A nurse suspects that a client may have aplastic anemia based on clinical manifestations and assessment. Which one of the following lab results would be consistent with this diagnosis?

Hemoglobin level of 15 g/dL (range 12 to 16 g/dL)

Platelet level of 275,000/mm3 (range 150,000-400,000 per mm3)

White blood cell count 1100 cells/mm3 (range 5000-10,000 cells/mm3)

Erythrocyte count 5.1 cells/mL (range 4.2-5.4 cells/mL)

Answer and Explanation

The Correct Answer is C

Reasoning:

Choice A reason: A hemoglobin level of 15 g/dL is within the normal range and not consistent with aplastic anemia, which causes pancytopenia, including low hemoglobin due to bone marrow failure. Normal hemoglobin suggests adequate red blood cell production, ruling out aplastic anemia as the primary diagnosis.

Choice B reason: A platelet level of 275,000/mm3 is normal and does not support aplastic anemia, which involves bone marrow failure, leading to thrombocytopenia (low platelets). Normal platelet counts indicate intact megakaryocyte function, inconsistent with the pancytopenia characteristic of aplastic anemia’s bone marrow suppression.

Choice C reason: A white blood cell count of 1100 cells/mm3 indicates leukopenia, a hallmark of aplastic anemia. Bone marrow failure reduces production of all blood cell lines, including leukocytes, leading to low white cell counts, increasing infection risk, and supporting the diagnosis of aplastic anemia in this context.

Choice D reason: An erythrocyte count of 5.1 cells/mL is normal and not indicative of aplastic anemia, which causes anemia through reduced red blood cell production. Normal erythrocyte counts suggest preserved erythropoiesis, which is inconsistent with the pancytopenia expected in aplastic anemia’s bone marrow failure.

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Correct Answer is C

Explanation

Reasoning:

Choice A reason: Detecting infection via fever and tachycardia is important in sickle cell anemia, but auscultation of lungs and heart is not primarily for these signs. Fever is assessed by temperature, and tachycardia by pulse, not stethoscope. Auscultation focuses on organ-specific complications like respiratory or cardiac issues, not systemic signs.

Choice B reason: Dehydration can trigger sickle cell crises, but auscultation of lungs and heart does not directly assess hydration status. Fluid status is evaluated through vital signs, skin turgor, or urine output, not heart or lung sounds, making this response less accurate for the purpose of auscultation.

Choice C reason: Auscultating lungs and heart in sickle cell anemia detects abnormal sounds indicating acute respiratory complications, like acute chest syndrome, or heart failure from chronic anemia or vaso-occlusion. Crackles, wheezes, or murmurs suggest these complications, making this the most accurate explanation for the child’s question.

Choice D reason: Motor strength and stroke-related signs are assessed through neurological exams, not lung or heart auscultation. While stroke is a risk in sickle cell anemia due to vaso-occlusion, auscultation targets cardiopulmonary complications, not motor or neurological deficits, making this response inappropriate.

A. Sodium of 140 mEq/L (range 135-145 mEq/L) B. Glucose of 100 mg/dL (range 60-100 mg/dL) C. A blood pressure reading of 135/90 mm Hg D. Potassium of 6.0 mEq/L (range 3.5-5 mEq/L)

Correct Answer is D

Explanation

Reasoning:

Choice A reason: A sodium level of 140 mEq/L is within the normal range and not diagnostic of Addison’s disease. This condition, caused by adrenal insufficiency, typically leads to hyponatremia due to reduced aldosterone, which decreases sodium reabsorption, making a normal sodium level uncharacteristic of the disease.

Choice B reason: A glucose level of 100 mg/dL is normal and not specific to Addison’s disease. Hypoglycemia is more common due to cortisol deficiency, which impairs gluconeogenesis. A normal glucose level does not support the diagnosis, as it does not reflect the metabolic disruptions of adrenal insufficiency.

Choice C reason: A blood pressure of 135/90 mm Hg is elevated but not diagnostic of Addison’s disease. The condition typically causes hypotension due to reduced aldosterone and cortisol, leading to low blood volume and vascular tone. Hypertension suggests another etiology, not adrenal insufficiency.

Choice D reason: A potassium level of 6.0 mEq/L indicates hyperkalemia, a diagnostic sign of Addison’s disease. Aldosterone deficiency reduces potassium excretion in the kidneys, leading to elevated serum potassium. This, combined with hyponatremia and hypotension, is a hallmark of adrenal insufficiency, making hyperkalemia a key diagnostic finding.

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A nurse suspects that a client may have aplastic anemia based on clinical manifestations and assessment. Which one of the following lab results would be consistent with this diagnosis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is doing a physical examination of a child with sickle cell anemia. When the child asks why the nurse auscultates the lungs and heart, what would be the best response by the nurse?

Correct Answer is C

Explanation

The nurse assesses a client who has been diagnosed with Addison's disease. Which of the following is a diagnostic sign of this disease?

Correct Answer is D

Explanation

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