What genetic abnormality would a nurse expect in a client diagnosed with Chronic Myelogenous Leukemia (CML)?

Trisomy 21 (Down syndrome)

Fragile X syndrome

BRCA1 gene mutation

Philadelphia chromosome (BCR-ABL fusion gene)

Answer and Explanation

The Correct Answer is D

A.   Trisomy 21 is a chromosomal disorder resulting in Down syndrome. While individuals with Down syndrome have an increased risk of developing certain leukemias (such as acute lymphoblastic leukemia), it is not directly associated with CML.
B.   Fragile X syndrome is a genetic condition caused by a mutation in the FMR1 gene on the X chromosome, leading to intellectual disability and other developmental issues. It is not associated with CML or any form of leukemia. This option is unrelated to the genetic abnormalities seen in CML.
C.   The BRCA1 gene mutation is associated with an increased risk of breast and ovarian cancers. While mutations in BRCA1 can affect cancer susceptibility, they are not linked to Chronic Myelogenous Leukemia. Thus, this option does not apply to CML.
D.   The Philadelphia chromosome is a specific genetic abnormality found in the majority of patients with CML. It results from a translocation between chromosomes 9 and 22, creating the BCR-ABL fusion gene, which produces a tyrosine kinase that drives the proliferation of leukemic cells.

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Correct Answer is B

Explanation

A. Using a cold compress is typically employed for reducing swelling or discomfort, but it does not address the visual deficits associated with homonymous hemianopia. This intervention would not assist the client in compensating for their visual field loss.
B. Teaching scanning techniques involves training the client to actively search for visual information from their affected side. This can include turning their head and using their eyes to scan to the left (for right homonymous hemianopia) or to the right (for left homonymous hemianopia). This compensatory strategy is crucial for helping the client navigate their environment safely and effectively during rehabilitation.
C. Applying an eye patch is not appropriate for homonymous hemianopia, as it may further limit visual input. In fact, patching could exacerbate difficulties by reducing overall vision and is generally more relevant for conditions like amblyopia or for treating diplopia (double vision), rather than compensating for a visual field deficit.
D. Using eye drops is typically for treating dry eyes, redness, or other ocular conditions, and does not directly address the issues related to homonymous hemianopia. This intervention would not help the client learn to compensate for their visual field loss.

A. "Is the 'lump' painful?" B. "Have you had any trouble urinating?" C. "Have you had unprotected sex recently?" D. "Do you have any discharge from your penis?"

Correct Answer is A

Explanation

A. This response is relevant and helps assess the characteristics of the lump. Pain can be an important factor in differentiating between conditions, such as epididymitis, testicular torsion, or tumors. However, while it is a useful question, it may not provide a comprehensive assessment of the situation.
B. This question can be relevant depending on the underlying cause of the lump. Issues with urination may suggest a problem related to the prostate or bladder rather than the testicle itself. While it can help assess urinary tract involvement, it may not directly address the significance of the lump in the testicle.
C. This question is important in the context of sexually transmitted infections (STIs), which can cause scrotal swelling or lumps due to conditions like epididymitis or orchitis. However, it does not directly assess the lump itself, making it less focused on the immediate concern.
D. This question addresses the possibility of an STI and related conditions. While it is relevant, it is not the best immediate question concerning the lump in the testicle. The presence of discharge may not directly correlate with the testicular lump itself.

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What genetic abnormality would a nurse expect in a client diagnosed with Chronic Myelogenous Leukemia (CML)?

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Naxlex Comprehensive Predictor Exams

A client diagnosed with a stroke is experiencing homonymous hemianopia. The most appropriate nursing intervention to help the client learn to compensate for this deficit during rehabilitation period would be to:

Correct Answer is B

Explanation

The nurse is caring for a male patient who complains about a small "lump" that he discovered in his right testicle. What would be the best response by the nurse?

Correct Answer is A

Explanation

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