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A nurse is assessing a patient with hemolytic anemia.
Which clinical manifestation is consistent with intravascular hemolysis?

Elevated bilirubin levels.

Hemoglobinuria.

Splenomegaly.

Increased ferritin levels.

Answer and Explanation

The Correct Answer is B

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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Correct Answer is C

Explanation

Choice A rationale:

A complete blood count (CBC) with differential can provide information about the overall red blood cell count and indices but may not confirm the presence of immune-mediated hemolysis.

Choice B rationale:

A peripheral blood smear can show abnormalities in the shape and structure of red blood cells but may not confirm the presence of immune-mediated hemolysis or identify the underlying cause.

Choice D rationale:

Serum bilirubin and haptoglobin levels can provide indirect evidence of hemolysis, but they do not confirm the presence of immune-mediated hemolysis or identify the underlying cause.

Choice C rationale:

The direct antiglobulin test (DAT), also known as the Coombs test, is used to detect the presence of antibodies or complement proteins on the surface of red blood cells.

A positive DAT result indicates immune-mediated hemolysis, confirming the suspicion raised by the clinical presentation of pallor, fatigue, and splenomegaly.

This test is crucial for diagnosing the specific type of immune-mediated hemolytic anemia and guiding further management.

A. "I'm feeling so weak lately.” B. "I had a blood transfusion a few years ago.” C. "I think I might have an autoimmune disorder.” D. "My family has a history of hemolytic disorders.”

Correct Answer is D

Explanation

Choice A rationale:

The statement, "I'm feeling so weak lately," is important information, but it does not prioritize the assessment.

Weakness is a common symptom of anemia, but in a patient with suspected hemolytic anemia, obtaining a family history of hemolytic disorders is more critical.

Choice B rationale:

The statement, "I had a blood transfusion a few years ago," is relevant to the patient's history but does not take priority over obtaining information about the family history of hemolytic disorders.

Choice C rationale:

The statement, "I think I might have an autoimmune disorder," is relevant and should be explored further, but it does not take priority over obtaining a family history of hemolytic disorders.

Choice D rationale:

The statement, "My family has a history of hemolytic disorders," is the most crucial aspect of the patient's history to prioritize.

Hemolytic disorders often have a genetic component, so family history can provide valuable information for diagnosis and management.

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A nurse is assessing a patient with hemolytic anemia.Which clinical manifestation is consistent with intravascular hemolysis?

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Naxlex Comprehensive Predictor Exams

A client presents with symptoms of hemolytic anemia, including pallor, fatigue, and splenomegaly.The nurse suspects immune-mediated hemolysis.Which diagnostic test should the nurse prioritize to confirm this suspicion?

Correct Answer is C

Explanation

A nurse is conducting a nursing assessment for a patient with suspected hemolytic anemia.Which aspect of the patient's history should the nurse prioritize?

Correct Answer is D

Explanation

A client with hemolytic anemia asks, "How is bilirubin processed in my body?" Which response by the nurse is accurate?

A nurse is providing education to a patient diagnosed with hemolytic anemia.Which self-care instructions should the nurse include? (Select all that apply)

A nurse is caring for a client with hemolytic anemia. The client presents with pallor, fatigue, tachycardia, and jaundice. Which of the following additional clinical manifestations should the nurse anticipate in this client?

A client with hemolytic anemia inquires, "What happens to my red blood cells?" Which explanation by the nurse is correct?

During the nursing assessment of a patient with hemolytic anemia, which physical examination findings should the nurse specifically focus on?

(Select all that apply):A nurse is providing education to a group of clients with different types of hemolytic anemia.Which types of hemolytic anemia are associated with abnormalities in the shape or structure of red blood cells? (Select all that apply)

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?

(Select all that apply): A nurse is educating a patient with hemolytic anemia about the potential complications.Which complications should the nurse include in the teaching? Select all that apply.

A nurse is assessing a patient with hemolytic anemia.
Which clinical manifestation is consistent with intravascular hemolysis?