A nurse is assessing a patient with suspected polycythemia.
Which of the following signs and symptoms should the nurse specifically assess for during the physical examination?
"I've been feeling tired and weak lately.”
"My skin has become very red and flushed.”
"I've noticed frequent nosebleeds.”
"I've been experiencing shortness of breath.”
The Correct Answer is B
Choice A rationale:
Feeling tired and weak is a common symptom of polycythemia due to the increased viscosity of the blood.
However, this is a general symptom and not specific to polycythemia alone.
Many conditions can cause fatigue.
Choice B rationale:
Red and flushed skin is a characteristic sign of polycythemia.
Increased red blood cell count can lead to increased blood flow to the skin, resulting in a flushed appearance.
This is a specific symptom of polycythemia and should be assessed during the physical examination.
Choice C rationale:
Frequent nosebleeds can occur in polycythemia due to increased blood viscosity and pressure on blood vessels.
This is another specific symptom that should be assessed in a patient with suspected polycythemia.
Choice D rationale:
Shortness of breath can also be a symptom of polycythemia, especially when there is an excessive increase in red blood cells.
However, like fatigue, it is not specific to polycythemia and can be caused by various respiratory and cardiac conditions.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Hyperthyroidism can lead to an increase in red blood cell production, known as secondary polycythemia.
However, it is not the most likely cause in this scenario.
The primary cause of secondary polycythemia is usually related to hypoxia or conditions that increase erythropoietin production.
Choice B rationale:
Renal cysts can lead to polycythemia due to increased erythropoietin production by the kidneys.
When the kidneys detect low oxygen levels in the blood (hypoxia), they release erythropoietin, a hormone that stimulates the production of red blood cells in the bone marrow.
Renal cysts can disrupt the normal function of the kidneys and trigger excessive erythropoietin release, causing secondary polycythemia.
Choice C rationale:
Smoking can lead to chronic obstructive pulmonary disease (COPD), which can cause secondary polycythemia due to chronic hypoxia.
However, renal cysts are a more direct cause in this scenario.
Choice D rationale:
Obesity can lead to sleep apnea, which can cause secondary polycythemia due to chronic hypoxia during sleep.
However, renal cysts are a more likely cause of secondary polycythemia than obesity alone.
Correct Answer is C
Explanation
Choice A rationale:
Dehydration does not cause polycythemia vera.
Polycythemia vera is a disorder of the bone marrow characterized by an overproduction of red blood cells.
Choice B rationale:
Chronic pulmonary disease is not a cause of polycythemia vera.
Polycythemia vera is typically due to a mutation in the JAK2 gene.
Choice C rationale:
This is the correct answer.
Polycythemia vera is often caused by a mutation in the JAK2 gene, which leads to an abnormal increase in red blood cell production.
Choice D rationale:
Smoking can lead to secondary polycythemia, but it is not the cause of polycythemia vera, which is a primary disorder of the bone marrow.
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