Nokea
The nurse is concerned that a patient is demonstrating signs of red blood cell production. What laboratory value did the nurse most likely use to make this decision?
- A. Iron
- B. Bilirubin
- C. Thrombin
- D. Intrinsic factor
Correct Answer: B
Rationale: The correct answer is B: Bilirubin. Elevated levels of bilirubin can indicate increased red blood cell breakdown or hemolysis, prompting the body to produce more red blood cells to compensate for the loss. Iron (A) is involved in red blood cell production but is not a direct indicator. Thrombin (C) is a clotting factor, not related to red blood cell production. Intrinsic factor (D) is necessary for vitamin B12 absorption, not directly linked to red blood cell production. Therefore, Bilirubin is the most likely laboratory value used to indicate increased red blood cell production.
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The health care provider tells the nurse that a client is to be started on a platelet inhibitor. About what drug does the nurse plan to teach the client?
- A. Clopidogrel (Plavix)
- B. Enoxaparin (Lovenox)
- C. Reteplase (Retavase)
- D. Warfarin (Coumadin)
Correct Answer: A
Rationale: The correct answer is A: Clopidogrel (Plavix). Platelet inhibitors like Clopidogrel work by preventing blood clots by inhibiting platelet aggregation. Clopidogrel is commonly used to reduce the risk of heart attack and stroke. Enoxaparin (Lovenox) is a low molecular weight heparin used to prevent blood clots. Reteplase (Retavase) is a thrombolytic agent used to dissolve blood clots. Warfarin (Coumadin) is an anticoagulant that works by inhibiting clotting factors in the liver, but it does not directly target platelets like Clopidogrel.
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 a 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 protein?
Correct Answer: B
Rationale: The correct answer is B: Do you have any history of lung disease? A high hemoglobin and hematocrit could indicate polycythemia, which can be secondary to chronic hypoxia from lung disease. Asking about lung disease helps determine if there is an underlying cause of the elevated levels.
Incorrect Choices:
A: Recent weight loss is more relevant for anemia.
C: Dark or bloody stools are more indicative of gastrointestinal bleeding and iron deficiency anemia.
D: Dietary intake of meats and protein is not directly related to the elevated hemoglobin and hematocrit levels.
Incorrect about pernicious an:
- A. hyperchlorhydria
- B. premature graying of hair
- C. anti intrinsic factor antibody in 60% of pts.
- D. gastric polyp may occur
Correct Answer: A
Rationale: The correct answer is A: hyperchlorhydria. Pernicious anemia is characterized by vitamin B12 deficiency due to impaired absorption, not excess stomach acid. Premature graying of hair is unrelated. Presence of anti-intrinsic factor antibody and risk of gastric polyps are associated with pernicious anemia, but not hyperchlorhydria. Therefore, choice A is the correct answer as it does not align with the typical symptoms and characteristics of pernicious anemia.
RBCs break into fragments, they are referred to as schistocytes. These type of cells are seen in
- A. Sickle cell trait
- B. Thalassemia
- C. Microangiopathic hemolytic anemia
- D. Idiopathic thrombocytopenic purpura
Correct Answer: C
Rationale: The correct answer is C: Microangiopathic hemolytic anemia. Schistocytes are fragmented red blood cells seen in conditions where RBCs are physically sheared or damaged as they pass through small blood vessels. In microangiopathic hemolytic anemia, abnormal or damaged blood vessels cause mechanical destruction of RBCs, leading to the formation of schistocytes. Sickle cell trait (A) and Thalassemia (B) are genetic disorders that do not typically cause schistocytes. Idiopathic thrombocytopenic purpura (D) is a condition characterized by low platelet count, not associated with schistocytes.
Diagnostic testing has resulted in a diagnosis of acute myeloid leukemia (AML) in an adult patient who is otherwise healthy. The patient and the care team have collaborated and the patient will soon begin induction therapy. The nurse should prepare the patient for which of the following?
- A. Daily treatment with targeted treatment medications
- B. Radiation therapy on a daily basis
- C. Hematopoietic stem cell transplantation
- D. An aggressive course of chemotherapy
Correct Answer: D
Rationale: The correct answer is D: An aggressive course of chemotherapy. For AML, induction therapy typically involves aggressive chemotherapy to achieve remission. This approach aims to rapidly reduce the number of leukemia cells in the body. Targeted treatment medications are not the standard first-line therapy for AML. Radiation therapy is not commonly used as a primary treatment for AML. Hematopoietic stem cell transplantation is usually considered after achieving remission with chemotherapy as a consolidation therapy. Therefore, preparing the patient for an aggressive course of chemotherapy aligns with the standard treatment approach for AML.