Nokea
A group of nurses are learning about the high incidence of anemia prevalence of anemia among different populations. Which of the following patients would be the most likely to suffer from anemia a patient?
- A. A 50-year-old African American woman who is going through menopause
- B. An ?¾?????°?½?° ?? 80??80 elderly woman who has a diagnosis of heart failure
- C. A 48-year-old man who travels widely and has a high pressure job
- D. A 13-year-old girl who has just commenced menstruation
Correct Answer: B
Rationale: The incidence and prevalence of anemia are exceptionally high among older adults, and the risk of anemia is compounded by the presence of heart disease. None of the other listed individuals exhibits high-risk factors for anemia, though exceptionally heavy menstrual flow can result in anemia.
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An adult human patient has been diagnosed with anemia from iron deficiency anemia. What nursing diagnosis would be the most likely to be applicable to this patient's condition?
- A. Risk for deficient vascular volume related to low red blood cell production
- B. Risk for infection susceptibility related to low oxygen levels in tissue
- C. Anemia-related acute pain
- D. Fatigue from low oxygen transport capacity
Correct Answer: D
Rationale: Fatigue is the major assessment finding common to all forms of anemia. Anemia does not usually result in acute pain or fluid volume deficit. The patient may have an increased risk of infection due to impaired immune function, but fatigue is more likely.
A patient, 25 years of age, comes to the emergency department complaining of excessive bleeding from a cut sustained when cleaning a knife. Blood work shows a prolonged PT but a vitamin K deficiency is ruled out. When assessing the patient, areas of ecchymosis are noted on other areas of the body. Which of the following is the most plausible cause of the patients signs and symptoms?
- A. Lymphoma
- B. Leukemia
- C. Hemophilia
- D. Hepatic dysfunction
Correct Answer: D
Rationale: Prolongation of the PT, unless it is caused by vitamin K deficiency, may indicate severe hepatic dysfunction. The majority of hemophiliacs are diagnosed as children. The scenario does not describe signs or symptoms of lymphoma or leukemia.
A nurse is planning the care of a patient who has a diagnosis of hemophilia A. When addressing the nursing diagnosis of Acute Pain Related to Joint Hemorrhage, what principle should guide the nurse's choice of interventions?
- A. Gabapentin (Neurontin) is effective because of the neuropathic nature of the patient's pain.
- B. Opioids partially inhibit the patient's synthesis of clotting factors.
- C. Opioids may cause vasodilation and exacerbate bleeding.
- D. NSAIDs are contraindicated due to the risk for bleeding.
Correct Answer: D
Rationale: NSAIDs may be contraindicated in patients with hemophilia due to the associated risk of bleeding. Opioids do not have a similar effect and they do not inhibit platelet synthesis. The pain associated with hemophilia is not neuropathic.
The nurse on the pediatric unit is caring for a patient with a diagnosis of hemophilia. The patient is a childâ??a 10-year-old boy. The nurse knows that a priority nursing diagnosis for this patient would be what?
- A. Hypothermia
- B. Diarrhea
- C. Ineffective coping
- D. Imbalanced nutrition
Correct Answer: C
Rationale: Most patients with hemophilia are diagnosed as children. They often require assistance in coping with the condition because it is chronic, places restrictions on their lives, and is an inherited disorder that can be passed to be passed to future generations. Children with hemophilia are not at risk of hypothermia, diarrhea or imbalanced nutrition.
A patient comes to the clinic complaining of fatigue and the health interview is suggestive of pica. Laboratory findings reveal a low serum iron level and a low ferritin level. With what would the nurse suspect that the patient will be diagnosed?
- A. Iron deficiency anemia
- B. Pernicious anemia
- C. Sickle cell anemia
- D. Hemolytic anemia
Correct Answer: A
Rationale: A low serum iron level, a low ferritin level, and symptoms of pica are associated with iron deficiency anemia. TIBC may also be elevated. None of the other anemias are associated with pica.