A client with suspected hemolytic anemia is undergoing diagnostic evaluation.
The nurse reviews the laboratory results and finds a low hemoglobin level, normal mean corpuscular volume (MCV), and elevated reticulocyte count.
Which additional laboratory findings would be consistent with this diagnosis?
"My serum bilirubin levels are quite high.”
"I have noticed a significant decrease in my haptoglobin levels.”
"My lactate dehydrogenase (LDH) levels are within the normal range.”
"The peripheral blood smear showed no abnormalities in my RBCs.”
The Correct Answer is B
Choice A rationale:
Elevated serum bilirubin levels can be seen in hemolytic anemia due to increased breakdown of red blood cells.
However, it is not specific to hemolytic anemia and can occur in other conditions as well.
Choice B rationale:
Haptoglobin is a protein that binds to free hemoglobin released from the destruction of red blood cells.
In hemolytic anemia, there is increased hemolysis, leading to a decrease in haptoglobin levels as it gets consumed to bind to the released hemoglobin.
This is consistent with the clinical picture described in the question.
Choice C rationale:
Lactate dehydrogenase (LDH) is an enzyme found in various tissues, including red blood cells.
Elevated LDH levels can be seen in hemolytic anemia due to the release of LDH from damaged red blood cells.
However, LDH elevation is not specific to hemolytic anemia and can occur in other conditions.
Choice D rationale:
The absence of abnormalities in the peripheral blood smear does not rule out hemolytic anemia.
Some forms of hemolytic anemia may not show distinct abnormalities in the appearance of red blood cells on a peripheral blood smear.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
The statement, "My skin looks paler than usual," is a valid physical examination finding, but it is a general symptom of anemia and not specific to hemolytic anemia.
Other types of anemia can also cause pale skin.
Choice B rationale:
The statement, "I've been having chest pain occasionally," is important to assess, but it is not a specific physical examination finding related to hemolytic anemia.
Chest pain may have various causes, and additional information is needed to determine its significance.
Choice C rationale:
The statement, "I've noticed my urine is getting darker," is a specific physical examination finding that is highly relevant to hemolytic anemia.
Dark urine can result from the breakdown of red blood cells and the release of hemoglobin into the urine, a characteristic feature of hemolytic anemia.
Choice D rationale:
The statement, "I've been experiencing abdominal pain," is important to assess, but it is not a specific physical examination finding related to hemolytic anemia.
Abdominal pain can have various causes, and further evaluation is needed to determine its association with the patient's condition.
Correct Answer is B
Explanation
Choice A rationale:
Elevated bilirubin levels.
Elevated bilirubin levels are not a specific clinical manifestation of intravascular hemolysis.
Bilirubin levels may be elevated in various types of anemia, but it is not a characteristic sign of intravascular hemolysis.
Choice B rationale:
Hemoglobinuria.
Hemoglobinuria is a clinical manifestation consistent with intravascular hemolysis.
When red blood cells are destroyed within blood vessels, hemoglobin is released into the bloodstream, and it can be filtered by the kidneys and excreted in the urine, leading to hemoglobinuria.
Choice C rationale:
Splenomegaly.
Splenomegaly can occur in some types of anemia, but it is not a specific clinical manifestation of intravascular hemolysis.
It may be more commonly associated with conditions like hereditary spherocytosis or thalassemia.
Choice D rationale:
Increased ferritin levels.
Increased ferritin levels are not a specific clinical manifestation of intravascular hemolysis.
Ferritin is a marker of iron storage in the body and is not directly related to the destruction of red blood cells.
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