Choice A rationale:

Chest x-ray Chest x-ray is not typically used to diagnose central nervous system involvement in leukemia.

It is primarily used to assess the condition of the lungs and chest cavity.

Therefore, it is not the correct procedure for the nurse to be referring to in this context.

Choice B rationale:

Lumbar puncture A lumbar puncture, also known as a spinal tap, is the diagnostic procedure the nurse is likely referring to when discussing the risk of central nervous system involvement in leukemia.

It involves the insertion of a needle into the spinal canal to collect cerebrospinal fluid (CSF) for analysis.

This procedure is essential in assessing whether leukemia cells have spread to the central nervous system.

Leukemic cells in the CSF can indicate central nervous system involvement, which may require specific treatment approaches.

Choice C rationale:

CT scan While a CT scan can provide valuable information about various parts of the body, it is not the primary procedure used to diagnose central nervous system involvement in leukemia.

CT scans are typically more useful for assessing solid organs and structures, not for analyzing cerebrospinal fluid.

Choice D rationale:

Bone marrow aspiration Bone marrow aspiration is a diagnostic procedure used to assess the bone marrow and is crucial for diagnosing leukemia and determining the subtype of leukemia.

It does not directly assess central nervous system involvement, so it is not the procedure the nurse is likely referring to in this context.