, and gait is consequently unsteady.

C. has experienced a sudden loss of balance and slurred speech.

D. has had a gradual onset of weakness, headache, and visual disturbances over the last 2 days.

Question 19

Amniocentesis has suggested that a couple’s first child will be born with sickle cell disease. The parents are unfamiliar with the health problem, and their caregiver is explaining the complexities. Which of the following statements by the parents would suggest a need for further teaching or clarification?

Answers:

A. “Our baby’s red cells are prone to early destruction because of his or her weak membranes.”

B. “Our son or daughter likely won’t show the effects of sickling until he or she is school-aged because of the different hemoglobin in babies.”

C. “Not all of his or her red cells will be sickled, but low oxygen levels can cause them to become so.”

D. “Sickled cells can block his or her blood vessels, especially in the abdomen, chest, and bones.”

Question 20

During science class, a student asks, “What’s the difference between plasma and serum in the blood?” The nurse responds that the primary difference between plasma and serum is that plasma contains

Answers:

A. hydrogen ions.

B. heparin.

C. white…

Case-Assignment: Patient’s Site Placement.

Case-Assignment: Patient’s Site Placement.

Case-Assignment: Patient’s Site Placement.

Case-Assignment: Patient’s Site Placement.

ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT;Case-Assignment: Patient’s Site Placement.

Week 1 discussion Changes in Sites of Care Since the culture and practices of care settings are inherently different, changes in sites of care are often difficult for geriatric patients. Efforts should be made to limit changes to only those necessary; however, sometimes a patient’s situation might require multiple changes in sites of care. When selecting sites of care, such as home, assisted living, rehabilitation facilities, and hospitals, many factors must be considered by patients, their families, and their health care providers. Health status, ability to perform self-care, financial limitations, and patient preferences are all factors that might influence a patient’s site placement. As an advanced practice nurse who recommends sites of care and facilitates changes, you must evaluate factors and consider sites that limit the impact of these changes on geriatric patients. To prepare: Review this week’s media presentation, as well as Chapters 4 and 7 of the Flaherty and Resnick text. Reflect on your personal experiences, observations, and/or clinical practices from the last 5 years. Select a case from the last 5 years that involves an elderly patient who has been in two different sites of care such as home, assisted living, hospital, etc. Note: When referring to your patient, make sure to use a pseudonym or other false form of identification. This is to ensure the privacy and protection of the patient. Reflect on issues that occurred because of the change in the patient’s sites of care. Think about the impact of differences in the settings themselves, inherent cultures of the settings, and ethical practices of these sites on the patient. Consider whether the patient had an advanced directive in place at the time of the change in sites of care. Reflect on whether any difficult treatment decisions had to be made as a result. Think about the impact of financial issues on site placement and treatment decisions. Post on or before Day 3 a description of a case from your personal or clinical experiences in the last 5 years that involves an elderly patient who has been in at least two different sites of care. Explain the impact of differences in the settings themselves, inherent culture of the settings, and ethical practices of these sites on the patient. Then, explain whether the patient had an advanced directive in place at the time of the change in sites of care, and if so, whether any difficult treatment decisions had to be made as a result. Finally, explain the impact of financial issues on site placement and treatment decisions. Read a selection of your colleagues’ responses. Respond on or before Day 6 to at least two of your colleagues on two different days in one or more of the following ways: Suggest community resources that may assist with related cases in the future. Recommend appropriate alternative site placements for your colleagues’ patients based on your geographic location. Provide insights on policy implications of your colleagues’ cases (i.e., Medicare, Medicaid, Veteran’s Affairs, etc.). Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

Source: http://www.collegepaperslab.com/questions/health-care/572627-walden-nurs6540-week-1-discussion-latest-2017/
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Refuting an Argument

Could you write the intro paragraph until Feb 23?

Thesis statement using all three components (subject+assertion+rationale)
Introduction Paragraph (at least 4-5 sentences long)
Outline/Brainstorming Chart/Map (This could be any of the techniques that you chose to use from the Brainstorming lecture)

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Which statement regarding behavioral genetics is accurate?

1- Which statement regarding general cancer Show more PLEASE I REAL NEED HELP FOR FOR MY NURSING QUIZ. THANKS 1- Which statement regarding general cancer development is true? Select one: a . Cancers usually develop in tissues that are missing a nucleus. b. Most mutations leading to cancer development occur in structural genes. c. The risk for cancer development increases with age. d. Children of older mothers have a greater risk for cancer development. 2- Which schizophrenia fact is correct? Select one: a. Copy number variants appear to play the most important role in genetic risk for schizophrenia. b. Because the phenotype of schizophrenia is so obvious diagnosis and inheritance risk are the most easily determined of all the psychiatric disorders. c. When one identical twin is affected with schizophrenia the other most certainly will be affected. d. When schizophrenia has more genetic influence its onset begins in very early childhood. 3- Which statement regarding behavioral genetics is accurate? Select one: a. The genetic susceptibility or predisposition toward a behavioral disorder requires the trigger of an infectious disease for expression. b. Genes and gene products have been discovered that directly control behavior. c. A genetic predisposition toward a specific behavior can be modified by altering environmental influences. d. The genotypes and phenotypes of behavioral problems or deviations follow Mendelian autosomal recessive inheritance patterns. 4- A patient is 34 years old and concerned about possibly being a carrier for HNPCC because his father died of colon cancer at 39 his fathers sister died of colon cancer at age 41 and his brother (aged 37) now has colon cancer. The brothers testing is negative for all the known mutations associated with inherited forms of colon cancer. How should this patient be counseled about his risk for colon cancer? Select one: a. Explain that he could benefit from testing even though his brother is negative for these mutations because reduced penetrance might account for his negative status. b. Explain that testing for him would be of no benefit because of the current test limitations but that his family history does place him a high risk. c. Explain that because the brother with cancer is negative for these gene mutations this cancer is most likely sporadic and his risk is the same as general population risk. d. Explain that his risk is not related to his brothers diagnosis because he did not inherit any genes from him but that since his father is a first-degree relative testing should be considered. 5- Sometimes health-care providers with information about family members genetic risk are confronted by conflicting ethical principles. Which principle is LEAST likely to conflict with the health-care providers duty to warn? Select one: a. Beneficence b. Right to privacy c. Genetic discrimination d. Autonomy 6- Why do genetic counseling programs include extensive courses on laboratory methods in genetics? Select one: a. To be able to draw blood proficiently and safely b. To perform standard karyotyping on routine blood specimens c. To help patients understand testing procedures and results d. To serve as a backup genetics technician in small laboratories 7- What is the result of a mutation occurring in a suppressor gene? Select one: a. Increased error-prone DNA repair b. Increased unequal crossing over during meiosis I c. Gain of a new function d. Loss of an existing function 8- What is the best description of the genetic contribution to onset of autism? Select one: a. Exposure to a teratogen can be a cause of autism spectrum in many cases. b. Autism spectrum is caused by a single gene mutation in most but not all cases. c. Known causes of autism spectrum include copy number variants and chromosomal problems. d. Autism spectrum disorders have a much stronger environmental input than genetic input to expression of the phenotype. 9- What is the heritability estimate for addiction to alcohol in both males and females? Select one: a. 60% to 80% b. 50% to 60% c. 20% to 40% d. 10% to 20% 10- An 85-year-old patient states that she does not perform breast self-exam because there is no history of breast cancer in her family. What is the best response? Select one: a. Because your breasts are no longer as dense as they were when you were younger your risk for breast cancer is now decreased. b. Breast cancer can be found more frequently in some families; however the risk for general nonfamilial breast cancer increases with age. c. Examining your breasts once per year when you have your mammogram is sufficient screening for someone with your history. d. You are correct. Breast cancer is an inherited type of malignancy and your family history indicates a low risk for you. 11- How are malignant tumors different from benign tumors? Select one: a. Benign tumors have totally normal features and malignant tumors have totally abnormal features. b. Malignant tumors lose plasma membranes and benign tumors continue to produce them. c. Malignant tumors grow by expansion and benign tumors grow by invasion. d. Benign tumors retain parental cell functions and malignant tumors lose parental cell functions. 12- Why is determining the genetic contribution important to assess in stroke patients? Select one: a. Comorbidities mask the symptoms and delay the diagnosis. b. Often the person with a stroke cannot provide accurate family information. c. Stroke classification and phenotype remain heterogeneous. d. Environmental risk factors have equal contribution to the problem. 13- A certified family nurse practitioner with an MSN degree in family practice who works in a clinic serving patients who have connective tissue disorders refers to himself as a clinical geneticist. Is this title appropriate? Select one: a. Yes he is a clinician employed in a setting specializing in patients with genetic-based health problems b. No a clinical geneticist is a physician who has completed a fellowship in clinical genetics. c. No a clinical geneticist must be certified as a genetic counselor. d. Yes he is an advanced practice nurse. 14- What is the most accurate classification of the common forms of coronary artery disease and hypertension? Select one: a. Sequential genetic disorders related to age ethnicity and gender b. Complex disorders resulting from geneenvironment interactions c. Secondary disorders caused by lifestyle choices d. Primary disorders with an autosomal dominant pattern of inheritance 15- A woman whose sister tested positive for a specific mutation in the BRCA1 gene which increases the risk for breast and ovarian cancer is found not to have that mutation but does have a mutation of unknown significance near the known mutation site. How should this woman be counseled? Select one: a. She should be informed that because she does not have the mutation her risk for breast cancer is not greater than that of the general population. b. She should be informed of her gene mutation status and be presented with all the available prophylaxis options and reconstruction options. c. She should be info rmed that she does not have the specific mutation but that because another mutation is present she should be vigilant about screening d. She should be informed that her risk for breast cancer is greater than the general population but not as great as her sisters risk. Show less

 

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