A client comes into the clinic complaining of fatigue. Blood work shows an increased bilirubin concentration and an increased reticulocyte count. What would the nurse suspect the patient has?

Leukemia

Hemolytic anemia

Hypoproliferative anemia

Thrombocytopenia

Answer and Explanation

The Correct Answer is B

A. Leukemia:
Explanation: Leukemia is a cancer of the blood-forming tissues, including the bone marrow and lymphatic system. It typically presents with an abnormal increase in white blood cells. While fatigue can be a symptom, increased bilirubin concentration and an increased reticulocyte count are not typical findings in leukemia.

B. Hemolytic Anemia:
Explanation: Hemolytic anemia is characterized by the premature destruction of red blood cells, leading to an increased release of bilirubin (from the breakdown of hemoglobin) and an increased reticulocyte count (as the body attempts to compensate by producing more red blood cells). This is a likely possibility given the presented symptoms.

C. Hypoproliferative Anemia:
Explanation: Hypoproliferative anemia is characterized by a decreased production of red blood cells. It is unlikely in this scenario, as an increased reticulocyte count suggests an attempt by the bone marrow to increase red blood cell production.

D. Thrombocytopenia:
Explanation: Thrombocytopenia is a condition characterized by a low platelet count. It does not typically present with an increased bilirubin concentration or an increased reticulocyte count.

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Correct Answer is A

Explanation

A. IV administration of 50% dextrose in water:
This is the correct answer. The client is severely hypoglycemic, and IV administration of 50% dextrose in water is the most rapid way to raise the blood glucose level in an emergency situation.

B. IV bolus of 5% dextrose in 0.45% NaCl:
While this solution contains dextrose, it is not as concentrated as 50% dextrose. In an emergency, a more concentrated solution is needed to rapidly correct severe hypoglycemia.

C. Administer 4 oz. clear juice:
Oral intake may be too slow in this critical situation. IV administration is more appropriate for rapidly raising the blood glucose level.

D. Subcutaneous administration of 12 to 15 units of regular insulin:
This would further lower the blood glucose level and is not appropriate for treating severe hypoglycemia.

A. 15 to 20 g of a fast-acting carbohydrate such as orange juice. B. I.V. bolus of dextrose 50%. C. I.M. or subcutaneous glucagon. D. 10 U of fast-acting insulin

Correct Answer is C

Explanation

A. 15 to 20 g of a fast-acting carbohydrate such as orange juice:
This is a standard and initial treatment for hypoglycemia. Fast-acting carbohydrates, like orange juice or glucose tablets, can quickly raise blood sugar levels. However, in the scenario described, the client is still conscious, and glucagon may be a more appropriate choice.

B. I.V. bolus of dextrose 50%:
Intravenous (IV) dextrose is a more aggressive intervention and is typically reserved for severe cases of hypoglycemia or for unconscious patients. It is not the first-line treatment for conscious patients.

C. I.M. or subcutaneous glucagon:
Glucagon is a hormone that raises blood sugar levels by promoting the conversion of stored glycogen in the liver to glucose. It is administered either intramuscularly (I.M.) or subcutaneously. In a conscious patient with hypoglycemia who cannot take oral carbohydrates, glucagon can be an effective and rapid way to raise blood sugar levels.

D. 10 U of fast-acting insulin:
Administering more insulin in a situation of hypoglycemia would worsen the condition. The goal in hypoglycemia is to raise blood sugar, and giving more insulin would have the opposite effect.

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A client comes into the clinic complaining of fatigue. Blood work shows an increased bilirubin concentration and an increased reticulocyte count. What would the nurse suspect the patient has?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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