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 C

Explanation

A. This intervention can be appropriate since a very low platelet count increases the risk of bleeding, including gastrointestinal bleeding. However, this action alone does not directly address the immediate risks associated with the low platelet count.
B. While hydration is important for overall health, this intervention does not specifically address the risks associated with a low platelet count. Additionally, excessive fluid intake may not be appropriate for all patients, especially if there are underlying kidney issues or fluid restrictions.
C. Clients with AML and low platelet counts are at increased risk for infections and may develop febrile neutropenia. Monitoring temperature every four hours can help detect early signs of infection, allowing for timely intervention.
D. While maintaining oral hygiene is important, especially in patients undergoing chemotherapy, this intervention may not be the most critical action based on the acute concern of a very low platelet count. However, it is important to note that patients with low platelet counts may also experience bleeding from the gums, making gentle oral care essential.

A. Twin Donor B. Sibling Donor C. Self- Donor D. Matched Donor

Correct Answer is {"A":{"answers":"C"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"}}

Explanation

Allogeneic Transplant

Matched Donor: This refers to a donor who is not genetically identical to the recipient but has a similar tissue type. This can include unrelated donors who are matched through registries.

Sibling Donor: A sibling can be a potential donor if they have a matching tissue type. Since siblings share genes, there is a higher chance of finding a match.

Autologous Transplant

Self-Donor: In this type of transplant, the patient donates their own stem cells before undergoing treatment (such as chemotherapy or radiation). These cells are then stored and re-infused after treatment to help the body recover.

Syngeneic Transplant

Twin Donor: This involves a donor who is an identical twin. Since identical twins have the same genetic makeup, there is a perfect match, reducing the risk of graft-versus-host disease (GVHD).

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Blood Cell	Normal Ranges
Red blood cells (mature, circulating)	Male: 451-6.01 million/mm3 Female: 4.01-5.51 million/mm3
Hemoglobin	Adult (15-64 yr) Male 14-17.3 g/dL Female 11.7-155 g/dL
Hematocrit	42%-52% in males 36% -48% in females
Reticulocytes	0.5% -2.5% of total RBC count
White blood cells (total)	4.5-11.1 10/mm3
Neutrophils	59% Bands 3% Segs-56%
Eosinophils	2.7%
Basophils	0.5%
Lymphocytes	34%
Monocytes	4%


Platelets	150,000-450,000/mm3

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

Match the type of bone marrow transplant to the appropriate donor. The nurse is caring for a client who was diagnosed with Acute Myelogenous Leukemia (AML). The client is in need of a bone marrow transplant. Match the type of bone marrow transplant to the appropriate donor:

Correct Answer is {"A":{"answers":"C"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"}}

Explanation

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