National Physical Therapy Examination (NPTE) Practice Exam

When developing an exercise program for a patient with sickle cell anemia and a hematocrit of 27%, what condition should be of most concern?

1. Hypoxia

2. Excessive bruising

3. Dependent edema

4. Hypertension

The correct answer is: Hypoxia

In the context of a patient with sickle cell anemia and a hematocrit of 27%, the primary concern lies with hypoxia. Sickle cell anemia is characterized by the presence of abnormally shaped red blood cells that can lead to blockages in the blood vessels, reducing blood flow and oxygen delivery to tissues. A hematocrit level of 27% indicates a lower than normal proportion of red blood cells, which can further compromise the oxygen-carrying capacity of the blood. When oxygen delivery to tissues is impaired, patients are at risk for multiple complications, including pain crises, fatigue, and organ damage. Exercise can increase the demands on the body for oxygen, and in individuals with compromised oxygen transport, this can result in significant hypoxic events. Therefore, careful consideration must be given to the intensity and nature of the exercise regimen to avoid exacerbating this condition. While other conditions such as excessive bruising, dependent edema, or hypertension could arise in various contexts, they are not immediate concerns specifically related to the hemoglobin levels and exercise implications in sickle cell anemia. Thus, addressing hypoxia is crucial in developing a safe and effective exercise program for this patient.