The nurse recognizes that patients with von Willebrand disease are at risk for prolonged bleeding times for which reason?

Adequate platelet production.

Deficiency in intrinsic clotting system factor.

Impairment of the thrombin fibrinogen reaction.

Variable factor VIII deficiencies and platelet dysfunction.

Answer and Explanation

The Correct Answer is D

Choice A rationale:

Adequate platelet production does not explain the prolonged bleeding times in von Willebrand disease. These patients often have normal platelet counts, but their platelets do not function properly due to the absence or dysfunction of von Willebrand factor.

Choice B rationale:

Deficiency in intrinsic clotting system factor is not the primary cause of prolonged bleeding times in von Willebrand disease. The deficiency or dysfunction of von Willebrand factor, a protein that helps platelets adhere to the blood vessel walls and clot properly, is the key issue in this disorder.

Choice C rationale:

Impairment of the thrombin fibrinogen reaction does not directly relate to von Willebrand disease. This disorder primarily involves platelet dysfunction and variable factor VIII deficiencies, leading to prolonged bleeding times.

Choice D rationale:

Variable factor VIII deficiencies and platelet dysfunction are characteristic of von Willebrand disease. Factor VIII helps with blood clotting, and its deficiency, along with impaired platelet function, contributes to the prolonged bleeding times in patients with von Willebrand disease.

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Correct Answer is D

Explanation

Choice A rationale:
Triple-drug therapy is not the standard treatment for pernicious anemia after a gastrectomy. Pernicious anemia is primarily caused by vitamin B12 deficiency due to the absence of intrinsic factor, which is essential for vitamin B12 absorption.
Choice B rationale:
IV therapy is a broad term and does not specify the treatment for pernicious anemia. In the context of pernicious anemia, cobalamin replacement therapy administered via intramuscular injections is the preferred treatment.
Choice C rationale:
Quadruple-drug therapy is not a recognized treatment for pernicious anemia. The primary treatment for pernicious anemia involves cobalamin replacement therapy to address the vitamin B12 deficiency.
Choice D rationale:
Cobalamin replacement therapy is the appropriate treatment for pernicious anemia after a gastrectomy. Since the patient lacks intrinsic factor, which is necessary for vitamin B12 absorption, cobalamin replacement therapy bypasses the need for intrinsic factor and provides the necessary vitamin B12 directly.

A. Sodium level of 136 mEq/L, potassium level of 4.5 mEq/L. B. Sodium level of 145 mEq/L, potassium level of 4.8 mEq/L. C. Sodium level of 135 mEq/L, potassium level of 3.6 mEq/L. D. Sodium level of 144 mEq/L, potassium level of 3.7 mEq/L.

Correct Answer is C

Explanation

Choice A rationale:

The sodium level is within the normal range, but the potassium level is slightly elevated. This does not support the rationale for changing the IV prescription to a lower potassium concentration.

Choice B rationale:

The sodium level is slightly elevated, and the potassium level is within the normal range. This does not support the rationale for changing the IV prescription to a lower potassium concentration.

Choice C rationale:

Sodium level of 135 mEq/L, potassium level of 3.6 mEq/L is the correct answer. In this option, both sodium and potassium levels are within normal ranges. Changing the IV prescription to DSNS with 20 mEq KCl/L ensures that the patient receives adequate hydration (from the dextrose and normal saline) without causing hyperkalemia.

Choice D rationale:

The sodium level is slightly elevated, and the potassium level is within the normal range. This does not support the rationale for changing the IV prescription to a lower potassium concentration.

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The nurse recognizes that patients with von Willebrand disease are at risk for prolonged bleeding times for which reason?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which treatment is likely to be planned for a patient who develops pernicious anemia after a gastrectomy?

Correct Answer is D

Explanation

The nurse receives a health care provider's prescription to change a patient's IV from D5. half-normal saline with 40 mEq KCl/L to DSNS with 20 mEq KCl/L. Which set of serum laboratory values supports the rationale for this IV prescription change?

Correct Answer is C

Explanation

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