Nokea
All produce microcytic anemia except:
- A. sideroblastic an.
- B. thalassemia
- C. pernicious anemia
- D. lead poisoning
Correct Answer: C
Rationale: The correct answer is C: pernicious anemia. Pernicious anemia is a macrocytic anemia caused by vitamin B12 deficiency, leading to large red blood cells. Sideroblastic anemia (A) is a type of microcytic anemia due to ineffective iron utilization. Thalassemia (B) causes microcytic anemia due to decreased production of hemoglobin. Lead poisoning (D) can also lead to microcytic anemia by disrupting heme synthesis. Therefore, pernicious anemia is the only choice that does not produce microcytic anemia.
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A nurse is caring for a client who is about to begin taking aspirin to reduce the risk of a cardiovascular event. The nurse should identify that the drug inhibits platelet aggregation by which of the following mechanisms?
- A. Activating thromboxane A2
- B. Blocking adenosine diphosphate receptor agonists
- C. Suppressing specific clotting factors
- D. Inhibiting cyclooxygenase action in platelets
Correct Answer: D
Rationale: The correct answer is D: Inhibiting cyclooxygenase action in platelets. Aspirin inhibits cyclooxygenase, specifically COX-1, in platelets, leading to the inhibition of thromboxane A2 production. Thromboxane A2 is a potent platelet aggregator. By inhibiting its production, aspirin reduces platelet aggregation, thus reducing the risk of cardiovascular events.
A: Activating thromboxane A2 - This is incorrect because aspirin actually inhibits the production of thromboxane A2.
B: Blocking adenosine diphosphate receptor agonists - This is incorrect because aspirin primarily works through the inhibition of cyclooxygenase, not adenosine diphosphate receptors.
C: Suppressing specific clotting factors - This is incorrect because aspirin's primary mechanism of action is through platelet inhibition, not through suppressing clotting factors.
A patient who is taking warfarin (Coumadin) 5 mg daily has an international normalized ratio (INR) of 2.5. It is time to administer the next dose of Coumadin. What should the nurse do?
- A. Notify the physician STAT.
- B. Hold the dose of Coumadin.
- C. Prepare to administer vitamin K.
- D. Administer the daily Coumadin as ordered.
Correct Answer: D
Rationale: The correct answer is D: Administer the daily Coumadin as ordered.
Rationale:
1. INR of 2.5 is within the therapeutic range (2-3) for patients on warfarin.
2. Holding the dose may lead to fluctuation in INR and risk of thrombosis or bleeding.
3. Notifying the physician is not necessary as the INR is within the target range.
4. Administering vitamin K is not indicated unless the patient is experiencing significant bleeding.
In summary, administering the daily Coumadin as ordered is appropriate as the INR is within the therapeutic range, ensuring continuity of anticoagulation therapy without unnecessary intervention.
Outstanding feature of ITP:
- A. fever
- B. gum bleeding
- C. moderate splenomegaly
- D. stema tenderness
Correct Answer: B
Rationale: The correct answer is B: gum bleeding. In Immune Thrombocytopenic Purpura (ITP), the hallmark feature is thrombocytopenia leading to mucocutaneous bleeding, including gum bleeding. Fever (choice A) is not a typical feature of ITP. Splenomegaly (choice C) can be present in chronic ITP but is not a defining feature. Sterna tenderness (choice D) is not specific to ITP and is not considered a characteristic feature. Thus, gum bleeding is the outstanding feature of ITP due to the primary pathophysiology of decreased platelet count leading to bleeding manifestations.
The nurse notes that a patient's gaping wound is developing a blood clot. Which body substance is responsible for this clot formation?
- A. Plasma
- B. Platelets
- C. Red blood cells
- D. White blood cells
Correct Answer: B
Rationale: Platelets are responsible for clot formation in the body. When a wound occurs, platelets are activated and adhere to the site, forming a plug to stop bleeding. They release chemicals to further enhance clot formation. Plasma is the liquid component of blood, red blood cells carry oxygen, and white blood cells are part of the immune system, none of which are directly involved in clot formation.
A nurse is caring for a client who is taking clopidogrel to prevent stent restenosis. The nurse should monitor the client for which of the following adverse reactions?
- A. Hyperuricemia
- B. Hyponatremia
- C. Lymphocytopenia
- D. Thrombocytopenia
Correct Answer: D
Rationale: The correct answer is D: Thrombocytopenia. Clopidogrel is an antiplatelet medication that works by inhibiting platelet aggregation. Therefore, monitoring for thrombocytopenia, a decrease in platelet count, is crucial to assess the drug's effectiveness and potential side effects. Hyperuricemia (A) is not directly associated with clopidogrel use. Hyponatremia (B) is not a common adverse reaction of clopidogrel. Lymphocytopenia (C) is not typically linked to clopidogrel and is more commonly seen with other medications or conditions.