A patient with a hematologic disorder has a smooth, shiny, red tongue. Which laboratory result would the nurse expect to see?

Correct Answer: B

Rationale: In this case, the correct answer is B) Hgb 9.6 g/dL (96 g/L). A smooth, shiny, red tongue is a classic symptom of iron deficiency anemia, which is characterized by low hemoglobin levels. Hemoglobin is a protein found in red blood cells that carries oxygen throughout the body. When hemoglobin levels are low, the body may not be getting enough oxygen, leading to symptoms like a smooth, shiny, red tongue. Option A) Neutrophils 45% is not directly related to the symptom described in the question. Neutrophils are a type of white blood cell involved in fighting infection. Option C) WBC count 13,500/µL indicates an elevated white blood cell count, which is not typically associated with the described symptom. Option D) Red blood cell count 6.4 × 10^6/µL is within the normal range and does not explain the smooth, shiny, red tongue observed in the patient. From an educational perspective, understanding the connection between hematologic disorders and physical symptoms is crucial for nurses to provide quality care. Recognizing the correlation between a smooth, shiny, red tongue and iron deficiency anemia can prompt appropriate interventions such as iron supplementation and dietary modifications. This case highlights the importance of comprehensive assessment skills and knowledge of hematologic conditions in nursing practice.

Correct Answer: C

Rationale: In educating a patient about a bone marrow examination, it is crucial to provide accurate information to alleviate anxiety and promote understanding. Option C, "The patient will experience a brief, very sharp pain during aspiration of the bone marrow," is the correct choice. This is accurate because bone marrow aspiration involves inserting a needle into the bone to withdraw a sample, which can cause temporary discomfort or sharp pain due to pressure on the bone. Option A, stating that the procedure will be done under general anesthesia because it is so painful, is incorrect. Bone marrow examinations are typically performed with local anesthesia, and general anesthesia is not routinely required. Option B, indicating the patient will not have any pain after the area at the puncture site is anesthetized, is incorrect as it may lead to false expectations. While local anesthesia can reduce pain during the procedure, some discomfort or pain may still be experienced during bone marrow aspiration. Option D, suggesting that there will be no pain during the procedure, but an ache will be present several days afterward, is also incorrect. Pain during the procedure is possible, and any discomfort post-procedure is usually mild and managed with over-the-counter pain relievers. In an educational context, it is essential to inform patients about the potential discomfort they may experience during a bone marrow examination, emphasizing the temporary nature of the pain and the importance of following post-procedure care instructions. Providing accurate information helps patients prepare mentally and physically for the procedure, ultimately improving their overall experience and compliance with healthcare recommendations.

Correct Answer: C

Rationale: In this scenario, the correct term the nurse should use when reporting the marked decrease in RBCs, WBCs, and platelets in the patient's laboratory results to the physician is "C) Pancytopenia." **Explanation of Correct Answer (C):** Pancytopenia is the term used to describe a reduction in all three major blood cell types: red blood cells (RBCs), white blood cells (WBCs), and platelets. This condition indicates a problem with the bone marrow's ability to produce these essential blood cells. **Explanation of Incorrect Answers:** A) Hemolysis refers to the premature destruction of red blood cells, not a decrease in all blood cell types. B) Leukopenia specifically denotes a decrease in white blood cells only, not all blood cell types. D) Thrombocytosis is an increase in platelet count, not a decrease in all blood cell types. **Educational Context:** Understanding the term "pancytopenia" is crucial for healthcare professionals, especially in hematology and oncology. Recognizing pancytopenia alerts healthcare providers to potentially serious underlying conditions such as bone marrow failure, infections, or certain cancers. It prompts further evaluation and appropriate management to address the root cause of the blood cell deficiencies.

Correct Answer: C

Rationale: The correct answer is C) Increase dietary iron intake with foods such as lean red meat, dark green leafy vegetables, and whole grains. Iron deficiency anemia is a condition characterized by low levels of red blood cells due to inadequate iron in the body. Increasing dietary iron intake is crucial in correcting this deficiency because iron is essential for the production of hemoglobin, the protein in red blood cells that carries oxygen to tissues. Lean red meat, dark green leafy vegetables, and whole grains are rich sources of iron that can help replenish iron stores in the body. Option A) Sleep 7 to 8 hours each night, while important for overall health, is not directly related to correcting iron deficiency anemia. Option B) Decreasing salt intake and drinking more water may be beneficial for managing conditions like hypertension or kidney disease but do not address the root cause of iron deficiency anemia. Option D) Aerobic exercise is beneficial for overall health, but it does not directly impact iron levels or correct iron deficiency anemia. Educationally, it is important for patients with iron deficiency anemia to understand the role of dietary iron in managing their condition. Teaching them about iron-rich foods and the importance of incorporating them into their diet can help them actively participate in their treatment and improve their overall health outcomes.

Correct Answer: A

Rationale: In patients with Immune Thrombocytopenic Purpura (ITP), there is a decreased platelet count, leading to an increased risk of bleeding. Therefore, careful monitoring of platelet count is crucial in managing these patients. Option A, "Platelet count and RBC," is the correct answer because monitoring platelet count provides information on the patient's risk of bleeding and guides treatment decisions. Option B, "WBC and bleeding time," is incorrect because ITP primarily affects platelets, not white blood cells or clotting time. Monitoring WBC is not directly relevant to bleeding risks in ITP. Bleeding time is a less reliable test and is not routinely used for monitoring ITP. Option C, "PT and PTT," is incorrect because these tests assess the extrinsic and intrinsic pathways of the coagulation cascade, which are not directly impacted in ITP. Monitoring PT and PTT is more relevant in assessing coagulation abnormalities in conditions like hemophilia or liver disease. Option D, "Iron and ferritin levels," is also incorrect because these tests assess iron stores in the body and are not directly related to the risk of bleeding in ITP. Monitoring iron and ferritin levels is more indicative of iron deficiency anemia rather than bleeding risks in ITP. Educationally, understanding the rationale behind monitoring specific parameters in different hematologic conditions is essential for providing optimal patient care. In ITP, focusing on platelet count monitoring helps in assessing bleeding risks, guiding treatment strategies, and evaluating the effectiveness of interventions like platelet transfusions or medications. This knowledge is crucial for healthcare professionals managing patients with hematologic disorders to ensure appropriate and evidence-based care.