A 53-year-old man presents with inability to concentrate, itching ...

[james0929]

A 53-year-old man presents with inability to concentrate, itching in his fingers and toes, elevated blood pressure, and unexplained weight loss.
 
  He is diagnosed with primary polycythemia. What will be the primary goal of his treatment?
  A)
  To control his hypertension
  B)
  To increase the amount of oxygen distributed by his red blood cells
  C)
  To reduce the mean size of his red cells
  D)
  To reduce the viscosity of his blood

Question 2

The school nurse knows several children with hemophilia A. After recess, one student with hemophilia comes to the school nurse complaining of pain in his knee from falling on the playground.
 
  The nurse notes there is swelling in the knee and pain on palpation. The nurse should
  A)
  administer some NSAIDs to relieve the pain.
  B)
  wrap the knee in an ace bandage for compression.
  C)
  apply some warm compresses to the knee.
  D)
  notify parents to pick up the child and possibly administer factor VIII.

[SAUXC]

Answer to Question 1

Ans:
D

Feedback:

While hypertension may accompany polycythemia vera, the primary goal of treatment is to control the increase in blood viscosity that accompanies the disease. Polycythemia vera is not associated with increased corpuscular volume, and oxygen distribution is not a priority problem.

Answer to Question 2

Ans:
D

Feedback:

Prevention of trauma is important. ASA and other NSAIDs that affect platelet function should be avoided. Factor VIII replacement therapy administered at home has reduced the typical musculoskeletal damage. Wrapping with a bandage will not prevent damage. Warm compression will extend the bleed.

[james0929]

Excellent

[isabelt_18]

TYSM