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
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.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Development of a buffalo hump and moon face:
This is associated with Cushing's syndrome, a disorder characterized by prolonged exposure to high levels of cortisol.
B. Central obesity and purple striations:
Also indicative of Cushing's syndrome, where excess cortisol can lead to the accumulation of fat in the abdominal area (central obesity) and the development of purple stretch marks (striae).
C. Sudden weight loss without dieting:
This is more characteristic of hyperthyroidism, where the thyroid gland is overactive, leading to increased metabolism and unintended weight loss.
D. Positive Trousseau's sign when checking the client's blood pressure:
Trousseau's sign is associated with hypocalcemia and is seen in conditions affecting the parathyroid gland rather than the thyroid. It involves carpal spasm induced by inflating a blood pressure cuff above the systolic pressure for a few minutes.

Correct Answer is D
Explanation
A. "When I went to the restroom the last few days, my urine smelled odd."
Changes in the smell of urine can be associated with various conditions, including diabetes. However, it's not a specific symptom.
B. "I've always been a fan of sweet foods, but lately I'm turned off by them."
A change in taste preferences may not be directly related to diabetes. It's not a typical symptom.
C. "No matter how much sleep I get, it seems to take me hours to wake up."
Fatigue and difficulty waking up are general symptoms that can be caused by various factors, including diabetes. However, it's not specific to diabetes alone.
D. "Lately, I drink a lot, but I can't seem to quench my thirst."
Excessive thirst (polydipsia) and increased urination (polyuria) are classic symptoms of diabetes, suggesting elevated blood sugar levels.
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