The nurse recognizes that patients with von Willebrand disease are at risk for prolonged bleeding times for which reason?
Adequate platelet production.
Deficiency in intrinsic clotting system factor.
Impairment of the thrombin fibrinogen reaction.
Variable factor VIII deficiencies and platelet dysfunction.
The Correct Answer is D
Choice A rationale:
Adequate platelet production does not explain the prolonged bleeding times in von Willebrand disease. These patients often have normal platelet counts, but their platelets do not function properly due to the absence or dysfunction of von Willebrand factor.
Choice B rationale:
Deficiency in intrinsic clotting system factor is not the primary cause of prolonged bleeding times in von Willebrand disease. The deficiency or dysfunction of von Willebrand factor, a protein that helps platelets adhere to the blood vessel walls and clot properly, is the key issue in this disorder.
Choice C rationale:
Impairment of the thrombin fibrinogen reaction does not directly relate to von Willebrand disease. This disorder primarily involves platelet dysfunction and variable factor VIII deficiencies, leading to prolonged bleeding times.
Choice D rationale:
Variable factor VIII deficiencies and platelet dysfunction are characteristic of von Willebrand disease. Factor VIII helps with blood clotting, and its deficiency, along with impaired platelet function, contributes to the prolonged bleeding times in patients with von Willebrand disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D"]
Explanation
Choice A rationale:
Palpitations are not directly related to a low hemoglobin level. They can occur due to various cardiac conditions but are not specific to anemia.
Choice B rationale:
Conjunctival pallor is a common physical finding in patients with low hemoglobin levels (anemia) Anemia leads to reduced oxygen-carrying capacity, causing paleness in mucous membranes such as the conjunctiva.
Choice C rationale:
Sternal tenderness is not a typical finding associated with low hemoglobin levels. It is more often associated with conditions affecting the sternum or adjacent structures, such as infections or inflammation.
Choice D rationale:
A heart rate of 104 beats/min can be a compensatory response to anemia. When the body senses reduced oxygen levels due to anemia, the heart rate may increase to pump more blood and oxygen to vital organs, attempting to compensate for the low hemoglobin levels.
Correct Answer is A
Explanation
Choice A rationale:
The patient's symptoms of leg pain that worsens at night and occurs when the legs are elevated but improves when they are dangled are indicative of peripheral arterial disease (PAD) PAD is a condition caused by the narrowing of arteries in the legs due to atherosclerosis. This narrowing restricts blood flow to the muscles, causing pain, especially during activities or positions that demand increased blood flow like walking or elevating the legs.
Choice B rationale:
Lymphatic obstruction typically does not cause pain in the same manner described by the patient. Lymphatic obstruction may cause swelling and discomfort, but it usually does not lead to pain that worsens with elevation and improves with dangling.
Choice C rationale:
Chronic venous insufficiency can cause leg pain and swelling, especially when standing for extended periods. However, the characteristic of pain worsening at night and with leg elevation points more towards arterial issues like PAD rather than venous insufficiency.
Choice D rationale:
Musculoskeletal abnormalities could cause localized pain, but the pattern described by the patient (worsening at night, relief with dangling) is not typical of musculoskeletal issues. PAD, on the other hand, often presents with these specific symptoms due to compromised blood flow to the muscles in the legs.
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