Author Question: A 23-year-old woman without any known significant medical history comes to the clinic with ... (Read 43 times)

dmcintosh · **on:** Jul 23, 2018

A 23-year-old woman without any known significant medical history comes to the clinic with complaints of fatigue, pallor, and listlessness.

After obtaining a health history, the nurse practitioner should initially order which of the following laboratory tests?
a. Pregnancy test
b. Urinalysis
c. Stool for guaiac
d. Platelet count

Question 2

A patient has been taking ferrous sulfate for anemia and comes to the clinic for a follow-up appointment a month later. What clinical indication would the nurse look for as a sign of successful treatment?

a. The patient states that she has less bleeding during menstruation.
b. Hemoglobin level rises by at least 2 gm/dL.
c. Hematocrit level rises by at least 1 gm/dL.
d. Reticulocytes decrease within 1 week.

Sophiapenny · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: A
The initial pregnancy test is inexpensive and quick, and should be completed to rule out a pregnancy before other expensive diagnostic tests are ordered.
The question asks for the first laboratory test that should be ordered for this patient and the urinalysis is not an initial test that needs to be done given this patient's condition.
A stool test for guaiac is not indicated unless the patient complains of blood in the stool or has a history or suspicion of colorectal cancer.
A platelet count is indicated for bleeding deficiencies, which have not been confirmed in this patient.

Answer to Question 2

ANS: B
When therapy is successful, the hemoglobin level increases by 2 gm /dL within 1 month.
Iron does not affect bleeding during menstruation; rather, it is essential to the function of hemoglobin and myoglobin.
When assessing a patient's response to iron therapy, the hematocrit is not the laboratory parameter that is used to see if the iron is effective.
Reticulocytes increase within 3 to 4 days of the start of iron therapy.