In caring for an infant after circumcision, the nurse observes continued bleeding from the site and suspects hemophilia. Which hematological components are insufficient causing bleeding if hemophilia is present?

Deficiency of factors VIII or IX.

Diminished amount of vitamin K.

Decreased amount of platelets.

Missing factors V and VII.

Answer and Explanation

The Correct Answer is A

A) Deficiency of factors VIII or IX.

Hemophilia is a genetic disorder characterized by deficient or defective clotting factors, specifically factors VIII (hemophilia A) or IX (hemophilia B). These clotting factors are essential for the formation of stable blood clots. Therefore, if hemophilia is present, the deficiency of factors VIII or IX can lead to impaired clot formation and prolonged bleeding.

B) Diminished amount of vitamin K:

Vitamin K deficiency can lead to impaired blood clotting due to inadequate synthesis of clotting factors in the liver. However, hemophilia is specifically associated with deficiencies in factors VIII or IX, not vitamin K.

C) Decreased amount of platelets:

Platelets play a crucial role in primary hemostasis and initial platelet plug formation at the site of vascular injury. While decreased platelet count or dysfunction can lead to bleeding disorders such as thrombocytopenia or platelet function disorders, hemophilia specifically involves deficiencies in clotting factors, not platelets.

D) Missing factors V and VII:

Factor V and VII are other clotting factors involved in the coagulation cascade, but they are not deficient in hemophilia. Hemophilia is specifically characterized by deficiencies in factors VIII (hemophilia A) or IX (hemophilia B).

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Correct Answer is C

Explanation

A. Myocardial infarction:

Myocardial infarction (MI) typically presents with severe and prolonged chest pain or discomfort that is not relieved by rest or nitroglycerin. MI is characterized by myocardial necrosis due to prolonged ischemia, often resulting from the occlusion of a coronary artery by a thrombus or plaque rupture. While chest pressure and breathlessness are symptoms commonly associated with MI, the transient nature of the symptoms described by the client, as well as their relief after rest, is more indicative of stable angina rather than MI.

B. Unstable angina:

Unstable angina is characterized by new-onset angina, increasing frequency, or worsening intensity of angina symptoms. It is considered a medical emergency as it may precede a myocardial infarction. However, unstable angina typically presents with symptoms at rest or with minimal exertion and is not usually relieved by rest or nitroglycerin. The client's symptoms, which are relieved by rest, are more consistent with stable angina.

C. Stable angina:

Stable angina is characterized by predictable chest pain or discomfort that occurs with exertion or stress and is relieved by rest or nitroglycerin. The symptoms described by the client, including chest pressure and breathlessness that improve with rest, are consistent with stable angina. Stable angina occurs due to transient myocardial ischemia caused by an imbalance between myocardial oxygen supply and demand, often related to coronary artery disease.

D. Prinzmetal angina:

Prinzmetal angina, also known as variant angina, is characterized by chest pain or discomfort that occurs at rest, often in the early morning hours, and is typically caused by coronary artery spasm rather than fixed atherosclerotic lesions. While Prinzmetal angina can present with transient symptoms similar to those described by the client, it is less common than stable angina and is often associated with transient ST-segment elevation on electrocardiogram (ECG), which is not mentioned in the scenario.

A. Excessive urine output. B. Excessive fluid intake. C. Increased calcium reabsorption. D. Increased serum alkalinity.

Correct Answer is C

Explanation

Renal calculi, also known as kidney stones, are solid masses made up of crystals that form in the kidneys due to various factors, including supersaturation of urine with stone-forming substances, inadequate urine volume, and conditions that promote crystal precipitation and retention in the urinary tract. Here's the breakdown of the pathological process contributing to the client's clinical presentation:

A) Excessive urine output:

Excessive urine output (polyuria) is not typically associated with the formation of renal calculi. In fact, low urine output (oliguria) or concentrated urine may increase the risk of stone formation by reducing the volume of urine available to dilute stone-forming substances.

B) Excessive fluid intake:

Excessive fluid intake is generally beneficial in preventing kidney stone formation by increasing urine volume and diluting stone-forming substances. Therefore, it is not likely to contribute to the development of renal calculi in this scenario.

C) Increased calcium reabsorption:

Correct. Increased calcium reabsorption in the renal tubules can lead to hypercalcemia and hypercalciuria, which are risk factors for the formation of calcium-containing kidney stones (calcium oxalate or calcium phosphate stones). Excessive calcium reabsorption may occur due to various factors, including hormonal imbalances (e.g., hyperparathyroidism) or medications that affect calcium metabolism.

D) Increased serum alkalinity:

Increased serum alkalinity (alkalosis) is not typically associated with the formation of renal calculi. Urinary pH may influence the formation of certain types of kidney stones (e.g., uric acid stones are more likely to form in acidic urine), but alkalosis alone is not a primary factor in stone formation.

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In caring for an infant after circumcision, the nurse observes continued bleeding from the site and suspects hemophilia. Which hematological components are insufficient causing bleeding if hemophilia is present?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

The nurse is caring for an older client who is on complete bed rest. The nurse notes hematuria when the client suddenly reports excruciating pain that radiates from the back to the groin. Which pathological process has contributed to the client's clinical presentation of a possible renal calculi?

Correct Answer is C

Explanation

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