Nokea
The nurse suspects that a patient has polycythemia vera based on which finding in the patient's laboratory reports? Select all that apply.
- A. Increased cobalamin levels.
- B. Decreased histamine levels.
- C. Increased hemoglobin levels.
- D. Increased red blood cell levels.
Correct Answer: C,D
Rationale: Increased hemoglobin and red blood cell levels are hallmark features of polycythemia vera, characterized by excessive red blood cell production.
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With which term will the nurse document the finding after noting multiple 1-mm red macules when assessing the skin of a patient with leukemia and thrombocytopenia?
- A. Purpura.
- B. Bruising.
- C. Petechiae.
- D. Ecchymosis.
Correct Answer: C
Rationale: Petechiae are small, red or purple 1-mm macules due to minor bleeding from broken capillaries, common in thrombocytopenia.
Which instruction would the nurse include in the teaching plan for a patient newly diagnosed with microcytic hypochromic anemia?
- A. Take enteric-coated iron with each meal.
- B. Take cobalamin with green, leafy vegetables.
- C. Take the iron with orange juice 1 hour before meals.
- D. Decrease the intake of the antiseizure medications to improve anemia.
Correct Answer: C
Rationale: Taking iron with orange juice 1 hour before meals enhances absorption due to vitamin C, optimal for treating microcytic hypochromic anemia.
Which statement is true regarding hemophilia?
- A. Hemophilia is not hereditary in nature.
- B. Hemophilia can be treated by replacement therapy.
- C. Hemophilia is an X-linked dominant genetic disorder.
- D. Hemophilia B is the most common form of hemophilia.
Correct Answer: B
Rationale: Hemophilia is a hereditary bleeding disorder treated by replacement therapy with clotting factor concentrates, making option B correct.
The nurse provides education to a patient with thrombocytopenia about precautions to be taken at home. The nurse identifies that further teaching is needed when the patient performs which action?
- A. Drinks 14 glasses of water daily.
- B. Shaves once a day using an electric razor.
- C. Uses an alcohol-based mouthwash twice a day.
- D. Brushes teeth with a soft-bristle toothbrush twice a day.
Correct Answer: C
Rationale: Alcohol-based mouthwash can cause mucosal irritation and bleeding, inappropriate for thrombocytopenia, suggesting further education is needed.
Which arterial blood gas (ABG) data corresponds with a patient's clinical manifestations of respiratory alkalosis?
- A. pH = 7.46, PaCO2 = 44 mm Hg, PaO2 = 95 mm Hg, and HCO3 = 36 mEq/L.
- B. pH = 7.27, PaCO2 = 70 mm Hg, PaO2 = 80 mm Hg, and HCO3 = 26 mEq/L.
- C. pH = 7.30, PaCO2 = 35 mm Hg, PaO2 = 70 mm Hg, and HCO3 = 20 mEq/L.
- D. pH = 7.52, PaCO2 = 24 mm Hg, PaO2 = 85 mm Hg, and HCO3 = 24 mEq/L.
Correct Answer: D
Rationale: Respiratory alkalosis is characterized by a high pH (>7.45) and a low PaCO2 (<35 mm Hg). The data in option D (pH = 7.52, PaCO2 = 24 mm Hg) indicates respiratory alkalosis.