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 D
Explanation
Choice A reason: Retching is the involuntary attempt to vomit, involving abdominal muscle contractions without expelling stomach contents. The patient is actively expelling contents, which defines vomiting, not just the effort of retching, making this an incorrect term for documentation.
Choice B reason: Expectorate refers to coughing up and spitting out mucus or sputum from the respiratory tract. The patient is expelling stomach contents, not respiratory secretions, making expectorate an incorrect term for this gastrointestinal event.
Choice C reason: Regurgitation is the passive return of undigested food or liquid from the stomach or esophagus, often without force. The forceful expulsion of stomach contents described indicates vomiting, not regurgitation, making this an incorrect documentation term.
Choice D reason: Vomiting is the forceful expulsion of stomach contents through the mouth, driven by coordinated abdominal and diaphragmatic contractions. The patient’s active expulsion into a basin matches this definition, making vomiting the correct term for documentation.
Correct Answer is A
Explanation
Choice A reason: Acute pancreatitis is likely, given severe abdominal pain, elevated amylase and lipase, fever, hypotension (89/46 mm Hg), tachycardia (116 bpm), and alcohol history. These are classic signs, with C-reactive protein indicating inflammation, making this the first suspected diagnosis for this patient.
Choice B reason: Cholecystitis causes right upper quadrant pain and fever but is less associated with elevated amylase/lipase or severe hypotension. Pancreatitis aligns better with the patient’s alcohol use, vital signs, and lab results, so this is incorrect as the primary suspicion.
Choice C reason: Hepatitis C may cause liver inflammation but not acute abdominal pain or elevated amylase/lipase. The patient’s acute symptoms, alcohol history, and vital signs point to pancreatitis, not a chronic viral infection, making this incorrect for the first diagnosis.
Choice D reason: Liver cirrhosis is chronic, not acute, and doesn’t typically cause sudden pain or elevated amylase/lipase. Acute pancreatitis matches the patient’s acute presentation, alcohol use, and lab findings, so cirrhosis is incorrect as the initial suspected diagnosis.
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