Which laboratory report finding would support the nurse's conclusion that a patient has thalassemia major? Select all that apply.
One, some, or all responses may be correct.
Increased bilirubin levels.
Increased reticulocyte level.
Increased mean corpuscular volume.
Increased total iron-binding capacity.
Correct Answer : A,B,D
Choice A rationale:
Increased bilirubin levels can occur in thalassemia major due to the destruction of red blood cells, leading to elevated bilirubin, which is a breakdown product of hemoglobin. This elevation can contribute to jaundice and other symptoms.
Choice B rationale:
Thalassemia major leads to the destruction of red blood cells, causing the bone marrow to release more reticulocytes (immature red blood cells) into the bloodstream. Therefore, an increased reticulocyte level is expected in thalassemia major.
Choice C rationale:
Increased mean corpuscular volume (MCV) is not a typical finding in thalassemia major. Thalassemia major is characterized by microcytic (smaller than normal) red blood cells, leading to a decreased MCV.
Choice D rationale:
Thalassemia major causes increased iron absorption by the intestines, leading to elevated total iron-binding capacity (TIBC) TIBC measures the body's capacity to bind and transport iron in the blood, and elevated levels are seen in conditions with increased iron demand, such as thalassemia major.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is choice C. Uses an alcohol-based mouthwash twice a day.
Choice A rationale:
Drinking 14 glasses of water daily is generally beneficial as it helps maintain hydration and supports overall health. However, it is important to balance fluid intake to avoid overhydration.
Choice B rationale:
Shaving with an electric razor is recommended for patients with thrombocytopenia because it reduces the risk of cuts and bleeding compared to using a traditional razor.
Choice C rationale:
Using an alcohol-based mouthwash can cause dryness and irritation of the oral mucosa, which can lead to bleeding, especially in patients with thrombocytopenia. It is better to use a non-alcoholic mouthwash.
Choice D rationale:
Brushing teeth with a soft-bristle toothbrush is advised to minimize the risk of gum bleeding and maintain oral hygiene.
Correct Answer is B
Explanation
Choice A rationale:
Metabolic acidosis is characterized by a low pH (<7.35) and a low bicarbonate level (<22 mEq/L) The given arterial blood gas (ABG) values indicate a pH of 7.48 (which is alkalotic), a PaCO2 of 38 (within the normal range of 35-45 mm Hg), and an HCO3- of 30 (which is elevated) These values indicate metabolic alkalosis, not metabolic acidosis.
Choice B rationale:
Metabolic alkalosis is characterized by a high pH (>7.45) and an elevated bicarbonate level (>26 mEq/L) The given ABG values indicate a pH of 7.48 (which is alkalotic) and an elevated HCO3- of 30, indicating metabolic alkalosis. This condition can result from excessive loss of acids (e.g., vomiting) or excessive intake of bicarbonate or alkali substances.
Choice C rationale:
Respiratory acidosis is characterized by a low pH (<7.35) and a high PaCO2 (>45 mm Hg) The given ABG values indicate a normal pH of 7.48 and a PaCO2 of 38 (within the normal range), ruling out respiratory acidosis.
Choice D rationale:
Respiratory alkalosis is characterized by a high pH (>7.45) and a low PaCO2 (<35 mm Hg) The given ABG values indicate a pH of 7.48 (which is alkalotic) and a PaCO2 of 38 (within the normal range), ruling out respiratory alkalosis.
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