Nokea
A 1-year-old is admitted to the hospital with sickle cell anemia in crisis. Upon admission, which therapy will assume priority?
- A. Fluid administration
- B. Exchange transfusion
- C. Anticoagulant
- D. IM administration of iron and folic acid
Correct Answer: A
Rationale: Fluid administration is the priority in sickle cell crisis to prevent dehydration and reduce blood viscosity, which can worsen sickling.
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The nurse is caring for the following clients. Which client should the nurse assess first?
- A. The client whose partial thromboplastin time (PTT) is 38 seconds.
- B. The client whose hemoglobin is 14 g/dL and hematocrit is 45%.
- C. The client whose platelet count is 75,000 per cubic millimeter of blood.
- D. The client whose red blood cell count is 4.8 x 106/mm3.
Correct Answer: C
Rationale: Platelets 75,000 (C) indicate thrombocytopenia, risking bleeding, a priority. PTT 38 (A) is therapeutic, Hb/Hct (B) are normal, and RBC 4.8 (D) is normal.
The client asks the nurse to look at a lesion on the client’s body. Which characteristics should prompt the nurse to consider that the client may have a basal cell carcinoma (BCC)?
- A. Nodular in appearance, depression in the center, and has a “pearly” characteristic
- B. Irregular color, surface, and border, less than one centimeter, and appears eroded
- C. Dry, hyperkeratotic scaly-like papule and has the appearance similar to a wart
- D. Vesiculopustular lesion with a thick, honey-colored crust and pruritic in nature
Correct Answer: A
Rationale: BCC is nodular and ulcerative. Clinical manifestations include small, slowly enlarging papule; borders are translucent or “pearly” with overlying telangiectasia; erosion, ulceration, and depression of center. B. Clinical manifestations of malignant melanoma (not BCC) include irregular color, surface, and border; variegation of color including red, white, blue, black, gray, brown; flat or elevated; eroded or ulcerated. C. Actinic keratosis (not BCC) is characterized by being horny and “wartlike.” D. Impetigo is characterized by thick, honey-colored crusts and is treated with antibiotics and topical treatment.
The nurse is assessing the client newly diagnosed with endometrial cancer. Which common findings would the nurse expect?
- A. Abnormal vaginal bleeding and pain in the pelvic area
- B. Weight loss and profuse sweating, especially at night
- C. Anorexia and enlarged supraclavicular lymph nodes
- D. Unexplained spikes in temperature and splenomegaly
Correct Answer: A
Rationale: A. Abnormal vaginal bleeding and pain in the pelvic region appear as the most common presenting symptoms in the client with endometrial cancer. B. Weight loss is not a common presenting symptom unless the cancer is advanced. Night sweats may occur with hormone changes. C. Supraclavicular lymph nodes are located just above the clavicle, lateral to where it joins the sternum, and not near the uterus. D. Unexplained temperature spikes and splenomegaly are not common presenting symptoms.
The nurse is discharging a client diagnosed with anemia. Which discharge instruction should the nurse teach?
- A. Take the prescribed iron until it is completely gone.
- B. Monitor pulse and blood pressure at a local pharmacy weekly.
- C. Have a complete blood count checked at the HCP’s office.
- D. Perform isometric exercise three (3) times a week.
Correct Answer: C
Rationale: Multiple Choice CBC checks (C) monitor anemia recovery. Taking iron indefinitely (A) depends on cause, BP/pulse checks (B) are nonspecific, and isometric exercise (D) may strain low oxygen capacity.
The client is diagnosed with chronic lymphocytic leukemia (CLL) after routine laboratory tests during a yearly physical. Which is the scientific rationale for the random nature of discovering the illness?
- A. CLL is not serious, and clients die from other causes first.
- B. There are no symptoms with this form of leukemia.
- C. This is a childhood illness and is self-limiting.
- D. In early stages of CLL, the client may be asymptomatic.
Correct Answer: D
Rationale: Early CLL is often asymptomatic (D), detected via routine labs. CLL is serious (A), has symptoms later (B), and is adult-onset (C), not self-limiting.