A 21-year-old patient with a known history of sickle cell anemia presents to the emergency department with severe pain in the lower back and joints, fatigue, and fever. What is the most likely cause of these symptoms?
Acute lymphoblastic leukemia
Iron-deficiency anemia
Vaso-occlusive crisis
Pneumonia
The Correct Answer is C
Choice A Reason:
Acute lymphoblastic leukemia (ALL) is a type of cancer that affects the blood and bone marrow. While it can cause symptoms such as fatigue and fever, it is less likely to cause severe pain in the lower back and joints, which are more characteristic of a vaso-occlusive crisis in sickle cell anemia. ALL typically presents with symptoms like frequent infections, easy bruising or bleeding, and bone pain, but the combination of severe pain, fatigue, and fever in a patient with sickle cell anemia points more towards a vaso-occlusive crisis.
Choice B Reason:
Iron-deficiency anemia is a condition where there is a lack of adequate iron to form healthy red blood cells. Symptoms include fatigue, weakness, and pale skin, but it does not typically cause severe pain in the lower back and joints or fever. The presence of severe pain and fever in a patient with sickle cell anemia is more indicative of a vaso-occlusive crisis rather than iron-deficiency anemia.
Choice C Reason:
Vaso-occlusive crisis is a common and painful complication of sickle cell anemia. It occurs when sickled red blood cells block blood flow to parts of the body, causing severe pain, often in the back, joints, and abdomen. This condition can also lead to fever and fatigue due to the body’s inflammatory response and the reduced oxygen delivery to tissues. Given the patient’s history of sickle cell anemia and the described symptoms, a vaso-occlusive crisis is the most likely cause.
Choice D Reason:
Pneumonia is an infection that inflames the air sacs in one or both lungs, which can cause symptoms such as fever, chills, and difficulty breathing. While pneumonia can occur in patients with sickle cell anemia, it is less likely to cause severe pain in the lower back and joints. The combination of severe pain, fatigue, and fever in this patient is more consistent with a vaso-occlusive crisis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Scleral buckling is a surgical procedure used to treat retinal detachment by indenting the wall of the eye. This technique involves placing a silicone band (buckle) around the sclera (the white part of the eye) to push the wall of the eye against the detached retina. This helps to reattach the retina and prevent further detachment. Scleral buckling is effective in treating many types of retinal detachments and is a common procedure for this condition.
Choice B Reason:
Photorefractive keratectomy (PRK) is a type of refractive surgery used to correct vision problems such as myopia, hyperopia, and astigmatism. It involves reshaping the cornea using a laser but is not used to treat retinal detachment. PRK does not involve indenting the wall of the eye or addressing issues with the retina.
Choice C Reason:
Vitrectomy is a surgical procedure that involves removing the vitreous gel from the eye to treat various eye conditions, including retinal detachment. While vitrectomy can be used to treat retinal detachment, it does not involve indenting the wall of the eye. Instead, it allows the surgeon to access the retina and perform necessary repairs.
Choice D Reason:
Intravitreal injection involves injecting medication directly into the vitreous cavity of the eye. This procedure is used to treat conditions such as macular degeneration, diabetic retinopathy, and retinal vein occlusion. It is not used to treat retinal detachment by indenting the wall of the eye.
Correct Answer is A
Explanation
Choice A Reason:
Monitoring platelet counts and assessing for signs of bleeding is crucial for managing thrombocytopenia. Thrombocytopenia is characterized by a low platelet count, which increases the risk of bleeding. Regular monitoring helps in detecting any significant drops in platelet levels, allowing for timely interventions to prevent severe bleeding. Assessing for signs of bleeding, such as petechiae, bruising, or nosebleeds, is essential to manage the condition effectively and prevent complications.
Choice B Reason:
Administering aspirin to manage pain and prevent clot formation is not appropriate for patients with thrombocytopenia. Aspirin is an antiplatelet agent that inhibits platelet function, which can exacerbate bleeding tendencies in patients with low platelet counts. Using aspirin in this context could increase the risk of bleeding and is therefore contraindicated.
Choice C Reason:
Administering a diuretic to reduce fluid retention and swelling is not relevant for managing thrombocytopenia. Diuretics are used to manage conditions like hypertension and edema but do not address the underlying issue of low platelet counts. In fact, diuretics can lead to electrolyte imbalances, which may complicate the patient’s condition further.
Choice D Reason:
Encouraging the patient to increase physical activity to improve circulation is not a priority intervention for thrombocytopenia. While physical activity is generally beneficial for overall health, it can increase the risk of trauma and bleeding in patients with low platelet counts. It is important to avoid activities that could lead to injury and bleeding in these patients.
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