Aplastic anemia is a disorder in which the bone marrow cells that develop into mature blood cells become damaged. The damaged bone marrow cells can lead to low numbers of red blood cells, white blood cells, and/or platelets. When the cause of aplastic anemia cannot be diagnosed, the cause is likely which of the following?

Radiation exposure

An autoimmune disorder

Chemotherapy drugs

Toxins

Answer and Explanation

The Correct Answer is B

A.   Radiation exposure: Radiation exposure can cause aplastic anemia, but if the cause is unknown, it is less likely to be due to a specific and identifiable event like radiation exposure.
B.   An autoimmune disorder: When the cause of aplastic anemia cannot be diagnosed, it is often attributed to an autoimmune disorder where the body attacks its own bone marrow cells.
C.   Chemotherapy drugs: Chemotherapy drugs can cause aplastic anemia, but this cause would typically be known based on the patient's medical history.
D.   Toxins: Toxins can cause aplastic anemia, but like chemotherapy drugs and radiation, this cause would generally be identifiable.

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Correct Answer is A

Explanation

A. Given the low hemoglobin level and weight, the patient is likely experiencing fatigue due to decreased oxygen-carrying capacity of the blood, leading to activity intolerance.
B. While weight loss may contribute to body image disturbance, it is not the primary concern for a patient with iron-deficiency anemia and low hemoglobin levels.
C. Anxiety related to the hospital environment may be present, but it is not the most appropriate nursing diagnosis based on the patient's clinical presentation and laboratory findings.
D. Impaired tissue integrity related to immobility is not the most appropriate nursing diagnosis for a patient with iron-deficiency anemia. This diagnosis is more commonly associated with pressure ulcers or skin breakdown in patients who are immobile for extended periods, which is not described in this scenario.

A. Reticulocyte count B. White blood count / Absolute neutrophil count C. Total lymphocyte count D. Platelet count

Correct Answer is B

Explanation

A. Reticulocyte count: Reticulocyte count measures immature red blood cells and is not the primary measure for the effectiveness of filgrastim, which is used to boost white blood cells.
B. White blood count / Absolute neutrophil count: Filgrastim (Neupogen) is used to increase white blood cells, specifically neutrophils. Therefore, monitoring the white blood count (WBC) and absolute neutrophil count (ANC) is the appropriate way to determine the effectiveness of the drug.
C. Total lymphocyte count: While lymphocytes are a type of white blood cell, filgrastim primarily affects neutrophils, making WBC/ANC a better indicator.
D. Platelet count: Filgrastim does not directly impact platelet production, so platelet count is not the primary measure of its effectiveness.

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Naxlex Comprehensive Predictor Exams

In helping prepare a nursing care plan for a 90-pound, 82-year-old woman with iron-deficiency anemia with a hemoglobin of 8.2, the nurse agrees that the most appropriate nursing diagnosis would be:

Correct Answer is A

Explanation

Which laboratory test will the nurse use to determine whether filgrastim (Neupogen) is effective for a patient with acute lymphocytic leukemia who is receiving chemotherapy?

Correct Answer is B

Explanation

A pediatric nurse health educator provides a teaching session to the nursing staff regarding hemophilia. Which of the following information regarding this disorder would the nurse plan to include in this discussion?

A 16-year-old is admitted with sickle cell crisis. The patient has a pain scale rating of 10 and the following vital signs: HR 115, BP 120/82, RR 18, oxygen saturation 91%, temperature 101.4°F. Select all the appropriate nursing interventions for this patient at this time?

A nurse is caring for a client who is experiencing menopausal changes and requests information about the use of herbal therapies to relieve her discomfort. Which of the following statements should the nurse make?

A nurse is reinforcing teaching about breast self-examination (BSE) with a client who has a regular menstrual cycle. The nurse should instruct the client to perform BSE at which of the following times?

A nurse is reinforcing teaching to a client who is to undergo a breast biopsy by needle aspiration. Which of the following statements should the nurse make?

A nurse is caring for a client who is being evaluated for endometrial cancer. Which of the following findings should the nurse expect the client to report?

Iron-deficiency anemia can cause pica, a rare condition in which a person craves eating nonfood items. Which of these would a client with this type of anemia eat?