Nokea
A 5-year-old boy is admitted because he bled profusely when he lost his first baby tooth. After a workup, he is diagnosed as having classic hemophilia. His mother asks the nurse if his two younger sisters will also develop hemophilia. What is the best answer for the nurse to give?
- A. They will not develop the disease.'
- B. Statistically, one of them is likely to develop the disease.'
- C. They are not likely to get the disease, but they may be carriers.'
- D. If it doesn't show up by the time they start school, they are unlikely to develop the condition.'
Correct Answer: C
Rationale: Hemophilia is an X-linked recessive disorder. Females are unlikely to develop the disease but may be carriers, especially if the mother is a carrier.
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The nurse is assessing a client diagnosed with acute myeloid leukemia. Which assessment data support this diagnosis?
- A. Fever and infections.
- B. Nausea and vomiting.
- C. Excessive energy and high platelet counts.
- D. Cervical lymph node enlargement and positive acid-fast bacillus.
Correct Answer: A
Rationale: AML causes neutropenia, leading to fever/infections (A). Nausea (B) is nonspecific, high platelets/energy (C) are incorrect (AML causes thrombocytopenia/fatigue), and acid-fast bacillus (D) indicates TB, not AML.
The laboratory results for a male client diagnosed with leukemia include RBC count 2.1 x 106/mm3, WBC count 150 x 103/mm3, platelets 22 x 103/mm3, K+ 3.8 mEq/L, and Na+ 139 mEq/L. Based on these results, which intervention should the nurse teach the client?
- A. Encourage the client to eat foods high in iron.
- B. Instruct the client to use an electric razor when shaving.
- C. Discuss the importance of limiting sodium in the diet.
- D. Instruct the family to limit visits to once a week.
Correct Answer: B
Rationale: Low platelets (22,000) increase bleeding risk; an electric razor (B) prevents cuts. Iron (A) is for anemia, sodium (C) is normal (139), and limiting visits (D) is excessive.
The charge nurse is making assignments on a medical floor. Which client should be assigned to the most experienced nurse?
- A. The client diagnosed with iron-deficiency anemia who is prescribed iron supplements.
- B. The client diagnosed with pernicious anemia who is receiving vitamin B12 intramuscularly.
- C. The client diagnosed with aplastic anemia who has developed pancytopenia.
- D. The client diagnosed with renal disease who has a deficiency of erythropoietin.
Correct Answer: C
Rationale: Aplastic anemia with pancytopenia (C) is complex, risking bleeding/infection, requiring experienced care. Iron (A), B12 (B), and renal anemia (D) are more stable.
The female client, who has Hodgkin’s lymphoma with cervical and axillary node involvement, is to receive chemotherapy and radiation. The nurse evaluates that the client is coping positively when the client makes which statement?
- A. “I’ve a wig that matches my hair color, but I’ll miss my own hair.”
- B. “I am so glad that the treatments won’t cause me to lose my hair.”
- C. “I’m happy that the drug-radiation combination prevents mucositis.”
- D. “I’ve faith that my doctor will cure me and I’ll never have cancer again.”
Correct Answer: A
Rationale: A. The client is expressing feelings about hair loss but has acted positively related to her feelings and obtained a wig. This statement indicates positive coping. B. This statement reflects that either the client is in denial or is uninformed regarding the effects of chemotherapy and radiation treatments. Chemotherapy and radiation will involve the cervical lymph nodes; side effects will include alopecia. C. Chemotherapy and radiation will involve the cervical lymph nodes; side effects will include mucositis. D. The risk for other cancers is increased after chemotherapy and radiation for Hodgkin’s lymphoma, so long-term surveillance is crucial.
When assessing the client who is recovering from a radical hysterectomy with vulvectomy, the nurse notes lymphedema of the lower extremities. Which intervention should be implemented by the nurse?
- A. Elevate the head of the client’s bed to 45 degrees.
- B. Increase the client’s intake of fluids high in sodium.
- C. Encourage the client to exercise the lower extremities.
- D. Apply splints to both of the client’s lower extremities.
Correct Answer: C
Rationale: A. Elevating the head of the bed to a 45-degree angle may increase lymphedema of the lower extremities. B. Intake of fluids high in sodium will cause fluid retention. C. Leg exercises will improve drainage when lymphedema is present. D. Lower-extremity splints can cause skin breakdown of edematous tissue.