A client's morning laboratory test results include hemoglobin 11.0 g/dL (110 g/L) and hematocrit 34% (0.34 volume fraction). Based on these findings, this client is at risk for which pathophysiological findings?
Reference Ranges:
Hemoglobin [14 to 18 g/dL (140 to 180 g/L)]
Hematocrit [42% to 52% (0.42 to 0.52 volume fraction)]
Fatigue and weakness.
Cardiac dysrhythmias.
Fever and infection.
Decreased clotting time.
The Correct Answer is A
A) Fatigue and weakness:
Correct. The client's hemoglobin and hematocrit levels are below the reference ranges, indicating mild anemia. Anemia, characterized by low red blood cell count or hemoglobin levels, can lead to symptoms such as fatigue, weakness, and shortness of breath, as the body's oxygen-carrying capacity is reduced. Fatigue and weakness are common manifestations of anemia and are indicative of tissue hypoxia due to decreased oxygen delivery.
B) Cardiac dysrhythmias:
While severe anemia can lead to cardiac complications, such as dysrhythmias, the client's hemoglobin and hematocrit levels are only slightly below the reference ranges, indicating mild anemia. Cardiac dysrhythmias are more commonly associated with severe anemia or acute changes in hemoglobin levels rather than the mild anemia indicated in this scenario.
C) Fever and infection:
Anemia is not typically associated with fever and infection. While anemia may occur secondary to chronic inflammatory conditions or certain infections, the client's symptoms of fatigue and weakness are more directly related to the decreased oxygen-carrying capacity of the blood due to mild anemia.
D) Decreased clotting time:
Anemia is not directly associated with changes in clotting time. While severe anemia can lead to alterations in platelet function and clotting factors, the client's hemoglobin and hematocrit levels are only slightly below the reference ranges, indicating mild anemia. Decreased clotting time is not a typical manifestation of mild anemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Gout is a form of inflammatory arthritis characterized by sudden, severe attacks of pain, redness, and swelling in the joints, commonly affecting the big toe joint (first metatarsophalangeal joint). The primary pathophysiological process underlying gout involves the deposition of monosodium urate crystals in the joints and surrounding tissues. Here's an explanation of why option A is the correct answer:
A) Deposition of crystals in the synovial space of the joints produces inflammation and irritation:
Correct. Elevated levels of uric acid in the blood can lead to the formation of monosodium urate crystals, which then accumulate in the synovial fluid of joints, particularly in the big toe joint in many cases. These crystals trigger an inflammatory response, activating immune cells and causing swelling, redness, warmth, and severe pain in the affected joint. The inflammation and irritation result from the body's response to the presence of these crystals.
B) Chondrocyte injury destroys joint cartilage, producing osteophytes and joint inflammation:
This option describes a process more characteristic of osteoarthritis, where degeneration of joint cartilage leads to inflammation and the formation of osteophytes (bone spurs). Gout does not directly involve chondrocyte injury.
C) An immune complex and autoantibody deposition in connective tissue results in inflammation:
This process describes the pathophysiology of autoimmune diseases such as rheumatoid arthritis, where immune complexes and autoantibodies contribute to inflammation and tissue damage. In gout, the inflammation is primarily triggered by the deposition of urate crystals rather than immune complex deposition.
D) An autoimmune inflammation involving IgG response to an antigen causes joint destruction:
This option describes the autoimmune process seen in diseases like rheumatoid arthritis, where antibodies target specific antigens, leading to joint destruction. Gout is not an autoimmune disease, and joint destruction in gout is primarily due to inflammation caused by urate crystal deposition rather than autoimmune mechanisms.
Correct Answer is C
Explanation
Hypothyroidism is characterized by deficient production of thyroid hormones by the thyroid gland, leading to a decrease in circulating levels of triiodothyronine (T3) and thyroxine (T4). As a compensatory mechanism, the pituitary gland releases increased amounts of thyroid stimulating hormone (TSH) in an attempt to stimulate thyroid hormone production.
A) Increased triiodothyronine (T3) and thyroxine (T4) and decreased thyroid stimulating hormone (TSH):
This pattern of laboratory findings is not consistent with hypothyroidism. Hypothyroidism is characterized by decreased levels of T3 and T4 due to impaired thyroid function, leading to increased TSH levels as a compensatory response. Therefore, this option is incorrect.
B) Increased triiodothyronine (T3) and thyroid stimulating hormone (TSH):
While TSH levels are typically increased in hypothyroidism, T3 levels are usually decreased. Therefore, the combination of increased T3 and TSH is not indicative of hypothyroidism. This option is incorrect.
C) Decreased triiodothyronine (T3) and thyroxine (T4) and increased thyroid stimulating hormone (TSH):
Correct. In hypothyroidism, there is a decrease in both T3 and T4 levels due to impaired thyroid function. As a compensatory mechanism, the pituitary gland releases increased amounts of TSH to stimulate the thyroid gland. Therefore, this pattern of laboratory findings is consistent with hypothyroidism.
D) Decreased thyroid stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4):
Decreased levels of TSH, T3, and T4 are not indicative of hypothyroidism. Hypothyroidism is characterized by elevated TSH levels and decreased T3 and T4 levels. Therefore, this option is incorrect.
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