78-year-old with chronic anemia. Which activity is best delegated to an experienced nursing assistant?

Correct Answer: A

Rationale: The correct answer is A: Obtain stool specimens for Hemoccult slides. This task is appropriate for a nursing assistant as it involves a non-invasive procedure that can be easily taught and performed under supervision. The other options involve more complex tasks that require a higher level of training and knowledge. Having the patient sign a consent form (B) and giving GoLYTELY (C) involve patient interaction and medication administration, which are typically tasks for licensed nurses. Checking for allergies to contrast dye (D) requires knowledge of medication administration and possible adverse reactions, making it unsuitable for delegation to a nursing assistant.

Correct Answer: A

Rationale: The correct answer is A because a 1-year-old with hemophilia B and decreased responsiveness indicates a potentially life-threatening situation requiring immediate assessment. Hemophilia B can lead to severe bleeding, and decreased responsiveness suggests a critical condition. Choice B can wait as DDAVP is a scheduled medication. Choice C's thrombocytopenia in a 7-year-old with ALL is serious but not as urgent as a potentially unconscious child with hemophilia B. Choice D's RLQ pain in a 16-year-old with sickle cell is concerning but not as critical as decreased responsiveness in a young child with hemophilia B. Prioritizing based on urgency and potential severity is key in pediatric care.

Correct Answer: A

Rationale: The correct answer is A: PT (INR). The PT evaluates the extrinsic pathway by measuring the time it takes for blood to clot after adding tissue factor. This pathway involves factors outside the blood vessel. PTT (choice B) evaluates the intrinsic pathway, TT (choice C) evaluates the common pathway, and closure time (choice D) assesses platelet function, not the extrinsic pathway. Therefore, PT is the most appropriate choice for evaluating the extrinsic pathway.

Correct Answer: D

Rationale: The correct answer is D: Gastrointestinal blood loss. In the elderly, gastrointestinal blood loss is the most common cause of iron-deficiency anemia due to conditions like peptic ulcers, gastritis, and colorectal cancer. Blood loss leads to decreased iron levels, causing anemia. Malnutrition (A) can contribute but is less common in the elderly. Chronic kidney disease (B) typically leads to anemia of chronic disease, not iron-deficiency anemia. Medication side effects (C) may cause anemia, but gastrointestinal blood loss is more prevalent in the elderly population.

Correct Answer: D

Rationale: The correct answer is D: Vitamin K deficiency. Prolonged PT and aPTT indicate impaired coagulation factors, which are dependent on Vitamin K for synthesis. The normal blood test rules out hemophilia A, a genetic deficiency of factor VIII (choice A), thrombocytopenia, a low platelet count (choice B), and Von Willebrand disease, a deficiency in a blood protein that helps with clotting (choice C). Therefore, the most likely diagnosis is Vitamin K deficiency due to the abnormal coagulation factors.