Nokea
The nurse is assessing a client experiencing anemia. Which laboratory findings will the nurse expect for this client? (Select all that apply.)
- A. Increased hematocrit
- B. Decreased red blood cell count
- C. Decreased serum iron
- D. Decreased hemoglobin
Correct Answer: b
Rationale: The correct answer is B: Decreased red blood cell count. Anemia is characterized by a decrease in the number of red blood cells, leading to a lower than normal red blood cell count. In anemia, the body cannot transport enough oxygen to tissues, leading to symptoms such as fatigue and shortness of breath. Increased hematocrit (A) and decreased hemoglobin (D) are related to anemia but not specific enough to be conclusive. Decreased serum iron (C) may be seen in iron-deficiency anemia but is not always present in all types of anemia.
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Half life of plat. Is:
- A. 1-2days
- B. 3-4days
- C. 5-6days
- D. 7-8days
Correct Answer: B
Rationale: The correct answer is B: 3-4 days. The half-life of a substance is the time it takes for half of the original amount to decay. In this case, since the half-life of platinum is 3-4 days, it means that after 3-4 days, half of the initial amount of platinum will have decayed. This answer is correct because it accurately represents the time frame for platinum decay. The other choices are incorrect because they do not correspond to the known half-life of platinum. Choice A (1-2 days), C (5-6 days), and D (7-8 days) are outside the typical half-life range for platinum, making them incorrect options.
Increase Fe & normal TIBC are found in:
- A. thalassemia major
- B. haemosidrosis
- C. rheumatoid arthritis
- D. dissiminated malignancy
Correct Answer: C
Rationale: The correct answer is C: rheumatoid arthritis. In rheumatoid arthritis, chronic inflammation can lead to anemia of chronic disease, causing increased levels of serum iron (Fe) due to decreased iron utilization and normal Total Iron Binding Capacity (TIBC). Thalassemia major (A) would show decreased TIBC due to iron overload. Haemosiderosis (B) would show increased Fe and TIBC due to iron overload. Disseminated malignancy (D) may show decreased Fe and TIBC due to anemia of chronic disease or other factors.
A 17-year-old patient is referred to you for a platelet count of 1,200,000/mm3. On history, she notes that she often has numbness and tingling in her hands and feet and has frequent epistaxis. She is otherwise well-appearing and has no recent infections. On her exam, you note splenomegaly. What do you expect to see on further evaluation?
- A. Elevated C-reactive protein
- B. Low ferritin
- C. A hypocellular bone marrow
- D. Low von Willebrand factor activity
Correct Answer: D
Rationale: The correct answer is D: Low von Willebrand factor activity. This patient likely has Essential Thrombocythemia, a disorder characterized by excessive production of platelets by the bone marrow. This condition can lead to abnormal bleeding and clotting. The patient's symptoms of numbness, tingling, epistaxis, and splenomegaly are consistent with this diagnosis. Low von Willebrand factor activity is expected in Essential Thrombocythemia due to platelet dysfunction. Elevated C-reactive protein, low ferritin, and a hypocellular bone marrow are not typically associated with Essential Thrombocythemia and are less likely to be seen in this patient.
A peripheral blood smear showing increase in numbers of neutrophils, band cells, basophils, eosinophils, and platelets is most suggestive
- A. Acute myeloid leukemia
- B. Acute lymphoid leukemia
- C. Chronic myelocytic leukemia
- D. Chronic lymphocytic leukemia
Correct Answer: C
Rationale: Step-by-step rationale:
1. Increased neutrophils, band cells, basophils, and platelets suggest myeloproliferative disorder.
2. Presence of eosinophils indicates a chronic phase as seen in chronic myelocytic leukemia.
3. Chronic myelocytic leukemia commonly presents with increased granulocytes and platelets.
Summary:
- A: Acute myeloid leukemia is characterized by blast cells, not mature granulocytes.
- B: Acute lymphoid leukemia primarily affects lymphocytes, not myeloid cells.
- D: Chronic lymphocytic leukemia involves lymphocytes, not myeloid cells like in the given case.
An infant is born with a 7 cm × 6 cm lesion over the upper extremity from the elbow to the shoulder. The lesion is indurated and purpuric, with some petechiae around the edges. No other areas of petechiae are noted on the skin. The infant is doing well without other systemic problems. i were 9 and 9. You are called by the pediatric nurse practitioner to the NICU. What is the most appropriate next step?
- A. Do nothing because the infant is doing well and had good Apgars.
- B. Obtain an ultrasound for more information about the lesion.
- C. Obtain an MRI to assess the extent of the lesion.
- D. Obtain labs, including a CBC with platelet count and fibrinogen.
Correct Answer: D
Rationale: The correct answer is D: Obtain labs, including a CBC with platelet count and fibrinogen. This is the most appropriate next step because the infant's presentation with an indurated and purpuric lesion raises concern for a possible bleeding disorder or coagulopathy. By obtaining labs, including a CBC with platelet count and fibrinogen, we can assess the infant's hemostatic profile and rule out any underlying hematologic abnormalities. This step is crucial in ensuring the infant's well-being and guiding further management if any abnormalities are detected.
Why the other choices are incorrect:
A: Doing nothing is not appropriate as the presentation warrants further investigation.
B: An ultrasound may not provide useful information in this scenario as the lesion is concerning for a systemic issue.
C: An MRI is not the initial diagnostic test of choice for evaluating a possible bleeding disorder or coagulopathy.