The patient's laboratory results show a marked decrease in RBCs, WBCs, and platelets. What term should the nurse use when reporting the results to the physician?

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: 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.

Correct Answer: B

Rationale: In educating a patient recently diagnosed with hemophilia, it is crucial to teach them to recognize signs and symptoms to prevent complications. The correct answer is B) Excessive bleeding after minor trauma. This is because hemophilia is a bleeding disorder where the blood does not clot normally, leading to prolonged bleeding even after minor injuries. Recognizing this symptom is vital for the patient to seek prompt medical attention to prevent significant blood loss and potential complications. Option A) Clot formation, especially in the veins of the lower extremities, is incorrect as hemophilia predisposes individuals to bleeding disorders, not clot formation. Option C) Low blood counts and fatigue due to lack of adequate RBC production is incorrect as it describes symptoms of anemia, which is not typically associated with hemophilia. Option D) Anemia, bone pain, and infection are also incorrect as they are not typical signs and symptoms of hemophilia. Educationally, it is important to emphasize to the patient the importance of promptly seeking medical attention if they experience excessive bleeding after minor trauma. Teaching them to recognize this specific symptom can empower them to take control of their health and potentially prevent serious complications associated with hemophilia. Providing clear and detailed education can help the patient better manage their condition and improve their quality of life.

Correct Answer: A

Rationale: The correct answer is A) Von Willebrand disease. Von Willebrand disease is a hereditary bleeding disorder characterized by a deficiency or dysfunction of von Willebrand factor, a protein that plays a crucial role in blood clotting. The symptoms described in the scenario, such as prolonged nose bleeds and heavy menstrual bleeding, are typical manifestations of Von Willebrand disease due to impaired blood clotting. Option B) Polycythemia vera is a condition characterized by an overproduction of red blood cells, leading to an increased risk of blood clots, not bleeding episodes as described in the question. Option C) Multiple myeloma is a cancer of plasma cells that typically presents with symptoms such as bone pain, fatigue, and susceptibility to infections, rather than bleeding episodes. Option D) Disseminated intravascular coagulation is a serious condition where blood clots form throughout the body, leading to excessive bleeding, but the symptoms described in the question, such as prolonged nose bleeds and heavy menstrual bleeding, are not typical of this condition. In an educational context, understanding the signs and symptoms of various hematologic disorders is crucial for nurses and healthcare professionals to provide appropriate care and interventions for patients. Recognizing these symptoms can lead to early identification, diagnosis, and management of conditions such as Von Willebrand disease, which can significantly impact patient outcomes and quality of life.

Correct Answer: C

Rationale: In the treatment of pernicious anemia, the correct option is C) Parenteral vitamin B12. Pernicious anemia is caused by a lack of intrinsic factor, a protein necessary for the absorption of vitamin B12. Therefore, oral supplementation of vitamin B12 would be ineffective as the problem lies in absorption rather than intake. Option A) Oral iron is incorrect because pernicious anemia is not a condition related to iron deficiency. Option B) Oral folic acid is incorrect as folic acid supplementation may mask a vitamin B12 deficiency without treating the root cause. Option D) Oral prednisone is incorrect as it is a steroid medication and not a treatment for pernicious anemia. Educationally, understanding the specific treatment for pernicious anemia is crucial for nursing students and healthcare professionals. Knowing the rationale behind the correct treatment helps in providing effective care to patients with this condition. Administering parenteral vitamin B12 bypasses the absorption issues and ensures that patients receive the necessary nutrient directly.