An adult male is experiencing increased fatigue and occasional palpitations at rest. Which laboratory data would the nurse identify as consistent with these symptoms?
Red Blood Cells 48,000/μL (normal 4,700,000-6,100,000/μL)
Platelets (Plts) of 120,000/μL (normal 150,000-400,000/μL)
Hemoglobin (Hgb) of 6.9g/dL (normal 14-18g/dL)
White blood cell count (WBC) 11,000/mm³ (normal 5,000-10,000/mm³)
The Correct Answer is C
Choice A reason: The red blood cell (RBC) count provided is significantly below the normal range (4,700,000-6,100,000/μL). However, the unit of measure given in the question (48,000/μL) is incorrect for RBCs, so it may not be consistent with the symptoms of fatigue and palpitations. Typically, a low RBC count can contribute to these symptoms, but in this case, the measurement provided is not clear.
Choice B reason: Platelets of 120,000/μL are below the normal range (150,000-400,000/μL). While low platelet counts (thrombocytopenia) can lead to bleeding and bruising, they are not typically associated with symptoms of fatigue and palpitations. This finding is more indicative of a potential bleeding disorder rather than anemia or another condition that would cause the given symptoms.
Choice C reason: Hemoglobin (Hgb) of 6.9g/dL is significantly below the normal range (14-18g/dL) and indicates severe anemia. Anemia is a common cause of fatigue and palpitations because the body has a reduced capacity to carry oxygen to tissues. Low hemoglobin levels can lead to decreased oxygen delivery, resulting in increased fatigue and compensatory palpitations as the heart works harder to circulate oxygen-poor blood.
Choice D reason: White blood cell (WBC) count of 11,000/mm³ is slightly above the normal range (5,000-10,000/mm³) and indicates a mild leukocytosis, which is usually a sign of infection or inflammation. While leukocytosis can cause fatigue if there is an underlying infection, it is not directly associated with palpitations and severe fatigue. The primary concern with fatigue and palpitations lies more with oxygen-carrying capacity, which is affected by hemoglobin levels.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Taking a daily multivitamin with iron is important for overall health, but it is not specifically related to preventing sickle cell crises. While maintaining proper nutrition is essential, it does not directly address the triggers or management of sickle cell crises.
Choice B reason: Restricting fluids to 2 liters per day is not appropriate for patients with sickle cell disease. In fact, maintaining adequate hydration is crucial to prevent sickling of red blood cells and reduce the risk of a sickle cell crisis. Restricting fluids could lead to dehydration, which can exacerbate the condition.
Choice C reason: Limiting exposure to crowds is an important instruction for patients with sickle cell disease. Crowded environments can increase the risk of infections, which can trigger a sickle cell crisis. By avoiding crowded places, patients can reduce their exposure to potential infections and help prevent crises.
Choice D reason: While avoiding caffeinated beverages is generally good advice for overall health, it is not specifically related to preventing sickle cell crises. Caffeine can cause dehydration, but the primary focus for preventing crises is maintaining proper hydration and avoiding infections.
Correct Answer is D
Explanation
Choice A reason: This statement is incorrect because the combination of heparin and warfarin does not dissolve the blood clot faster. Instead, these medications have different mechanisms of action. Heparin works quickly to prevent further clot formation, while warfarin takes several days to reach therapeutic levels and maintain anticoagulation over the long term.
Choice B reason: While the risk of a blood clot in the lungs (pulmonary embolism) is a concern, the necessity of using both heparin and warfarin is not because of the need for multiple blood thinners but rather due to their complementary pharmacokinetics. Heparin provides immediate anticoagulation, whereas warfarin requires time to become effective.
Choice C reason: This statement is also incorrect. Heparin does not dissolve clots but works to prevent the extension of existing clots and the formation of new ones. Warfarin, likewise, does not dissolve clots but prevents further clot formation by inhibiting vitamin K-dependent clotting factors.
Choice D reason: This is the accurate response. Heparin works immediately, providing rapid anticoagulation, which is essential for acute management of venous thromboembolism. On the other hand, warfarin takes several days to achieve its anticoagulant effect because it works by inhibiting the synthesis of vitamin K-dependent clotting factors. Therefore, the patient is initially placed on heparin to provide immediate protection against clotting while warfarin is started simultaneously. Once warfarin reaches a therapeutic level, heparin can be discontinued, and warfarin can maintain long-term anticoagulation.
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