NUR 5315 NEWEST EXAM
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An adult patient with sickle cell anemia is at the greatest risk for which type of infection?
Pneumoccoccal
Staphylococcal
Fungal
Viral
An adult patient with sickle cell anemia has a functional asplenia. This leaves them at an increased risk
for acquiring pneumococcal infections.
Vaso-occlusive crises are best treated with which type of IV fluid?
Hypotonic
Isotonic
Hypertonic
Isometric
Hypotonic IV solutions are the best treatment for sickle cell crises. The administrative of a hypotonic IV
solution to a person experiencing a sickle cell crisis will help to reverse the crisis by causing fluid to shift
into the intracellular space. This will help the RBCs return to their normal biconcave shape.
Which 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
WITH DETAILED
VERIFIED ANSWERS AND
RATIONALES\ALREADY
GRADED A+\VERIFIED BY
EXPERT
An adult patient with sickle cell anemia is at the greatest risk for which type of infection?
Pneumoccoccal
Staphylococcal
Fungal
Viral
An adult patient with sickle cell anemia has a functional asplenia. This leaves them at an increased risk
for acquiring pneumococcal infections.
Vaso-occlusive crises are best treated with which type of IV fluid?
Hypotonic
Isotonic
Hypertonic
Isometric
Hypotonic IV solutions are the best treatment for sickle cell crises. The administrative of a hypotonic IV
solution to a person experiencing a sickle cell crisis will help to reverse the crisis by causing fluid to shift
into the intracellular space. This will help the RBCs return to their normal biconcave shape.
Which 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
