A nurse is caring for a client diagnosed with hemolytic anemia.
The client's laboratory results show low hemoglobin, low hematocrit, normal MCV, and high reticulocyte count.
Which of the following statements by the client indicates a need for further education regarding their condition?
"My reticulocyte count is higher than normal.”
"I have a lower-than-normal hematocrit level.”
"My MCV is within the normal range.”
"My hemoglobin level falls within the expected range.”
The Correct Answer is C
Choice A rationale:
The statement, "My reticulocyte count is higher than normal," indicates that the client has an understanding of their condition.
In hemolytic anemia, the bone marrow releases more reticulocytes (immature red blood cells) in response to the low hemoglobin levels to compensate for the destruction of red blood cells.
Choice B rationale:
The statement, "I have a lower-than-normal hematocrit level," is a correct assessment of the client's condition.
Hemolytic anemia typically results in low hematocrit levels due to the decreased number of red blood cells.
Choice C rationale:
The statement, "My MCV is within the normal range," is incorrect.
In hemolytic anemia, MCV (mean corpuscular volume) is often elevated because the remaining red blood cells are larger than normal.
This statement indicates a need for further education as it reflects a misunderstanding of the laboratory results.
Choice D rationale:
The statement, "My hemoglobin level falls within the expected range," is incorrect.
Hemolytic anemia typically results in low hemoglobin levels due to the destruction of red blood cells.
This statement indicates a need for further education as it reflects a misunderstanding of the laboratory results.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
"I have noticed that my urine has become very dark lately." Dark urine is a common clinical manifestation of hemolysis, as it indicates the presence of hemoglobin in the urine, known as hemoglobinuria.
This is a result of the breakdown of red blood cells and release of hemoglobin into the bloodstream.
Choice B rationale:
"My abdomen feels swollen and uncomfortable." Abdominal discomfort or swelling is not a specific clinical manifestation of hemolytic anemia.
It may be associated with conditions like splenomegaly but is not a characteristic sign of hemolysis.
Choice C rationale:
"I have been experiencing painful episodes in my bones." Painful episodes in the bones are not typically associated with hemolytic anemia.
Bone pain may be related to other conditions but is not a direct result of hemolysis.
Choice D rationale:
"I have been having severe headaches and chest pain." Severe headaches and chest pain are not specific clinical manifestations of hemolytic anemia.
These symptoms may have other causes and should be evaluated separately.
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.
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