The nurse practitioner (NP) is taking care of a patient with acute lymphocytic leukemia (ALL) with a white blood cell count of 6.0. Which of the following is NOT a common characteristic of ALL?
Age older than 50, Black race
Age younger than 18, White race
Trisomy 21 (Down syndrome), neurofibromatosis type 1, Bloom syndrome, and ataxia telangiectasia
Five-year overall survival rate estimated at greater than 85%
The Correct Answer is A
Choice A reason: ALL is most common in children, particularly those under 18 years of age, and is more prevalent in White populations. It is relatively rare in individuals over 50, and Black race is associated with slightly lower incidence rates. Therefore, this demographic profile is not typical of ALL.
Choice B reason: This is a common demographic for ALL. The disease predominantly affects children, especially those of White ethnicity, and is the most common pediatric cancer.
Choice C reason: Genetic syndromes such as Down syndrome, neurofibromatosis type 1, Bloom syndrome, and ataxia telangiectasia are known risk factors for developing ALL. These conditions are associated with genomic instability and increased malignancy risk.
Choice D reason: Advances in treatment have significantly improved survival rates for pediatric ALL, with five-year survival exceeding 85% in many cases. This reflects the effectiveness of current chemotherapy protocols and supportive care.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Sickle cell anemia is indeed inherited in an autosomal recessive pattern. Individuals must inherit two copies of the mutated beta globin gene (one from each parent) to manifest the disease. Carriers with one copy are typically asymptomatic but may pass the gene to offspring.
Choice B reason: The condition results from a point mutation in the beta globin gene, specifically a substitution of valine for glutamic acid at the sixth position. This leads to the production of hemoglobin S, which polymerizes under low oxygen conditions, causing red blood cells to assume a sickle shape.
Choice C reason: The sickled red blood cells can obstruct small blood vessels, leading to ischemia and infarction in various tissues, including bones. This can predispose patients to osteomyelitis and bone necrosis, particularly in long bones. Thus, this statement is accurate.
Choice D reason: This statement is false and stigmatizing. Patients with sickle cell anemia experience real and often severe pain due to vaso-occlusive crises. Labeling them as drug-seeking undermines their legitimate need for pain management and contributes to healthcare disparities.
Correct Answer is D
Explanation
Choice A reason: This is correct. When slough or eschar obscures the wound bed, the ulcer is classified as unstageable until the base is visible. Accurate staging requires assessment of tissue depth and type.
Choice B reason: This is correct. Pressure ulcers do not progress through stages as they heal. For example, a stage 4 ulcer does not become a stage 3 ulcer during healing. Instead, it is described as a “healing stage 4 ulcer.”
Choice C reason: This is correct. In individuals with dark skin, early signs of pressure injury may present as persistent discoloration rather than visible redness. Recognizing these variations is essential for early detection.
Choice D reason: This is incorrect. The presence of a pressure ulcer may reflect inadequate care, poor mobility support, or lack of access to services. While not always indicative of neglect, it warrants evaluation of the patient’s support system and care environment.
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