A client's electronic health record notes that the client has previously undergone treatment for secondary polycythemia. The nurse should assess for which factor?

Recent blood donation

A history of venous thromboembolism

Evidence of lung disease

Impaired renal function

Answer and Explanation

The Correct Answer is C

Reasoning:

Choice A reason: Recent blood donation is not a primary cause of secondary polycythemia, which results from chronic hypoxia or erythropoietin excess, not blood loss. Donation may temporarily reduce red blood cell count, but it does not drive the increased erythropoiesis seen in secondary polycythemia, making it less relevant.

Choice B reason: A history of venous thromboembolism is a consequence, not a cause, of secondary polycythemia. Increased red blood cell mass elevates blood viscosity, raising clotting risk, but thromboembolism does not trigger polycythemia. The nurse should assess for underlying causes like hypoxia, not its complications.

Choice C reason: Evidence of lung disease is critical to assess, as secondary polycythemia is often caused by chronic hypoxia from conditions like chronic obstructive pulmonary disease. Low oxygen levels stimulate erythropoietin production, increasing red blood cell mass to enhance oxygen delivery, making lung disease a primary factor to evaluate.

Choice D reason: Impaired renal function is not a primary cause of secondary polycythemia. While kidneys produce erythropoietin, renal disease typically causes anemia due to reduced erythropoietin. Rarely, renal tumors may increase erythropoietin, but lung disease is a more common driver of secondary polycythemia in clinical practice.

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Correct Answer is C

Explanation

Reasoning:

Choice A reason: Platelet count and WBC count are relevant, but blood glucose levels are not specific to DIC. DIC involves widespread clotting and bleeding, depleting platelets and coagulation factors, affecting clotting times. Glucose levels are unrelated to the coagulopathy central to DIC’s pathophysiology, making this set less comprehensive.

Choice B reason: Thrombin time is relevant to DIC, but calcium and potassium levels are not primary indicators. Calcium may affect clotting in specific contexts, but DIC primarily involves consumption of platelets and clotting factors, prolonging prothrombin and partial thromboplastin times, making these more critical parameters.

Choice C reason: Platelet count, prothrombin time (PT), and partial thromboplastin time (PTT) are key in DIC monitoring. DIC causes widespread microthrombi, consuming platelets and clotting factors, leading to low platelets and prolonged PT/PTT. These parameters directly reflect the coagulopathy and bleeding risk, making them essential for diagnosis and management.

Choice D reason: Fibrinogen level and platelet count are important in DIC, as both are consumed in widespread clotting. However, WBC count is less specific, as it reflects infection or inflammation, not coagulopathy. PT and PTT better capture the clotting factor depletion central to DIC’s pathophysiology.

A. To determine the cause of the TIA B. To remove atherosclerotic plaques blocking cerebral flow C. To prevent seizure activity that is common following a TIA D. To decrease cerebral edema

Correct Answer is B

Explanation

Reasoning:

Choice A reason: Carotid endarterectomy (CEA) does not determine the cause of TIAs but treats them by removing plaques. Diagnostic tests like carotid ultrasound identify atherosclerosis as the cause. CEA addresses the known obstruction, preventing further ischemic events, not investigating their etiology.

Choice B reason: CEA removes atherosclerotic plaques from the carotid artery, restoring blood flow to the brain. TIAs often result from plaque-induced stenosis, causing transient ischemia. By clearing the blockage, CEA prevents recurrent TIAs and strokes, directly addressing the underlying cause of cerebral hypoperfusion.

Choice C reason: Preventing seizure activity is not the purpose of CEA. Seizures are not common after TIAs, which are transient ischemic events without permanent damage. CEA targets vascular stenosis to prevent ischemia, not neurological complications like seizures, which are unrelated to its mechanism.

Choice D reason: Decreasing cerebral edema is not a goal of CEA. Edema is more associated with hemorrhagic stroke or severe ischemia, not TIAs. CEA restores blood flow by removing plaques, preventing ischemic events, not addressing brain swelling, which requires different interventions like mannitol.

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A client's electronic health record notes that the client has previously undergone treatment for secondary polycythemia. The nurse should assess for which factor?

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Naxlex Comprehensive Predictor Exams

While monitoring a client for the development of disseminated intravascular coagulation (DIC), the nurse should take note of which assessment parameters?

Correct Answer is C

Explanation

A client diagnosed with transient ischemic attacks (TIAs) is scheduled for a carotid endarterectomy (CEA). The nurse explains that this procedure will be done for what purpose?

Correct Answer is B

Explanation

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