Nokea
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.
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A patient newly diagnosed with thrombocytopenia is admitted to the medical unit. After the admission assessment, the patient asks the nurse to explain the disease. What should the nurse explain to this patient?
- A. There could be an attack on the platelets by antibodies.
- B. There could be decreased production of platelets.
- C. There could be impaired communication between platelets.
- D. There could be an autoimmune process causing platelet malfunction.
Correct Answer: B
Rationale: Thrombocytopenia can result from a decreased platelet production, increased platelet destruction, or increased consumption of platelets. Impaired platelet communication, antibodies, and autoimmune processes are not typical pathologies.
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 nurse is admitting a patient with immune thrombocytopenic purpura to the unit. In completing the admission assessment, the nurse must be alert for what medications that potentially alter platelet function?
- A. Antihypertensives
- B. Penicillins
- C. Sulfa-containing medications
- D. Aspirin
- E. NSAIDs
Correct Answer: C,D,E
Rationale: The nurse must be alert for sulfa-containing medications and others that alter platelet function (e.g., aspirin-based or other NSAIDs). Antihypertensive drugs and the penicillins do not alter platelet function.
A patients blood work reveals a platelet level of 17,000/mm3. When inspecting the patients integumentary system, what finding would be most consistent with this platelet level?
- A. Dermatitis
- B. Petechiae
- C. Urticaria
- D. Alopecia
Correct Answer: B
Rationale: When the platelet count drops to less than 20,000/mm?³, petechiae can appear. Low platelet levels do not normally result in dermatitis, urticaria (hives), or alopecia (hair loss).
A patient's electronic health record notes that he has previously undergone treatment for secondary polycythemia. How should this aspect of the patient's history guide the nurse's subsequent assessment?
- A. The nurse should assess for recent blood donation.
- B. The nurse should assess for evidence of lung disease.
- C. The nurse should assess for a history of venous thromboembolism.
- D. The nurse should assess the patient for impaired renal function.
Correct Answer: B
Rationale: Any reduction in oxygenation, such as lung disease, can cause secondary polycythemia. Blood donation does not precipitate this problem and impaired renal function typically causes anemia, not polycythemia. A history of VTE is not a likely contributor.