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A child who has hemophilia is admitted to the hospital with a swollen knee joint. He is complaining of severe pain. What is the priority of nursing care for this child upon admission?
- A. Maintain joint function
- B. Use a bed cradle
- C. Administer aspirin as needed for pain
- D. Encourage fluids
Correct Answer: B
Rationale: Using a bed cradle reduces pressure on the swollen, painful joint, prioritizing pain relief and comfort during a bleeding episode.
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Which medication is contraindicated for a client diagnosed with leukemia?
- A. Bactrim, a sulfa antibiotic.
- B. Morphine, a narcotic analgesic.
- C. Epogen, a biologic response modifier.
- D. Gleevec, a genetic blocking agent.
Correct Answer: C
Rationale: Epogen (C) stimulates RBC production, risky in leukemia due to blast proliferation. Bactrim (A) treats infections, morphine (B) manages pain, and Gleevec (D) targets CML.
The client is being admitted with folic acid deficiency anemia. Which would be the most appropriate referral?
- A. Alcoholics Anonymous.
- B. Leukemia Society of America.
- C. A hematologist.
- D. A social worker.
Correct Answer: C
Rationale: Folic acid deficiency anemia requires a hematologist (C) for evaluation/treatment. AA (A) is for alcoholism, Leukemia Society (B) is unrelated, and social work (D) is secondary.
The client has a hematocrit of 22.3% and a hemoglobin of 7.7 g/dL. The HCP has ordered two (2) units of packed red blood cells to be transfused. Which interventions should the nurse implement? Select all that apply.
- A. Obtain a signed consent.
- B. Initiate a 22-gauge IV.
- C. Assess the client’s lungs.
- D. Check for allergies.
- E. Hang a keep-open IV of D5W.
Correct Answer: A,C,D
Rationale: Consent (A), lung assessment (C), and allergy checks (D) ensure safe transfusion. A 22-gauge IV (B) is too small (18-gauge preferred), and D5W (E) is incompatible (use NS).
The nurse assesses that the client who is receiving radiation for cervical cancer continues to have diarrhea. Which nursing advice is most appropriate for this client?
- A. Eat a low-residue diet and take sitz baths twice daily.
- B. Drink fluids low in potassium and take frequent tub baths.
- C. Consume more milk products and take frequent showers.
- D. Drink high-sodium fluids and apply hydrocolloid pads to rectum.
Correct Answer: A
Rationale: A. The client with diarrhea should eat a low-residue diet to decrease roughage and bowel irritability and take sitz (or tub) baths twice daily to increase comfort. B. Intake of fluids that are high in potassium (not low) is recommended to replace electrolytes lost through diarrhea. C. Milk products are discouraged because they increase bowel irritability. D. Intake of fluids high in sodium should be avoided because it contributes to water retention, but hydrocolloid pads may be used on reddened areas to promote healing.
The nurse is caring for the female client recovering from a sickle cell crisis. The client tells the nurse her family is planning a trip this summer to Yellowstone National Park. Which response would be best for the nurse?
- A. That sounds like a wonderful trip to take this summer.'
- B. Have you talked to your doctor about taking the trip?'
- C. You really should not take a trip to areas with high altitudes.'
- D. Why do you want to go to Yellowstone National Park?'
Correct Answer: C
Rationale: High altitudes (e.g., Yellowstone) reduce oxygen, risking SCA crisis (C). Generic praise (A), deferring to HCP (B), or questioning motive (D) are less direct.