A 70-year-old Italian woman, Hb 10.2 g/dL, MCV 62, normal iron studies. Diagnosis?

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: 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.

Correct Answer: C

Rationale: The correct answer is C because bleeding time evaluates platelet function in vivo by measuring the time it takes for a small, standardized skin incision to stop bleeding. This test directly assesses the primary hemostasis process mediated by platelets. Choice A is incorrect because bleeding time can be influenced by various factors, making it less reliable and reproducible. Choice B is incorrect because bleeding time is typically evaluated using a stopwatch, not an optical densitometer. Choice D is incorrect because bleeding time is not a commonly ordered test due to its limitations and variability in results.

Correct Answer: A

Rationale: The correct answer is A: Thrombosis. Thrombotic thrombocytopenic purpura (TTP) is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and neurological deficits. Thrombosis is not a typical feature of TTP. In TTP, platelet aggregation leads to microthrombi formation, causing microangiopathic hemolytic anemia, thrombocytopenia, and neurological symptoms. Thrombosis, on the other hand, is more commonly associated with conditions such as deep vein thrombosis or pulmonary embolism. Therefore, choice A is not associated with TTP, making it the correct answer. Choices B, C, and D are incorrect as they are all features commonly seen in TTP.