A 25-year-old woman with prolonged bleeding post-dental extraction, family history, prolonged PTT, bleeding time 12 min. Best way to control bleeding?

Correct Answer: C

Rationale: The correct answer is C: Desmopressin (DDAVP). This patient likely has von Willebrand disease, a common bleeding disorder. Desmopressin releases von Willebrand factor and factor VIII from endothelial cells, aiding in hemostasis. Factor VIII concentrate (A) is used for hemophilia A, not von Willebrand disease. Fresh frozen plasma (B) contains various clotting factors but is not specific for von Willebrand disease. Whole blood transfusion (D) is not necessary in this case and does not address the underlying issue.

Correct Answer: C

Rationale: The correct next diagnostic study for a 26-year-old man with testicular mass and periaortic lymphadenopathy is to measure α-fetoprotein, β-hCG, and LDH levels (Choice C). This is because these tumor markers (α-fetoprotein, β-hCG, LDH) are essential in the evaluation of testicular cancer. Elevated levels of these markers can indicate the presence of germ cell tumors. Needle biopsy of a retroperitoneal mass (Choice A) would not be the initial step as it does not directly evaluate the testicular mass. Needle aspiration of the testicular mass (Choice B) may yield limited information compared to tumor marker levels. PET scan (Choice D) is typically not the first-line investigation for testicular cancer evaluation.

Correct Answer: B

Rationale: The correct answer is B: Thalassemia. Thalassemia is a genetic disorder characterized by abnormal hemoglobin production, leading to microcytic anemia with low MCV. In this case, the patient's low MCV of 62 indicates microcytic anemia, which is consistent with thalassemia. Normal iron studies rule out iron deficiency anemia (Choice C). Anemia of chronic disease (Choice D) typically presents with normocytic or mildly microcytic anemia, unlike the severe microcytic anemia seen in thalassemia. Sideroblastic anemia (Choice A) is characterized by ringed sideroblasts in the bone marrow and elevated ferritin, which are not present in this patient.

Correct Answer: C

Rationale: The correct answer is C because the patient post-colonoscopy with chronic GI bleeding requires close monitoring and immediate intervention if any complications arise. The float nurse from PACU is experienced in handling post-operative patients and can provide appropriate care for this patient's needs. Choice A is incorrect because a patient with thalassemia major receiving deferoxamine does not require immediate post-operative care. Choice B is incorrect as the patient with multiple myeloma needing discharge teaching can be managed by a regular floor nurse. Choice D is incorrect as the patient with pernicious anemia does not have urgent post-operative care needs.

Correct Answer: A

Rationale: The correct answer is A because a 30-year-old with renal failure needing epoetin alfa would benefit from a Licensed Practical Nurse (LPN) due to the need for ongoing medication administration and monitoring. Renal failure and epoetin alfa therapy require regular assessment of vital signs, medication side effects, and patient response, tasks well within an LPN's scope of practice. Summary: - Choice B is incorrect as managing hemophilia B for PRBCs requires specialized knowledge and skills beyond an LPN's scope. - Choice C is incorrect as managing polycythemia vera for phlebotomy involves more complex care that is typically outside an LPN's scope. - Choice D is incorrect as post-stem cell transplant care, including bone marrow aspiration, requires a higher level of nursing expertise typically provided by a Registered Nurse or Nurse Practitioner.