Lorretta, a 35-year-old female, is brought to the emergency department with complaints of bleeding from multiple sites, including her nose and gums. She also presents with pain and swelling in her left leg. She has a past medical history of deep vein thrombosis (DVT) and is currently on anticoagulant therapy. On examination, she has petechiae on her skin, swollen and tender left leg, and blood oozing from her IV site. Laboratory tests reveal prolonged bleeding time, decreased platelet count, elevated D-dimer levels, and prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT). What is going on with Lorretta?

Immune thrombocytopenic purpura (ITP)

Thrombotic thrombocytopenic purpura (TTP)

Hemophilia

Disseminated intravascular coagulation (DIC)

Answer and Explanation

The Correct Answer is D

Choice A reason: Immune thrombocytopenic purpura (ITP) causes isolated thrombocytopenia due to autoimmune platelet destruction, leading to bleeding like petechiae. However, it does not typically cause prolonged PT/aPTT, elevated D-dimer, or DVT, making it inconsistent with Lorretta’s multi-system coagulopathy.

Choice B reason: Thrombotic thrombocytopenic purpura (TTP) involves microangiopathic hemolytic anemia, thrombocytopenia, and organ damage but typically presents with neurological or renal symptoms, not prolonged PT/aPTT or DVT. Lorretta’s coagulopathy and DVT history better align with another condition, making TTP incorrect.

Choice C reason: Hemophilia, a genetic clotting factor deficiency, causes prolonged aPTT but not thrombocytopenia, elevated D-dimer, or DVT. It primarily affects males and causes joint or muscle bleeds, not diffuse bleeding like Lorretta’s, making this an incorrect diagnosis.

Choice D reason: Disseminated intravascular coagulation (DIC) involves widespread clotting and bleeding, causing thrombocytopenia, prolonged PT/aPTT, elevated D-dimer, and petechiae. Lorretta’s DVT history and anticoagulant use may trigger DIC, with leg swelling indicating thrombosis, making this the correct diagnosis.

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Correct Answer is B

Explanation

Choice A reason: Latent phase follows seroconversion, not precedes infection. The correct sequence—exposure, infection, seroconversion, AIDS—reflects HIV progression. This option misorders the phases, making it incorrect for AIDS development.

Choice B reason: AIDS progresses through exposure (virus contact), infection (HIV enters body), seroconversion (antibody detection), and AIDS (advanced disease). This sequence accurately describes the disease’s history, making it correct.

Choice C reason: Symptomatic AIDS is not a distinct phase; AIDS itself is symptomatic. The standard progression includes exposure, infection, seroconversion, and AIDS, so “symptomatic AIDS” is incorrect.

Choice D reason: Window phase is part of seroconversion, not separate, and acute phase is early infection. The sequence—exposure, infection, seroconversion, AIDS—is clearer, so this is incorrect.

A. Presence of insulin autoantibodies that destroy beta cells in the pancreas B. Need for lifelong insulin injections C. Resistance to insulin by insulin-sensitive tissues D. Increase of glucagon secretion from beta cells of the pancreas

Correct Answer is C

Explanation

Choice A reason: Insulin autoantibodies destroying beta cells characterize Type 1 diabetes, an autoimmune condition causing insulin deficiency. Type 2 involves insulin resistance with relative insulin insufficiency, not autoantibody-mediated beta cell destruction, making this an incorrect description.

Choice B reason: Lifelong insulin injections are typical in Type 1 diabetes due to absolute insulin deficiency. Type 2 patients may manage with lifestyle changes, oral medications, or insulin later, but it’s not a defining feature, making this incorrect.

Choice C reason: Type 2 diabetes is characterized by insulin resistance in tissues like muscle and liver, reducing glucose uptake despite normal or elevated insulin levels. This, with eventual beta cell dysfunction, defines the disease, making this the correct description.

Choice D reason: Increased glucagon secretion from alpha cells, not beta cells, may occur in diabetes, but it’s not the primary feature of Type 2. Insulin resistance is the hallmark, with beta cells producing insulin, making this an incorrect description.

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Naxlex Comprehensive Predictor Exams

Phases of AIDS.

Correct Answer is B

Explanation

Differentiate Type 2 diabetes mellitus from Type 1 diabetes mellitus. Type 2 is best described as:

Correct Answer is C

Explanation

A 20-year-old male is in acute pain with renal colic. What does the nurse suspect is the most likely cause?

The characteristic vascular changes at the site of an injury produce: (Select all that apply)

Thrombocytopenia:

A patient has been diagnosed with acute respiratory distress syndrome (ARDS). For what other health condition should the healthcare professional assess this patient as a priority?

If a sea star egg is taken from the ocean and put into Lake Michigan, would you expect the egg to shrink, swell, or stay the same size?

When talking about manifestations of Schizophrenia, there are positive and negative symptoms. Which of the following are negative symptoms? (Select all that apply)

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