A child is diagnosed with acquired aplastic anemia. The nurse knows that this child has the best prognosis with which treatment regimen?

Immunosuppressive therapy.

Chemotherapy.

Bone marrow transplantation.

Blood transfusions.

Answer and Explanation

The Correct Answer is C

Rationale:

A. Immunosuppressive therapy:This is a common treatment for aplastic anemia when a matched donor is unavailable, especially in older children and adults. However, it is less curative and carries a higher risk of relapse compared to bone marrow transplantation.

B. Chemotherapy: Chemotherapy is not the primary treatment for aplastic anemia. It is mainly used in malignancies. In some cases, chemotherapy may precede transplantation or be part of immunosuppressive therapy, but it is not curative alone.

C. Bone marrow transplantation: This is the treatment of choice and offers the best prognosis, particularly in children with a matched sibling donor. It provides a potential cure by replacing the defective marrow with healthy stem cells.

D. Blood transfusions: Transfusions manage symptoms and prevent complications like anemia or bleeding but do not treat the underlying cause. Long-term use increases the risk of iron overload and alloimmunization.

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Free Nursing Study Resources

Correct Answer is C

Explanation

Rationale:

A. Assess for fatty yellow streaks in the client's stool: This suggests steatorrhea, commonly linked to malabsorption syndromes—not relevant to recent thrombolytic use or bleeding risk.

B. Obtain a specimen for culture and sensitivity analysis: This is used to identify infectious organisms in cases of suspected gastrointestinal infection, not bleeding, which is the primary concern post-thrombolytic therapy.

C. Send a stool sample to the lab for a guaiac test: A guaiac test detects occult (hidden) blood in stool, which is essential for identifying gastrointestinal bleeding—a major complication of thrombolytic therapy.

D. Observe the stool for a clay-colored appearance: Clay-colored stool may indicate biliary obstruction or liver dysfunction, not a bleeding issue, which is the critical concern after thrombolytic administration.

A. The left radial pulse is 2+ bounding. B. Assessment of a bruit on the left forearm. C. Auscultation of a thrill on the left forearm. D. Distended, tortuous veins in the left hand.

Correct Answer is B

Explanation

Rationale:
A. The left radial pulse is 2+ bounding: A radial pulse reflects arterial blood flow but does not confirm the functionality of the AV fistula. It may be normal even if the fistula is occluded or nonfunctional.

B. Assessment of a bruit on the left forearm: A bruit, a whooshing sound heard with a stethoscope, indicates turbulent blood flow through the AV fistula, confirming that the fistula is patent and functioning. This is a key sign of fistula viability.

C. Auscultation of a thrill on the left forearm: A thrill is felt (palpated), not auscultated. While a thrill is also a sign of patency, the phrasing here is incorrect. The term “auscultation” applies to the bruit, not the thrill.

D. Distended, tortuous veins in the left hand: Prominent hand veins may occur with vascular changes but do not confirm AV fistula patency. Assessment must include direct evaluation for a bruit or thrill over the fistula site.

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A child is diagnosed with acquired aplastic anemia. The nurse knows that this child has the best prognosis with which treatment regimen?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client received a thrombolytic medication following a myocardial infarction. When the client has a bowel movement, which action should the nurse implement?

Correct Answer is C

Explanation

A client with chronic kidney disease (CKD) has an arteriovenous (AV) fistula in the left forearm. Which observation by the nurse indicates that the fistula is patent?

Correct Answer is B

Explanation

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