Nokea
A patient with renal failure has decreased erythropoietin production. Upon analysis of the patients complete blood count, the nurse will expect which of the following results?
- A. An increased hemoglobin and decreased hematocrit
- B. A decreased hemoglobin and hematocrit
- C. A decreased mean corpuscular volume (MCV) and red cell distribution width (RDW)
- D. An increased MCV and RDW
Correct Answer: B
Rationale: The decreased production of erythropoietin will result in a decreased hemoglobin and hematocrit. The patient will have normal MCV and RDW because the erythrocytes are normal in appearance.
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A patient is admitted to the diagnosis of pernicious anemia. The nurse should prepare to administer which of the following medications?
- A. Folic acid
- B. Vitamin B12
- C. Lactulose
- D. Magnesium sulfate
Correct Answer: B
Rationale: Pernicious anemia is characterized by vitamin B12 deficiency. Magnesium sulfate, lactulose, and folic acid do not address the pathology of this type of anemia.
A patient's low prothrombin time (PT) was attributed to a vitamin K deficiency and the patient's PT normalized after administration of vitamin K. When performing discharge education in an effort to prevent recurrence, what should the nurse emphasize?
- A. The need for adequate nutrition
- B. The need to avoid NSAIDs
- C. The need for constant access to factor concentrate
- D. The need for meticulous hygiene
Correct Answer: A
Rationale: Vitamin K deficiency is often the result of a nutritional deficit. NSAIDs do not influence vitamin K synthesis and clotting factors are not necessary to treat or prevent a vitamin K deficiency. Hygiene is not related to the onset or prevention of vitamin K deficiency.
A patient is being treated for DIC and the nurse has prioritized the nursing diagnosis of Risk for Deficient Fluid Volume Related to Bleeding. How can the nurse best determine if goals of care relating to this diagnosis are being met?
- A. Assess for edema.
- B. Assess skin integrity frequently.
- C. Assess the patient's level of consciousness frequently.
- D. Closely monitor intake and output.
Correct Answer: D
Rationale: The patient with DIC is at a high risk of deficient fluid volume. The nurse can best gauge the effectiveness of care by closely monitoring the patient's intake and output. Each of the other assessments is a necessary element of care, but none addresses fluid balance as directly as close monitoring of intake and output.
A patient with a history of atrial fibrillation has contacted the clinic saying that she has accidentally overdosed on her prescribed warfarin (Coumadin). The nurse should recognize the possible need for what antidote?
- A. IVIG
- B. Factor X
- C. Vitamin K
- D. Factor VIII
Correct Answer: C
Rationale: Vitamin K is administered as an antidote for warfarin toxicity.
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.