A 21-year-old patient with a known history of sickle cell anemia presents to the emergency department with severe pain in the lower back and joints, fatigue, and fever. What is the most likely cause of these symptoms?
Acute lymphoblastic leukemia
Iron-deficiency anemia
Vaso-occlusive crisis
Pneumonia
The Correct Answer is C
Choice A Reason:
Acute lymphoblastic leukemia (ALL) is a type of cancer that affects the blood and bone marrow. While it can cause symptoms such as fatigue and fever, it is less likely to cause severe pain in the lower back and joints, which are more characteristic of a vaso-occlusive crisis in sickle cell anemia. ALL typically presents with symptoms like frequent infections, easy bruising or bleeding, and bone pain, but the combination of severe pain, fatigue, and fever in a patient with sickle cell anemia points more towards a vaso-occlusive crisis.
Choice B Reason:
Iron-deficiency anemia is a condition where there is a lack of adequate iron to form healthy red blood cells. Symptoms include fatigue, weakness, and pale skin, but it does not typically cause severe pain in the lower back and joints or fever. The presence of severe pain and fever in a patient with sickle cell anemia is more indicative of a vaso-occlusive crisis rather than iron-deficiency anemia.
Choice C Reason:
Vaso-occlusive crisis is a common and painful complication of sickle cell anemia. It occurs when sickled red blood cells block blood flow to parts of the body, causing severe pain, often in the back, joints, and abdomen. This condition can also lead to fever and fatigue due to the body’s inflammatory response and the reduced oxygen delivery to tissues. Given the patient’s history of sickle cell anemia and the described symptoms, a vaso-occlusive crisis is the most likely cause.
Choice D Reason:
Pneumonia is an infection that inflames the air sacs in one or both lungs, which can cause symptoms such as fever, chills, and difficulty breathing. While pneumonia can occur in patients with sickle cell anemia, it is less likely to cause severe pain in the lower back and joints. The combination of severe pain, fatigue, and fever in this patient is more consistent with a vaso-occlusive crisis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason:
Weight loss is not typically associated with acromegaly. Acromegaly is characterized by excessive growth hormone production, leading to the enlargement of bones and tissues. Patients often experience weight gain rather than loss due to increased bone and soft tissue mass.
Choice B Reason:
Exophthalmos, or bulging eyes, is not a common manifestation of acromegaly. This symptom is more commonly associated with Graves’ disease, a thyroid disorder. Acromegaly primarily affects the bones and soft tissues, leading to changes in facial features and extremities.
Choice C Reason:
Thin and fragile hair is not a typical symptom of acromegaly. While hormonal imbalances can affect hair quality, acromegaly is more commonly associated with changes in bone and soft tissue structure. Symptoms like coarse, oily skin and excessive sweating are more characteristic of this condition.
Choice D Reason:
Enlarged hands and feet are hallmark signs of acromegaly. The excessive production of growth hormone leads to the enlargement of bones in the hands, feet, and face. Patients may notice that their rings no longer fit and that their shoe size has increased. This symptom is a key indicator of acromegaly and is often used in the diagnosis of the condition.
Correct Answer is B
Explanation
Choice A Reason:
A random blood glucose level of 126 mg/dL is not typically indicative of hyperglycemia. Hyperglycemia is generally defined as a blood glucose level above 180 mg/dL. A level of 126 mg/dL is closer to the threshold for diagnosing diabetes but does not necessarily indicate hyperglycemia.
Choice B Reason:
A history of poor wound healing is a common manifestation of hyperglycemia. High blood sugar levels can impair the body’s ability to heal wounds by affecting blood flow and the function of immune cells. This can lead to prolonged wound healing times and an increased risk of infections.
Choice C Reason:
Decreased urinary output is not a typical symptom of hyperglycemia. In fact, hyperglycemia often causes increased urinary output (polyuria) due to the body’s attempt to excrete excess glucose through urine. Decreased urinary output could be indicative of other conditions, such as dehydration or kidney issues.
Choice D Reason:
Clammy skin is more commonly associated with hypoglycemia (low blood sugar) rather than hyperglycemia. Hypoglycemia can cause symptoms such as sweating, shakiness, and clammy skin due to the body’s response to low blood sugar levels. Hyperglycemia, on the other hand, does not typically cause clammy skin.
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