Nokea
A patient's complete blood count (CBC) shows a hemoglobin of 19 g/dL and a hematocrit of 54%. Which question should the nurse ask to determine possible causes of this finding?
- A. Have you had any recent weight loss?
- B. Do you have any history of lung disease?
- C. Have you noticed any dark or bloody stools?
- D. What is your dietary intake of meats and proteins?
Correct Answer: B
Rationale: The correct answer is B: "Do you have any history of lung disease?" The elevated hemoglobin and hematocrit levels suggest polycythemia, which can be seen in conditions like chronic obstructive pulmonary disease (COPD). Option A is less relevant as weight loss is not typically associated with these blood count findings. Option C is more indicative of gastrointestinal bleeding rather than a respiratory issue. Option D focuses on dietary factors, which are less likely to cause such significant elevations in hemoglobin and hematocrit levels as seen in this case.
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A 52-year-old patient has a new diagnosis of pernicious anemia. The nurse determines that the patient understands the teaching about the disorder when the patient states:
- A. I need to start eating more red meat and liver.
- B. I will stop having a glass of wine with dinner.
- C. I could choose nasal spray rather than injections of vitamin B12.
- D. I will need to take a proton pump inhibitor such as omeprazole (Prilosec).
Correct Answer: C
Rationale: The correct answer is C. Pernicious anemia is a condition where the body can't absorb enough vitamin B12. Treatment usually involves lifelong replacement of vitamin B12. In this case, the patient understanding the disorder is correctly demonstrated by choosing nasal spray or injections of vitamin B12 for replacement therapy. Choices A, B, and D are incorrect because increasing red meat/liver intake, stopping wine consumption, or taking a proton pump inhibitor like omeprazole do not address the primary issue of vitamin B12 absorption in pernicious anemia.
Which statement by a patient indicates good understanding of the nurse¢â‚¬â„¢s teaching about prevention of sickle cell crisis?
- A. Home oxygen therapy is frequently used to decrease sickling.
- B. There are no effective medications that can help prevent sickling.
- C. Routine continuous dosage narcotics are prescribed to prevent a crisis.
- D. Risk for a crisis is decreased by having an annual influenza vaccination.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A 62-year-old man with chronic anemia is experiencing increased fatigue and occasional palpitations at rest. The nurse would expect the patient's laboratory test findings to include
- A. an RBC count of 4,500,000/μL.
- B. a hematocrit (Hct) value of 38%.
- C. normal red blood cell (RBC) indices.
- D. a hemoglobin (Hgb) of 8.6 g/dL.
Correct Answer: B
Rationale: The correct answer is B. In chronic anemia, the hematocrit (Hct) value is a crucial indicator of the proportion of red blood cells in the blood. A hematocrit value of 38% indicates a lower than normal level of red blood cells, which aligns with the patient's symptoms of fatigue and palpitations. Choices A, C, and D are incorrect because a low RBC count, normal RBC indices, and a hemoglobin level of 8.6 g/dL do not specifically address the decreased red blood cell mass associated with chronic anemia.
An appropriate nursing intervention for a hospitalized patient with severe hemolytic anemia is to
- A. provide a diet high in vitamin K
- B. alternate periods of rest and activity
- C. teach the patient how to avoid injury
- D. place the patient on protective isolation
Correct Answer: B
Rationale: In severe hemolytic anemia, the priority nursing intervention is to alternate periods of rest and activity. This approach helps to balance activity levels to prevent excessive fatigue while promoting mobility and preventing complications such as muscle weakness or deconditioning. Providing a diet high in vitamin K (choice A) is not directly related to managing hemolytic anemia. Teaching the patient how to avoid injury (choice C) is important but may not be the immediate priority. Placing the patient on protective isolation (choice D) is not indicated for hemolytic anemia, as it is not a contagious condition.
A patient who had a total hip replacement had an intraoperative hemorrhage 14 hours ago. Which laboratory test result would the nurse expect?
- A. Hematocrit of 46%
- B. Hemoglobin of 13.8 g/dL
- C. Elevated reticulocyte count
- D. Decreased white blood cell (WBC) count
Correct Answer: C
Rationale: The correct answer is C: Elevated reticulocyte count. Hemorrhage leads to the release of reticulocytes (immature red blood cells) from the bone marrow into circulation as a compensatory mechanism to replenish lost red blood cells. This response helps in restoring the oxygen-carrying capacity of the blood. Choices A and B, hematocrit of 46% and hemoglobin of 13.8 g/dL, may not reflect the immediate response to hemorrhage within 14 hours. Choice D, decreased white blood cell (WBC) count, is not directly related to the body's response to hemorrhage.