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%

Answer and Explanation

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.

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Correct Answer is A

Explanation

A. Three to seven days after menses stops. This is the best time to perform BSE as the breasts are least likely to be swollen and tender during this period.
B. Prior to the beginning of menses. Breasts are more likely to be swollen and tender before menstruation, which can make it harder to detect abnormalities.
C. On the second day of menstruation. During menstruation, hormonal changes can affect breast tissue, making the examination less reliable.
D. On the same day every month. For those with regular menstrual cycles, it is recommended to perform BSE a few days after menses stops for more accurate results.

A. Skin color B. Liver function C. Hematocrit D. Serum iron level

Correct Answer is D

Explanation

A. Skin color: While changes in skin color can occur in hemochromatosis due to excess iron deposition, it is not the most important parameter to monitor for the effectiveness of deferoxamine.
B. Liver function: Liver function tests can be abnormal in hemochromatosis due to iron overload, but monitoring liver function alone may not adequately assess the effectiveness of deferoxamine in reducing iron levels.
C. Hematocrit: Hematocrit measures the proportion of blood that is made up of red blood cells and may be elevated in hemochromatosis, but it is not the primary parameter to monitor the effectiveness of deferoxamine.
D. Serum iron level: Serum iron level is the most direct indicator of iron overload and the effectiveness of deferoxamine in chelating and removing excess iron from the body.

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Which finding about a patient with polycythemia vera is most important for the nurse to report to the health care provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is A

Explanation

Which patient information is most important for the nurse to monitor when evaluating the effectiveness of deferoxamine (Desferal) for a patient with hemochromatosis?

Correct Answer is D

Explanation

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