A 69-year-old man with weight loss, back pain, hyperglycemia. Most likely diagnostic study?

Correct Answer: A

Rationale: The correct answer is A: CT scan of abdomen. In a 69-year-old man with weight loss, back pain, and hyperglycemia, a CT scan of the abdomen is the most likely diagnostic study to identify potential underlying causes such as pancreatic cancer or other abdominal malignancies. This imaging modality can provide detailed information on the pancreas, surrounding structures, and possible metastases. Summary: B: Glucose tolerance test is not the most appropriate initial study for a patient presenting with these symptoms. C: Colonoscopy is indicated for evaluating lower gastrointestinal symptoms, not typically for weight loss, back pain, and hyperglycemia. D: Whole-body PET scan may be used for cancer staging, but a CT scan of the abdomen is more specific for identifying abdominal malignancies.

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.

Correct Answer: B

Rationale: The correct answer is B: Hemoglobin 7.1 g/dL. In ITP, low platelet count is common but does not typically require immediate reporting unless there are signs of significant bleeding. Hemoglobin of 7.1 g/dL indicates severe anemia, which requires prompt evaluation to assess the need for transfusion and determine the underlying cause. Increased eosinophils (A) are not typically concerning in ITP. Platelet count of 40,000/mm³ (C) is expected in ITP. Elevated reticulocyte count (D) may indicate compensatory response to anemia but does not warrant immediate reporting.