Nokea
Which of the following lab value profiles should the nurse know to be consistent with hemolytic anemia?
- A. Increased RBC, decreased bilirubin, decreased Hgb and Hct, increased reticulocytes
- B. Decreased RBC, increased bilirubin, decreased Hgb and Hct, increased reticulocytes
- C. Decreased RBC, decreased bilirubin, increased Hgb and Hct, decreased reticulocytes
- D. Increased RBC, increased bilirubin, increased Hgb and Hct, decreased reticulocytes
Correct Answer: A
Rationale: Step-by-step rationale for the correct answer (A):
1. Increased RBC: Hemolytic anemia leads to increased RBC production as the body compensates for the destruction of red blood cells.
2. Decreased bilirubin: Bilirubin levels decrease due to the accelerated breakdown of red blood cells.
3. Decreased Hgb and Hct: Hemolysis causes a decrease in hemoglobin and hematocrit levels as red blood cells are destroyed.
4. Increased reticulocytes: Reticulocytes are immature red blood cells released by the bone marrow in response to increased RBC destruction.
Summary:
- Choice B is incorrect as hemolytic anemia would lead to increased, not decreased, bilirubin levels.
- Choice C is incorrect as hemolytic anemia would lead to decreased, not increased, Hgb and Hct levels.
- Choice D is incorrect as hemolytic anemia would not lead to increased levels of all parameters
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The nurse knows which of the following is true about immunity?
- A. Antibody-mediated defense occurs through the T-cell system
- B. Cellular immunity is mediated by antibodies produced by the B-cells
- C. Antibodies are produced by the B-cells
- D. Lymphocytes increase with an allergic response
Correct Answer: C
Rationale: Rationale for Answer C: Antibodies are produced by the B-cells. B-cells are a type of lymphocyte that differentiate into plasma cells, which are responsible for producing antibodies in response to antigens. This process is a key component of the humoral immune response. Therefore, the statement that antibodies are produced by the B-cells is true.
Summary of Incorrect Choices:
A: Antibody-mediated defense occurs through the B-cell system, not the T-cell system. T-cells are involved in cell-mediated immunity.
B: Cellular immunity is mediated by T-cells, not antibodies produced by B-cells.
D: Lymphocytes increasing with an allergic response is not directly related to the production of antibodies by B-cells. Allergic responses involve a different mechanism.
Which of the ff conditions is evident by persistent hoarseness?
- A. Bacterial infection
- B. Aphonia
- C. Laryngeal cancer
- D. Peritonsillar abscess
Correct Answer: C
Rationale: The correct answer is C: Laryngeal cancer. Persistent hoarseness is a common symptom of laryngeal cancer due to vocal cord involvement. Laryngeal cancer causes changes in voice quality over time. Bacterial infection (A) usually presents with acute symptoms and resolves with treatment. Aphonia (B) is the complete loss of voice, not persistent hoarseness. Peritonsillar abscess (D) causes sore throat and difficulty swallowing, but not persistent hoarseness.
A client has cancer that has me tastasized to her bones. She is complaining of increased thirst, polyuria and decreased muscle tone. Her lab values are: Na 139mEq/L, k 4 mEq/L, Cl 103 mEq/L, and Ca 8 mg/dl. What electrolyte imbalance is present?
- A. Hypocalcemia
- B. Hyperkalemia
- C. Hypercalcemia
- D. Hypochloremia
Correct Answer: C
Rationale: The correct answer is C: Hypercalcemia. Increased thirst and polyuria are symptoms of hypercalcemia, as excess calcium can lead to dehydration and increased urine output. Decreased muscle tone is also a common symptom of hypercalcemia. The lab value of Ca 8 mg/dl confirms high levels of calcium in the blood.
Incorrect choices:
A: Hypocalcemia - This is incorrect as the lab value of Ca 8 mg/dl indicates normal to high levels of calcium, ruling out hypocalcemia.
B: Hyperkalemia - This is incorrect as the lab value of K 4 mEq/L is within normal range, ruling out hyperkalemia.
D: Hypochloremia - This is incorrect as the lab value of Cl 103 mEq/L is within normal range, ruling out hypochloremia.
At health fair, an oncology nurse answers questions about risk factors for various types of cancer. One person with a family history of colon cancer asks the nurse to identify risk factors for this type of cancer. The nurse should identify:
- A. Smoking
- B. Obesity
- C. Heavy alcohol consumption
- D. Saccharin consumption
Correct Answer: B
Rationale: The correct answer is B: Obesity. Obesity is a known risk factor for colon cancer as excess body fat, especially around the waist, can lead to inflammation and insulin resistance, increasing the likelihood of cancerous cell growth in the colon. Smoking (choice A) is more strongly associated with lung and other types of cancer, not specifically colon cancer. Heavy alcohol consumption (choice C) is linked to other types of cancer, such as liver and esophageal cancer, but not as strongly to colon cancer. Saccharin consumption (choice D) has not been definitively linked to an increased risk of colon cancer.
For a client with sickle cell anemia, how does the nurse assess for jaundice?
- A. The nurse assesses mental status, verbal ability, and motor strength
- B. The nurse observes the joints for signs of swelling
- C. The nurse inspects the skin and sclera for jaundice
- D. The nurse collects a urine specimen
Correct Answer: C
Rationale: The correct answer is C because jaundice is a common manifestation of sickle cell anemia due to the breakdown of red blood cells. The nurse should inspect the skin and sclera for the characteristic yellow discoloration indicating jaundice. This assessment is specific to identifying jaundice, which is directly related to the disease process.
Choice A is incorrect as it relates to assessing neurological function, not jaundice. Choice B is incorrect as joint swelling is not a typical sign of jaundice in sickle cell anemia. Choice D is incorrect as a urine specimen is not used to assess jaundice; skin and sclera inspection are more appropriate.