A 53-year-old man presents with inability to concentrate, itching in his fingers and toes, elevated blood pressure, and unexplained weight loss. He is diagnosed with primary polycythemia vera. What will be the primary goal of his treatment?
To extend the lifespan of his red blood cells
To reduce the mean size of his red blood cells
To reduce the viscosity of his blood
To control his hypertension
The Correct Answer is C
Choice A reason: Extending red blood cell lifespan is not a goal in polycythemia vera, where excessive red cell production increases blood viscosity. Treatment aims to reduce cell mass, not prolong cell life, as this would worsen hyperviscosity, making this an incorrect goal.
Choice B reason: Reducing the mean size of red blood cells is irrelevant, as polycythemia vera involves increased red cell count, not size. Treatment focuses on lowering hematocrit to decrease viscosity, not altering cell dimensions, making this an incorrect treatment goal.
Choice C reason: Reducing blood viscosity is the primary goal in polycythemia vera, achieved through phlebotomy or myelosuppressive therapy to lower red cell mass. This alleviates symptoms like itching and prevents thrombotic complications, directly addressing the disease’s pathophysiology, making this correct.
Choice D reason: Controlling hypertension is a secondary concern in polycythemia vera, often resulting from increased blood volume. While managed, the primary goal is reducing blood viscosity to prevent complications, as hypertension is a symptom, not the root cause, making this incorrect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Release of inflammatory mediators drives inflammation, not angiogenesis. Pathological angiogenesis is excessive or abnormal vessel growth, often in diseases like cancer, so this is incorrect for the term.
Choice B reason: New vessel formation in response to injury is physiological angiogenesis, not pathological. Pathological angiogenesis involves abnormal, excessive growth, so this is incorrect for the described process.
Choice C reason: Pathological angiogenesis is excessive or abnormal blood vessel growth, seen in conditions like tumors or retinopathy. This matches the definition, making it the correct choice for the term.
Choice D reason: Inhibition of vessel formation is anti-angiogenic, not pathological angiogenesis. Excessive vessel growth defines the pathological state, so this is incorrect for the term.
Correct Answer is D
Explanation
Choice A reason: Immune thrombocytopenic purpura (ITP) causes isolated thrombocytopenia due to autoimmune platelet destruction, leading to bleeding like petechiae. However, it does not typically cause prolonged PT/aPTT, elevated D-dimer, or DVT, making it inconsistent with Lorretta’s multi-system coagulopathy.
Choice B reason: Thrombotic thrombocytopenic purpura (TTP) involves microangiopathic hemolytic anemia, thrombocytopenia, and organ damage but typically presents with neurological or renal symptoms, not prolonged PT/aPTT or DVT. Lorretta’s coagulopathy and DVT history better align with another condition, making TTP incorrect.
Choice C reason: Hemophilia, a genetic clotting factor deficiency, causes prolonged aPTT but not thrombocytopenia, elevated D-dimer, or DVT. It primarily affects males and causes joint or muscle bleeds, not diffuse bleeding like Lorretta’s, making this an incorrect diagnosis.
Choice D reason: Disseminated intravascular coagulation (DIC) involves widespread clotting and bleeding, causing thrombocytopenia, prolonged PT/aPTT, elevated D-dimer, and petechiae. Lorretta’s DVT history and anticoagulant use may trigger DIC, with leg swelling indicating thrombosis, making this the correct diagnosis.
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