A client with a diagnosis of aplastic anemia has undergone allogenic bone marrow transplantation. Which of the following signs and symptoms would most clearly suggest the existence of graft versus host disease (GVHD)?
A) Shortness of breath, audible crackles, and decreasing PaO2
B) Presence of a pruritic rash that has begun to slough off
C) Development of metabolic acidosis
D) Diaphoresis, fever, and anxiety
Ans: B
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In cases of GVHD, there is development of a pruritic, maculopapular rash that begins on the palms and soles and frequently extends over the entire body, with subsequent desquamation. Respiratory complications are atypical, and neither metabolic acidosis nor diaphoresis and fever are common.
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