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NURS 5315 FINAL QUESTIONS AND ANSWERS 2024
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NURS 5315 FINAL QUESTIONS AND ANSWERS 2024
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NURS 5315 FINALWhich abnormality is normally seen in a newborn?
Polycythemia
Leukopenia
Monocytopenia
Anemia
A newborn will normally have polycythemia . RBC counts decrease for the first 6-8
weeks after birth. Leukocytosis and monocytosis are normally seen in the
newborn as well.
Which patient will most likely have issues with bleeding secondary to a platelet
dysfunction?
A 72y/o patient with acute myelogenous leukemia .
A 3y/o male child with hemophilia A.
A patient with Hageman deficiency.
A patient with a protein C deficiency.
Acute leukemia causes a thrombocytopenia, thus patients with acute leukemia
are likely to experience bleeds secondary to platelet deficiencies. Hemophilia A
causes a coagulopathy. Hagemen factor is a coagulation protein that has a role in
the coagulation cascade but a deficiency does not cause a coagulopathy. A
protein C deficiency causes a hypercoagulable state.
A male patient presents to the emergency department with a complaint of acute,
left elbow progressive pain and swelling. An x-ray completed of the elbow was
,concerning for hemarthrosis. Which of the following lab values would be the most
important for the nurse practitioner to order?
Platelet count
White blood count
Prothrombin time
Hemoglobin
A coagulopathy is a dysfunction in either the intrinsic or extrinsic clotting cascade
which prevents hemostasis. The clotting cascade is independent of the platelet
plug formation and individuals with a coagulopathy may have normal platelet
production and function. The clinical picture is consistent with a coagulopathy
and not a platelet disorder. Individuals with a coagulopathy tend to bleed into the
joints and persons with thrombocytopenia or platelet dysfunction tend to
experience mucosal bleeds. While a platelet count is reasonable the question ask
which lab would be the most important to order. In this instance the prothrombin
time is the most important to order. The prothrombin time will identify a disorder
in the clotting cascade and the clinical scenario is consistent with a coagulopathy.
A white blood cell count may be helpful to rule out an infected joint but given the
clinical scenario it is not the most important lab to order. Again a hemoglobin will
be helpful to determine the extent of the bleeding but what is most important at
this point is to determine the etiology. The prothrombin time will help isolate the
etiology which will help the nurse practitioner determine the appropriate
treatment.
A 70-year-old female client presents to your office with a three week history of
numbness and tingling in her bilateral, lower extremities. The sensation has
progressively gotten worse and she complains of fatigue. The CBC shows a
hemoglobin of 8mg/dl and a hematocrit of 24%. Which of the following findings
would the nurse practitioner likely observe when examining the patient?
Koilonychia
, Positive stool guaiac
Jaundice
Smooth, beefy, red tongue
The clinical scenario is consistent with a pernicious anemia which is secondary to
a B12 deficiency. The only clinical manifestation listed in the choices that is
consistent with a B12 deficiency is option D. Koilonychia is a spooning of the nail
beds and is seen in iron deficiency anemia. A positive stool for guaiac may be
present in an iron deficiency anemia and could be a sign of colon cancer. Jaundice
would be present in a hemolytic anemia such as sickle cell anemia.
A 70-year-old female patient presents to your office with a three week history of
numbness and tingling in her bilateral, lower extremities. The sensation has
progressively gotten worse and she complains of fatigue. The CBC shows a
hemoglobin of 8mg/dl and a hematocrit of 24%. Which of the following
treatments will the nurse practitioner likely order?
Vitamin K
Vitamin B12
Iron
Folic Acid
The clinical scenario is consistent with a pernicious anemia which is secondary to
a B12 deficiency. The human body stores approximately 10 years of vitamin B12
and therefore this anemia tends to present more commonly in the elderly. Other
individuals at risk for B12 deficiency include alcoholics, vegans, those with a
gastrectomy, inflammatory bowel disease, and persons who have had a surgical
resection of the ileum. The ileum is the site of absorption of B12. Vitamin K is
used to reverse the effects of warfarin and not to treat anemia. Iron is used to
treat iron deficiency anemia. Folic acid is used to treat an anemia secondary to
folic acid deficiency.
A woman of childbearing age is most likely to experience which type of anemia?
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