Nokea
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: Macrocytosis is characterized by enlarged red blood cells. In Systemic Lupus Erythematosus (SLE), macrocytosis is not a typical finding. The other conditions listed - anemia of myxedema, methotrexate-induced macrocytosis, and macrocytosis due to chronic alcoholism-induced liver disease - are associated with macrocytosis due to various underlying mechanisms. Therefore, the correct answer is D, as macrocytosis is not a characteristic feature of SLE.
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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 taking folic acid to treat megaloblastic anemia. The nurse should monitor which of the following laboratory values to determine therapeutic effectiveness?
- A. Amylase level
- B. Reticulocyte count
- C. C-reactive protein
- D. Creatinine clearance
Correct Answer: B
Rationale: The correct answer is B: Reticulocyte count. Reticulocytes are immature red blood cells, and monitoring their count can help determine the effectiveness of folic acid in treating megaloblastic anemia. Increased reticulocyte count indicates improved production of red blood cells. Amylase level, C-reactive protein, and creatinine clearance are not directly related to monitoring the effectiveness of folic acid in treating megaloblastic anemia.
A nurse should identify that clopidogrel is contraindicated for clients who have which of the following conditions?
- A. Myocardial infarction
- B. Peptic ulcer disease
- C. Pancreatitis
- D. Myasthenia gravis
Correct Answer: B
Rationale: Clopidogrel is an antiplatelet medication that can increase the risk of bleeding. Patients with peptic ulcer disease are at a higher risk of gastrointestinal bleeding, so clopidogrel is contraindicated. Myocardial infarction, pancreatitis, and myasthenia gravis are not contraindications for clopidogrel use.
You receive a phone call that a 3-year-old patient on long-term warfarin therapy for congenital heart disease has an international normalized ratio (INR) of 5.8. On further history, you learn the patient and several family members have had recent gastrointestinal illnesses, but the patient is recovering. His mother reports he is not experiencing bleeding symptoms. Which of the following interventions would be most reasonable in this clinical scenario?
- A. Hold 1 to 2 doses of warfarin and recheck INR
- B. Administer oral vitamin K therapy
- C. Administer fresh frozen plasma (FFP)
- D. Administer recombinant factor VIIa
Correct Answer: A
Rationale: The correct answer is A: Hold 1 to 2 doses of warfarin and recheck INR. In this scenario, the patient's elevated INR of 5.8 indicates an increased risk of bleeding due to excessive anticoagulation. Since the patient is not experiencing bleeding symptoms and is recovering from gastrointestinal illness, temporarily holding 1 to 2 doses of warfarin is the most reasonable intervention to prevent bleeding complications while allowing the INR to normalize. Rechecking the INR after holding the doses will help assess the patient's response to the intervention. Choices B, C, and D are incorrect because administering oral vitamin K therapy, FFP, or recombinant factor VIIa are more aggressive interventions that are not warranted in this case where the patient is asymptomatic and recovering from a transient illness.
Haemolytic anemia is not produced by:
- A. penicillin
- B. lithium
- C. Quinidine
- D. methyldopa
Correct Answer: B
Rationale: The correct answer is B: lithium. Lithium does not cause hemolytic anemia because it does not affect red blood cell destruction. Penicillin (A), Quinidine (C), and Methyldopa (D) are known to cause hemolytic anemia by various mechanisms, such as immune-mediated destruction or oxidative damage to red blood cells. In contrast, lithium's mechanism of action does not involve direct harm to red blood cells, making it the correct choice in this scenario.