Which manifestation of anemia occurs with severe anemia?

Correct Answer: C

Rationale: The correct answer is C: Sensitivity to cold. Severe anemia can lead to decreased red blood cells, causing poor circulation and reduced oxygen delivery to tissues. This leads to feeling cold due to decreased metabolic activity. Heart palpitations (A) are common but not specific to severe anemia. Fatigue (B) is a common symptom in anemia but not exclusive to severe cases. Exertional dyspnea (D) is due to reduced oxygen-carrying capacity but is not specific to severe anemia.

Correct Answer: D

Rationale: The correct answer is D because in autoimmune hemolytic anemia, activation of the complement system leads to the formation of membrane attack complexes (MAC) that directly lyse the red blood cells. This process is known as complement-mediated hemolysis. Perforins from cytotoxic T cells (Choice A) are involved in cell-mediated cytotoxicity but are not typically responsible for hemolysis of red blood cells. Neutrophils releasing proteases (Choice B) or interleukin-2 binding to its receptor on red cells (Choice C) are not mechanisms commonly associated with hemolysis in autoimmune hemolytic anemia.

Correct Answer: C

Rationale: The correct answer is C: Desmopressin (DDAVP). This patient likely has von Willebrand disease, a common bleeding disorder. Desmopressin releases von Willebrand factor and factor VIII from endothelial cells, aiding in hemostasis. Factor VIII concentrate (A) is used for hemophilia A, not von Willebrand disease. Fresh frozen plasma (B) contains various clotting factors but is not specific for von Willebrand disease. Whole blood transfusion (D) is not necessary in this case and does not address the underlying issue.

Correct Answer: D

Rationale: Step 1: RAST testing is used to detect allergen-specific IgE antibodies in the blood. Step 2: Seasonal allergies are typically caused by exposure to specific allergens. Step 3: IgE is elevated in response to exposure to specific antigens, which matches the purpose of RAST testing. Step 4: IgG is not specific to allergies but is more related to various infections. IgM is for acute infections. IgA is for mucosal protection. Step 5: Therefore, the correct answer is D (IgE) as it aligns with the purpose of RAST testing and the client's symptom history.

Correct Answer: C

Rationale: The correct answer is C: Hearing loss. Amikacin, an aminoglycoside antibiotic, is known to cause ototoxicity, which can manifest as hearing loss. The client should contact the PHCP immediately if hearing loss occurs as it may be a sign of irreversible damage. Nausea (A), lethargy (B), and muscle aches (D) are common side effects of Amikacin but are not urgent or indicative of a serious adverse reaction requiring immediate medical attention.

Correct Answer: C

Rationale: The correct answer is C: Glycoprotein. Glycoproteins are the most common type of protein found in the cell membrane because they play crucial roles in cell signaling, adhesion, and recognition. They have sugar molecules attached to them, which help in cell-cell interactions. Lipoproteins (choice A) have lipids attached to them and are found in cell membranes but are not as common as glycoproteins. Mucoproteins (choice B) are proteins with carbohydrate chains but are not as prevalent in cell membranes. Nucleoproteins (choice D) are proteins associated with nucleic acids and are not typically found in the cell membrane.

Correct Answer: C

Rationale: The correct answer is C: Prothrombin time 28 seconds. A prolonged prothrombin time indicates impaired blood clotting function, posing a higher risk of bleeding. This is a critical issue that requires immediate attention to prevent severe complications. INR of 2.8 (choice A) is slightly elevated but not as urgent as PT. Platelet count of 128,000/mm³ (choice B) is low but not an immediate concern unless it drops further. RBC count of 5.1 million/L (choice D) is within the normal range and does not indicate an urgent issue.

Correct Answer: B

Rationale: The correct answer is B - A progressive, circular rash- often develops at the bite site, but can also develop at other sites such as the thighs and knees. This is the early manifestation of Lyme disease known as erythema migrans. The rash typically appears within 3-30 days after a tick bite and expands gradually. Double vision (Choice A) is associated with disseminated Lyme disease in the late stage. Severe joint swelling (Choice C) is not a common early symptom of Lyme disease. Chronic fatigue (Choice D) may occur in later stages but is not a specific early manifestation of Lyme disease.

Correct Answer: C

Rationale: The correct answer is C: Circulatory stasis can lead to thrombus and embolus formation. Immobilization in children can lead to decreased muscle activity and venous return, increasing the risk of blood clots forming in the veins (thrombus) due to stagnant blood flow. These clots can dislodge and travel to the lungs causing a pulmonary embolism. Choices A, B, and D are incorrect because immobilization typically leads to a decrease in metabolic rate, worsens venous return due to lack of movement, and can result in bone demineralization rather than an increase in bone calcium.