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A patient is presented with weakness of legs, arms, trunk, tingling and numbness that progressively worsens. Peripheral blood smear shows macrocytic anemia. Which of the following is not the factor causing this condition?
- A. Chronic atrophic gastritis
- B. Ileal resection
- C. Tapeworm infestation
- D. Alcoholism
Correct Answer: C
Rationale: The correct answer is C: Tapeworm infestation. The symptoms described are consistent with vitamin B12 deficiency, which can result in macrocytic anemia and neurological symptoms. Chronic atrophic gastritis and ileal resection can impair absorption of vitamin B12, leading to deficiency. Alcoholism can also lead to malnutrition and vitamin deficiencies. Tapeworm infestation, on the other hand, does not directly affect vitamin B12 absorption. Therefore, tapeworm infestation is not a factor causing the condition described.
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A patient is presented with fever, vomiting, hypotension and facial edema after his business trip back from Africa. Viral hemorrhagic fever is suspected in this patient. Which of the following family does the suspected virus belong to?
- A. Filovirus
- B. Togavirus
- C. Adenovirus
- D. Bunyavirus
Correct Answer: A
Rationale: The correct answer is A: Filovirus. Viral hemorrhagic fevers are caused by viruses within the Filovirus family, which includes Ebola and Marburg viruses. Symptoms such as fever, vomiting, hypotension, and facial edema are characteristic of these infections. Togavirus (choice B) does not typically cause hemorrhagic fevers. Adenovirus (choice C) and Bunyavirus (choice D) are not commonly associated with viral hemorrhagic fevers. Therefore, the suspected virus in this patient most likely belongs to the Filovirus family.
A nurse is caring for a client who is about to begin alteplase therapy to treat pulmonary embolism. Which of the following drugs should the nurse have available in the event of a severe adverse reaction?
- A. Vitamin K
- B. Aminocaproic acid
- C. Protamine
- D. Deferoxamine
Correct Answer: B
Rationale: Rationale: Aminocaproic acid is used to manage bleeding complications associated with thrombolytic therapy, like alteplase. In case of severe adverse reaction such as uncontrolled bleeding, aminocaproic acid can help by inhibiting fibrinolysis. Vitamin K (A) is not used for this purpose. Protamine (C) is used to reverse heparin anticoagulation, not for thrombolytic therapy. Deferoxamine (D) is used for iron toxicity, not related to thrombolytic therapy. Thus, having aminocaproic acid available is crucial for managing potential adverse reactions during alteplase therapy.
Sickle cell an. Is not complicated by:
- A. papillary necrosis
- B. pancreatitis
- C. osteomyelitis
- D. CHF
Correct Answer: B
Rationale: The correct answer is B: pancreatitis. Sickle cell anemia does not typically manifest with pancreatitis. The pathophysiology of sickle cell anemia involves sickle-shaped red blood cells leading to vaso-occlusive crises, resulting in complications such as papillary necrosis, osteomyelitis, and congestive heart failure. Pancreatitis is not a common complication of sickle cell anemia due to the absence of significant involvement of the pancreas in the disease process. Therefore, option B is the correct choice, as it does not align with the typical complications seen in sickle cell anemia.
A female patient's hematocrit level is 50% and oxygen saturation is 98% on room air. What should the nurse suspect as being the cause for this patient's hematocrit level?
- A. Dehydration
- B. Chronic renal failure
- C. Bone marrow suppression
- D. Bleeding esophageal varices
Correct Answer: A
Rationale: The correct answer is A: Dehydration. Dehydration can lead to hemoconcentration, resulting in an elevated hematocrit level. When a person is dehydrated, the plasma volume decreases, causing an increase in the proportion of red blood cells in the blood, leading to a higher hematocrit level. In this case, the patient's high hematocrit level of 50% is likely due to dehydration rather than the other options. Oxygen saturation being 98% on room air indicates adequate oxygenation, ruling out chronic renal failure, bone marrow suppression, and bleeding esophageal varices as potential causes for the high hematocrit level in this patient.
Macrocytosis is a characteristic of all except:
- A. an. Of myxedema
- B. methotrexate induced
- C. chronic alcoholism induced liver dis.
- D. SLE
Correct Answer: D
Rationale: Step-by-step rationale:
1. Macrocytosis refers to larger-than-normal red blood cells.
2. Systemic Lupus Erythematosus (SLE) is not typically associated with macrocytosis.
3. Anemia of myxedema, methotrexate-induced, and chronic alcoholism-induced liver disease can all lead to macrocytosis.
4. Therefore, the correct answer is D: SLE, as it is not commonly associated with macrocytosis.