Imagine this. You enter the unit as an RN on your first day on the job. You breathe in the smell of awesomeness and drink your Starbucks coffee. You see that you are taking care of a Mr. Smith who has been diagnosed Polycythemia Vera. Because you are so freakin' awesome, you know that Mr. Smith is at risk for which of the following complications?

Correct Answer: A

Rationale: The correct answer is A: Excessive Bleeding. Polycythemia Vera is a condition characterized by an overproduction of red blood cells, leading to increased blood viscosity and risk of thrombosis. Due to the increased number of red blood cells, there is a higher risk of clot formation, which can result in complications such as thrombosis, stroke, or heart attack. Excessive bleeding can also occur as a result of abnormal blood clotting mechanisms in Polycythemia Vera. Pruritus (choice B) is a common symptom but not a direct complication of Polycythemia Vera. Hepatomegaly (choice C) and Pancreatitis (choice D) are not commonly associated complications of Polycythemia Vera.

Correct Answer: A

Rationale: The correct answer is A: Applying pressure to the biopsy site. This is the priority post-procedure as it helps prevent bleeding and hematoma formation. Applying pressure aids in achieving hemostasis, reducing the risk of complications. Choice B is incorrect as inspecting for ecchymoses is important but not the priority over preventing bleeding. Choice C is also incorrect as sending specimens to the lab can be done after ensuring the client's safety. Choice D is incorrect as teaching about avoiding vigorous activity is important but not the immediate priority post-procedure.

Correct Answer: C

Rationale: The correct answer is C: MCHC. MCHC stands for Mean Corpuscular Hemoglobin Concentration, which is a measure of the average concentration of hemoglobin in a given volume of packed red blood cells. In this case, a saturation of 32-36% indicates the concentration of hemoglobin in the red blood cells. MCV (Mean Corpuscular Volume) measures the average volume of a red blood cell, MCH (Mean Corpuscular Hemoglobin) measures the average amount of hemoglobin in a red blood cell, and RDW (Red Cell Distribution Width) measures the variation in red blood cell size. These parameters do not directly indicate the saturation of hemoglobin in red blood cells, making them incorrect choices for this scenario.

Correct Answer: A

Rationale: The correct treatment option for Wilson's disease is A: Penicillamine. Penicillamine is a chelating agent that helps remove excess copper from the body. It binds to copper, forming a stable complex that can be excreted in the urine. Riboflavin (B) is a vitamin and not used in Wilson's disease treatment. Trientine (C) is another chelating agent used in Wilson's disease treatment but is not as commonly prescribed as penicillamine. Potassium disulfide (D) is not a recognized treatment for Wilson's disease.

Correct Answer: B

Rationale: The correct answer is B: Dipyridamole. Dipyridamole works by inhibiting the enzyme phosphodiesterase, leading to an increase in cyclic adenosine monophosphate (cAMP) levels. This increase in cAMP levels potentiates the effect of prostacyclins, which inhibit platelet stickiness and decrease platelet adhesion to thrombogenic surfaces. Rationale: A: Sulfinpyrazone is a uricosuric agent, not a platelet anti-aggregant. C: Ticlopidine and D: Clopidogrel are both antiplatelet agents but work by different mechanisms (ADP receptor antagonists). They do not potentiate prostacyclins and do not directly affect cAMP levels.