Nokea
During haemostasis, prostacyclin
- A. Cleaves prothrombin into thrombin
- B. Causes vasodilation
- C. Stimulates platelet aggregation
- D. Activates fibrinolysis
Correct Answer: B
Rationale: Prostacyclin is a vasodilator that inhibits platelet aggregation and promotes fibrinolysis. Vasodilation helps reduce blood pressure, improve blood flow, and prevent clot formation. Therefore, choice B is correct. Choice A is incorrect as prostacyclin does not cleave prothrombin. Choice C is incorrect as prostacyclin inhibits platelet aggregation. Choice D is incorrect as prostacyclin does not activate fibrinolysis.
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A nurse reviews the laboratory data for an older patient. The nurse would be most concerned about which finding?
- A. Hematocrit of 35%
- B. Hemoglobin of 11.8 g/dL
- C. Platelet count of 400000/L
- D. White blood cell (WBC) count of 2800/L
Correct Answer: D
Rationale: The correct answer is D: White blood cell (WBC) count of 2800/L. A low WBC count (leukopenia) in an older patient can indicate an impaired immune system, making them vulnerable to infections. This is concerning as older adults have a weakened immune response. A: Hematocrit of 35% is within the normal range. B: Hemoglobin of 11.8 g/dL is slightly low but not a major concern as long as it's not significantly lower. C: Platelet count of 400000/L is within the normal range and not typically a cause for concern.
A patient shows prolonged prothrombin time and activated partial thromboplastin time. Blood test otherwise is normal. Which of the following is the most probably diagnosis for this patient's condition?
- A. Hemophilia A
- B. Thrombocytopenia
- C. Von Willebrand factor disease
- D. Vitamin K deficiency
Correct Answer: D
Rationale: The correct answer is D: Vitamin K deficiency. Prolonged prothrombin time and activated partial thromboplastin time indicate impaired blood clotting, which is a characteristic of Vitamin K deficiency. Vitamin K is essential for the synthesis of clotting factors II, VII, IX, and X. Hemophilia A (Choice A) is a genetic disorder resulting in a deficiency of clotting factor VIII, leading to prolonged activated partial thromboplastin time only. Thrombocytopenia (Choice B) is a condition characterized by low platelet count, which can lead to bleeding but does not affect clotting factors. Von Willebrand disease (Choice C) is a genetic disorder affecting von Willebrand factor and platelet function, not clotting factors.
A 20-month-old otherwise healthy male presents late for his 18-month well child check. During his first year of life, he took iron-fortified formula and had a point-of-care hemoglobin (Hgb) of 12 g/dL at his 1-year well child check. His mother reports that he is a picky eater but loves milk and has recently become obsessive about chewing the corners of his cardboard books. Physical examination is normal except for a flow murmur. Which combination of laboratory test results listed below would most likely characterize this patient?
- A. Hgb 8.7 g/dL, mean corpuscular volume (MCV) 60 fL, serum ferritin 2 ng/mL
- B. Hgb 12.0 g/dL, MCV 80 fL, serum ferritin 30 ng/mL
- C. Hgb 9.2 g/dL, MCV 60 fL, serum ferritin 30 ng/mL
- D. Hgb 11.2 g/dL, MCV 90 fL, serum ferritin 7 ng/mL
Correct Answer: A
Rationale: The correct answer is A because it indicates iron deficiency anemia. The low Hgb of 8.7 g/dL is below normal range for his age. The MCV of 60 fL is low, indicating microcytic anemia which is characteristic of iron deficiency. The serum ferritin level of 2 ng/mL is very low, supporting the diagnosis.
Choice B is incorrect as the Hgb and MCV are within normal range, and the ferritin level is not indicative of iron deficiency. Choice C has a low Hgb but normal MCV and ferritin level. Choice D has a normal Hgb and low ferritin, but the MCV is high, inconsistent with iron deficiency anemia.
The nurse examines the lymph nodes of a patient during a physical assessment. Which assessment finding would be of most concern to the nurse?
- A. A 2-cm nontender supraclavicular node
- B. A 1-cm mobile and nontender axillary node
- C. An inability to palpate any superficial lymph nodes
- D. Firm inguinal nodes in a patient with an infected foot
Correct Answer: A
Rationale: The correct answer is A: A 2-cm nontender supraclavicular node. This finding is concerning because supraclavicular nodes are not normally palpable. Enlarged supraclavicular nodes can indicate metastatic cancer. B is incorrect because mobile and nontender axillary nodes are usually benign. C is incorrect as the inability to palpate superficial nodes may be normal. D is incorrect as firm inguinal nodes could indicate a localized infection or inflammation.
A nurse is teaching a client about taking ferrous sulfate to treat iron deficiency anemia. Which of the following instructions should the nurse include? (Select All)
- A. Eat iron-enriched foods.
- B. Spread the dosage across each day.
- C. Take the drug on an empty stomach.
- D. Report dark green or black stools.
Correct Answer: A
Rationale: The correct answer is A: Eat iron-enriched foods. Iron-enriched foods help increase iron levels in the body, aiding in treating iron deficiency anemia. Consuming these foods along with ferrous sulfate can enhance the effectiveness of the treatment.
B: Spreading the dosage across each day is important to maintain consistent iron levels but is not the most crucial aspect of treatment.
C: Taking the drug on an empty stomach may enhance absorption but can also lead to stomach upset, so it is not necessary for all clients.
D: Reporting dark green or black stools is important to monitor for gastrointestinal bleeding, but it is not an instruction related to taking ferrous sulfate.