Which finding about a patient with polycythemia vera is most important for the nurse to report to the health care provider?
Presence of plethora (excess body fluid)
Calf swelling and pain
Platelet count 450,000/microL
Hematocrit 55%
The Correct Answer is B
A. Presence of plethora is a common symptom of polycythemia vera and indicates increased blood volume but is not immediately life-threatening.
B. Calf swelling and pain could indicate a deep vein thrombosis (DVT), which is a serious complication that requires immediate medical attention.
C. A platelet count of 450,000/microL is elevated but not as critical as the possibility of a DVT.
D. Hematocrit of 55% is high, which is expected in polycythemia vera, but it is not as immediately critical as the risk of thrombosis suggested by calf swelling and pain.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. This response accurately describes the pathophysiology of sickle cell crisis. During a crisis, sickled red blood cells clump together, leading to microvascular occlusion and impaired blood flow to tissues, resulting in pain.
B. Bleeding in the joints is not a characteristic feature of sickle cell crisis. It may occur in other conditions such as hemophilia or osteoarthritis but not in sickle cell crisis.
C. Disturbance in cellular metabolism is not the primary mechanism underlying the pain experienced during sickle cell crisis.
D. Bone marrow expansion with sickled cells may contribute to bone pain in sickle cell disease, but it is not the primary cause of pain during a sickle cell crisis.
Correct Answer is A
Explanation
A. The activity of the bone marrow is depressed. Aplastic anemia is a condition where the bone marrow fails to produce sufficient numbers of blood cells, including red cells, white cells, and platelets.
B. Red cells are absent as a result of chronic blood loss. This describes a condition like iron- deficiency anemia, not aplastic anemia.
C. The bone marrow fails to produce lymphocytes. Aplastic anemia affects the production of all blood cells, not just lymphocytes.
D. The kidneys fail to produce red blood cells. This describes anemia of chronic kidney disease, not aplastic anemia. In aplastic anemia, the problem lies with the bone marrow, not the kidneys.
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