CORRECT ANSWERS|LATEST
The legal authority of a nurse practitioner's scope of practice is defined by:
A. The NP's accreditation organization.
B. The healthcare institution.
C. State law
D. Federal law. - ANSWER C
You see a 34-year-old woman who complains of fatigue. Laboratory results reveal a
microcytic, hypochromic anemia with elevated RDW. You expect to find which of the
following upon review of the patient's health history?
A. Report that she has been a vegetarian since age 18
B. Report of heavy and prolonged bleeding during menstrual cycle
C. A history of alcohol abuse
D. A prior diagnosis of rheumatoid arthritis - ANSWER B
Most appropriate next-step testing for:
A.
Hb 10.2 g/dL (102 g/L) (12-14 g/dL [120-140 g/L]); LOW
MCV 85 fL (81-96 fL); NORMOCYTIC
MCHC 33.8 g/dL (338 g/L) (31-37 g/dL [310-370 g/L]); NORMOCHROMIC
RDW 13.2% (0.132 proportion) (11.5-15% [0.115-0.15 proportion]); NL
RBC 3.1 million/mm3 (4.2-5.4 million/mm3); NL
1. Fecal occult blood test
2. Serum ferritin
1
,3. Serum vitamin B12 or folate
4. Hemoglobin electrophoresis - ANSWER 1
Most appropriate next-step testing for:
B.
Hb 9.6 g/dL (96 g/L) (12-14 g/dL [120-140 g/L]); LOW
MCV 73 fL (81-96 fL); MICROCYTIC
MCHC 27.6 g/dL (276 g/L) (31-37 g/dL [310-370 g/L]); HYPOCHROMIC
RDW 19.2% (0.192 proportion) (11.5-15% [0.115-0.15 proportion]); HIGH
RBC 3.4 million/mm3 (4.2-5.4 million/mm3); LOW
1. Fecal occult blood test
2. Serum ferritin
3. Serum vitamin B12 or folate
4. Hemoglobin electrophoresis - ANSWER 2
Next step test for:
C.
Hb 8.4 g/dL (84 g/L) (12-14 g/dL [120-140 g/L]); LOW
MCV 118 fL (81-96 fL); MACROCYTIC
MCHC 33.4 g/dL (334 g/L) (31-37 g/dL [310-370 g/L]); NORMOCHROMIC
RDW 18.6% (0.186 proportion) (11.5-15% [0.115-0.15 proportion); HIGH
RBC 2.9 million/mm3 (4.2-5.4 million/mm3); LOW
1. Fecal occult blood test
2. Serum ferritin
3. Serum vitamin B12 or folate
2
, 4. Hemoglobin electrophoresis - ANSWER 3
Next step test for:
D.
Hb 11.6 g/dL (116 g/L) (12-14 g/dL [120-140 g/L]); LOW
MCV 76 fL (81-96 fL); MICROCYTIC
MCHC 29.2 g/dL (292 g/L) (31-37 g/dL [310-370 g/L]); HYPOCHROMIC
RDW 14.0% (0.14 proportion) (11.5-15% [0.115-0.15 proportion]); NL
RBC 5.8 million/mm3 (4.2-5.4 million/mm3) HIGH
1. Fecal occult blood test
2. Serum ferritin
3. Serum vitamin B12 or folate
4. Hemoglobin electrophoresis - ANSWER 4
Which of the following is most at risk of beta thalassemia minor?
A. A 26-year-old man of Middle Eastern ancestry and generally healthy
B. A 43-year-old woman of Northern European ancestry and type 2 diabetes mellitus
C. A 23-year-old woman of Asian ancestry with a BMI of 19 kg/m2
D. A 35-year-old man of Eastern European ancestry and a family history of
hypertension - ANSWER A
A 14-year-old female presents with a 3-day history of fever, sore throat and fatigue.
During physical examination the nurse practitioner appreciates exudative pharyngitis
and diffuse lymphadenopathy. A CBC with differential reveals the following:
WBC: 6,000/mm3 (4,500-11,000/mm3)
Neutrophils: 40% (40-60%)
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The legal authority of a nurse practitioner's scope of practice is defined by:
A. The NP's accreditation organization.
B. The healthcare institution.
C. State law
D. Federal law. - ANSWER C
You see a 34-year-old woman who complains of fatigue. Laboratory results reveal a
microcytic, hypochromic anemia with elevated RDW. You expect to find which of the
following upon review of the patient's health history?
A. Report that she has been a vegetarian since age 18
B. Report of heavy and prolonged bleeding during menstrual cycle
C. A history of alcohol abuse
D. A prior diagnosis of rheumatoid arthritis - ANSWER B
Most appropriate next-step testing for:
A.
Hb 10.2 g/dL (102 g/L) (12-14 g/dL [120-140 g/L]); LOW
MCV 85 fL (81-96 fL); NORMOCYTIC
MCHC 33.8 g/dL (338 g/L) (31-37 g/dL [310-370 g/L]); NORMOCHROMIC
RDW 13.2% (0.132 proportion) (11.5-15% [0.115-0.15 proportion]); NL
RBC 3.1 million/mm3 (4.2-5.4 million/mm3); NL
1. Fecal occult blood test
2. Serum ferritin
1
,3. Serum vitamin B12 or folate
4. Hemoglobin electrophoresis - ANSWER 1
Most appropriate next-step testing for:
B.
Hb 9.6 g/dL (96 g/L) (12-14 g/dL [120-140 g/L]); LOW
MCV 73 fL (81-96 fL); MICROCYTIC
MCHC 27.6 g/dL (276 g/L) (31-37 g/dL [310-370 g/L]); HYPOCHROMIC
RDW 19.2% (0.192 proportion) (11.5-15% [0.115-0.15 proportion]); HIGH
RBC 3.4 million/mm3 (4.2-5.4 million/mm3); LOW
1. Fecal occult blood test
2. Serum ferritin
3. Serum vitamin B12 or folate
4. Hemoglobin electrophoresis - ANSWER 2
Next step test for:
C.
Hb 8.4 g/dL (84 g/L) (12-14 g/dL [120-140 g/L]); LOW
MCV 118 fL (81-96 fL); MACROCYTIC
MCHC 33.4 g/dL (334 g/L) (31-37 g/dL [310-370 g/L]); NORMOCHROMIC
RDW 18.6% (0.186 proportion) (11.5-15% [0.115-0.15 proportion); HIGH
RBC 2.9 million/mm3 (4.2-5.4 million/mm3); LOW
1. Fecal occult blood test
2. Serum ferritin
3. Serum vitamin B12 or folate
2
, 4. Hemoglobin electrophoresis - ANSWER 3
Next step test for:
D.
Hb 11.6 g/dL (116 g/L) (12-14 g/dL [120-140 g/L]); LOW
MCV 76 fL (81-96 fL); MICROCYTIC
MCHC 29.2 g/dL (292 g/L) (31-37 g/dL [310-370 g/L]); HYPOCHROMIC
RDW 14.0% (0.14 proportion) (11.5-15% [0.115-0.15 proportion]); NL
RBC 5.8 million/mm3 (4.2-5.4 million/mm3) HIGH
1. Fecal occult blood test
2. Serum ferritin
3. Serum vitamin B12 or folate
4. Hemoglobin electrophoresis - ANSWER 4
Which of the following is most at risk of beta thalassemia minor?
A. A 26-year-old man of Middle Eastern ancestry and generally healthy
B. A 43-year-old woman of Northern European ancestry and type 2 diabetes mellitus
C. A 23-year-old woman of Asian ancestry with a BMI of 19 kg/m2
D. A 35-year-old man of Eastern European ancestry and a family history of
hypertension - ANSWER A
A 14-year-old female presents with a 3-day history of fever, sore throat and fatigue.
During physical examination the nurse practitioner appreciates exudative pharyngitis
and diffuse lymphadenopathy. A CBC with differential reveals the following:
WBC: 6,000/mm3 (4,500-11,000/mm3)
Neutrophils: 40% (40-60%)
3
