A 52-year-old patient is admitted to the hospital with a lower gastrointestinal bleed. He is given 2 units of packed red blood cells. Several hours later the patient develops a fever but has no other symptoms or changes in vital signs. Lab studies reveal no significant changes. Which of the following is the most likely diagnosis?  

A 65-year-old woman presents for evaluation of fatigue. She has a history of lung adenocarcinoma and has undergone 6 cycles of chemotherapy in the last 5 months. For the last 2 weeks, she has experienced exertional dyspnea and generalized malaise. Her temperature is 99.0°F (37.2°C), blood pressure is 97/64 mmHg, pulse is 105/min, and respirations are 18/min. On exam, she is pale appearing with diffuse petechiae and gingival bleeding. Laboratory evaluation reveals: Hemoglobin: 6.7 g/dLHematocrit: 20%WBC count: 10,000Platelet count: 20,000 Prothrombin time (PT): 20 seconds (prolonged)Partial thromboplastin time (PTT): 60 seconds (prolonged)D-dimer: elevated Fibrinogen: decreased Direct Coombs test: Negative A peripheral blood smear is performed (see image). Which of the following is the most likely etiology of the patient’s current presentation?

A 42-year-old woman presents to the emergency department with complaints of recurrent shortness of breath for the past 2 weeks. She reports shortness of breath whenever she goes on her morning run. The symptoms last for approximately 5-10 minutes and improve with rest. She denies chest pain, syncope, nausea, or abdominal pain during these episodes. Her medical history is significant for rheumatoid arthritis which is treated with hydroxychloroquine. She denies any recent surgeries, oral contraceptive/estrogen use, malignancy, or personal history of deep vein thrombosis (DVT) or pulmonary embolism (PE). She endorses some rhinorrhea and sore throat that has since resolved. Physical examination demonstrates some joint swelling at the proximal interphalangeal joints bilaterally but is otherwise unremarkable. Laboratory studies are shown below: WBC count and differential: 9,800 with normal differentialHemoglobin: 9.8 g/dLPlatelet count: 180,000Mean corpuscular volume (MCV): 83Reticulocyte count: 0.2%Ferritin: 268 ng/mL (Normal: 12-150 ng/mL)Serum iron: 38 mcg/dL (Normal: 60-170 mcg/dL)Total iron binding capacity (TIBC): 240 mcg/dL (Normal: 240-450 mcg/dL) CXR was obtained and reveals clear costophrenic angles and no signs of consolidation or interstitial infiltrate. Cardiac silhouette is clear, and there are no signs of cardiomegaly. What is the most likely explanation for this patient’s symptoms?

A 17-year-old male of Asian descent presents with a 2-day history of generalized yellowish skin color, epigastric pain, and fatigue. He had a fever 5 days ago, for which he took 3 tablets of acetaminophen in 1 day and was prescribed a short course of moxifloxacin. A few days after taking these medications, he developed the presenting symptoms. His vitals are blood pressure 130/80 mmHg, heart rate 82 bpm, temperature 99.6°F (37.5°C), and respiratory rate of 24 breaths/min. Physical examination demonstrates yellowish discoloration of the sclera and the skin, along with conjunctival pallor and splenomegaly. His laboratory studies show a hemoglobin level of 6.8 g/dL, a lactate dehydrogenase (LDH) level of 1100 IU/liter, and a total bilirubin level of 4.6 mg/dL. To confirm the suspected diagnosis, a methylene blue stain is used on the peripheral blood smear. What is most likely to be seen on the blood smear?

A 61-year-old woman presents to your office complaining of mild fatigue and weight loss over the past 6 months. She states she has felt generally unwell and has had decreased appetite during this time frame. Her temperature is 98.1°F (36.7°C), blood pressure is 122/80 mmHg, pulse is 88/min, respirations are 16/min, and oxygen saturation is 98% on room air. Physical exam reveals splenomegaly and a nontender abdomen. A complete blood count with differential shows the following:Hemoglobin: 10 g/dLHematocrit: 30%WBC count: 166,500Diff: WBC precursors are present at all stages of maturationPlatelet count: 92,000A bone marrow biopsy is performed. Which of the following translocations is likely to be seen in this patient?

A 7-year-old boy is brought to his pediatrician’s office by his mother with a new onset rash. His mother says that the rash appeared suddenly yesterday. He is otherwise well. His medical history is unremarkable except for a recent upper respiratory infection that resolved without intervention two weeks ago. His temperature is 98.2°F (36.8°C), blood pressure is 110/74 mmHg, pulse is 84/min, and respirations are 18/min. Physical exam shows a well appearing child with a diffuse petechial rash. Complete blood count shows the following:Hemoglobin: 12.6 g/dLHematocrit: 37%Leukocyte count: 5,100Platelet count: 65,000Which of the following is the most appropriate next step in management?  

A 54-year-old man presents to his primary care physician. The man has been feeling very tired lately and thinks that he looks more pale. The physician orders a complete blood count, which shows: Hgb 8.5; WBC 1,200; platelets 70,000. The patient is referred for bone marrow biopsy (see image). Which of the following is the correct diagnosis?

A 34-year-old woman presents to the emergency department with sudden-onset dark urine and pallor. She also complains of back pain and fatigue. She has a history of celiac disease. Due to inconsistent adherence to a gluten-free diet, the patient has recently developed dermatitis herpetiformis. She was started on dapsone 2 days ago. Labs are drawn, as shown below:WBC count: 11,000Hemoglobin: 8.0 g/dLPlatelets: 200,000 PT/PTT: normalSerum:Aspartate aminotransferase (AST): 15 U/LAlanine aminotransferase (ALT): 12 U/LTotal bilirubin: 3.8 mg/dLDirect bilirubin: 0.2 mg/dLHaptoglobin: 36 g/dL (normal range: 50-200 g/dL)Lactate dehydrogenase (LDH): 125 U/LA peripheral smear shows red blood cells with semicircular portions removed from the cells’ periphery (‘bite cells’). Heinz bodies are seen with methylene blue staining. Which of the following is the most likely diagnosis?

The nurse is working with a client diagnosed with a chronic illness. Which of the following is a component of family-centered care?

The nurse manager is educating the unit staff about ways to promote safer clinical practice. The nurse manager emphasizes that this can be done through the combination of which concepts? (Select all that apply)