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Differential Diagnosis (DD) Answer Key || Chapter 05

MCQ

1. If rapid onset of anemia occurs after major surgery, which of the following symptom patterns might develop?


a. Continuous oozing of blood from the surgical site
b. Exertional dyspnea and fatigue with increased heart rate
c. Decreased heart rate
d. No obvious symptoms would be seen

2. Chronic GI blood loss sometimes associated with use of NSAIDs can result in which of the following problems?


a. Increased incidence of joint inflammation
b. Iron defciency
c. Decreased heart rate and bleeding
d. Weight loss, fever, and loss of appetite

3. Under what circumstances would you consider asking a client about a recent change in altitude or elevation?

When you live at an elevation of 3500 feet above sea level (or higher) and the client describes symptoms of unknown origin such as headache, dizziness, fatigue, and changes in sensation of the feet and hands (decreased feeling, burning, numbness, tingling, or joint pain, swelling, and loss of motion [sickle cell disease])


4. Preoperatively, clients cannot take aspirin or antiinflammatory medications because these:


a. Decrease leukocytes
b. Increase leukocytes
c. Decrease platelets
d. Increase platelets
e. None of the above

5. Skin color and nail bed changes may be observed in the client with:


a. Thrombocytopenia resulting from chemotherapy
b. Pernicious anemia resulting from Vitamin B12 defciency
c. Leukocytosis resulting from AIDS
d. All of the above

6. In the case of a client with hemarthrosis associated with hemophilia, what physical therapy intervention would be contraindicated?

Local heat applied to the involved joint(s)


7. Bleeding under the skin, nosebleeds, bleeding gums, and black stools require medical evaluation as these may be indications of:


a. Leukopenia
b. Thrombocytopenia
c. Polycythemia
d. Sickle cell anemia


8. Describe the two tests used to distinguish an iliopsoas bleed
from a joint bleed.

(1) Trunk flexion over the hips produces severe pain in the presence of iliopsoas bleeding. Only mild pain occurs on trunk flexion over the hips for a hip hemorrhage. Gently rotating the hip internally or externally causes severe pain in the presence of a hip hemorrhage but only minimal (or no) pain with iliopsoas bleeding.

9. What is the signifcance of nadir?

Nadir, or the lowest point the white blood count reaches, usually occurs 7 to 14 daysafter chemotherapy or radiation therapy. At that time, the client is extremely susceptible to infection; the therapist must follow all universal precautions, especially those pertaining to good handwashing.


10. When exercising a client with known anemia, what two measures can be used as guidelines for frequency, intensity, and
duration of the program?

(1) Client tolerance; (2) Perceived exertion levels

ANSWER KEY

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