Nokea
A client is admitted to the emergency department with significant blood loss. The physician prescribes 2 units of packed red blood cells to be transfused immediately. Which blood groups would be compatible with his O Rh-positive blood group?
- A. O Rh-positive or O Rh-negative
- B. Only O Rh-positive
- C. Only O Rh-negative
- D. AB Rh-positive or Rh-negative
Correct Answer: A
Rationale: People with Rh-positive blood can receive Rh-positive or Rh-negative blood because a negative Rh indicates a missing Rh factor. Antibodies, immunoglobulins in plasma that inactivate any substance that is non-self, react with incompatible red blood cell antigens. Therefore, people with type O blood are universal donors because they do not have antigens on the red cell membrane. Therefore, the client can be transfused with either O Rh-positive or O Rh-negative blood.
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A client is scheduled for a bone marrow aspiration and is extremely apprehensive about having the procedure done. The nurse explains that there may be a feeling of pressure or discomfort when puncturing the bone. What intervention can the nurse provide to assist with this concern?
- A. Inform the client that he will not be able to move and will have to tolerate the discomfort for 20 minutes.
- B. Inform the client that if he is concerned that he will move when the bone is punctured, soft wrist restraints can be used if the client approves.
- C. Assist the client with focused imagery to avoid focusing on the procedure and any discomfort associated with it.
- D. Suggest chewing gum or eating candy in order to focus on something other than the discomfort.
Correct Answer: C
Rationale: Suggest distraction techniques to avoid focusing on the pressure or discomfort associated with puncturing the bone that may take approximately 20 minutes. Restraints should not be applied during the procedure because the client may not be able to determine if they are too tight. The client has a right to pain relief and should not have to 'tolerate' pain for 20 minutes. Chewing gum or eating candy may increase the client's risk for aspiration during the procedure.
The nurse is reviewing laboratory studies that determine a client is deficient in copper. What does the nurse understand is the importance of copper in the body?
- A. Essential for the maturation of red blood cells
- B. Basic nutritional component of heme in hemoglobin
- C. Involved in the transfer of iron from storage to plasma
- D. Serves as a coenzyme in hemoglobin formation
Correct Answer: C
Rationale: Copper is involved in the transfer of iron from storage to plasma. Folic acid and Bâ??â?? are essential for the maturation of red blood cells. Iron is the basic nutritional component of heme in hemoglobin. Vitamin B6 serves as a coenzyme in hemoglobin formation.
A student nurse is having difficulty understanding the function of globulins. What information can the client provide to the student regarding the function of globulins?
- A. Immunologic agents
- B. Destruction of invading organisms
- C. Precursors to clot formation
- D. Transport of oxygen to the tissues
Correct Answer: A
Rationale: Globulins function primarily as immunologic agents; they prevent or modify some types of infectious diseases. Globulins do not destroy invading organisms, participate in clot formation, or transport oxygen to the tissues.
A client is taking a medication that has the side effect of depressing the hematopoietic system. What signs of leukopenia should the nurse monitor for while the client is taking this drug?
- A. Fever, sore throat, and chills
- B. Nausea and vomiting
- C. Diarrhea, diaphoresis, and fever
- D. Intolerance to heat and rash
Correct Answer: A
Rationale: Closely monitor clients taking medications that depress the hematopoietic system, particularly thrombocytes and leukocytes. Signs of leukopenia include fever, sore throat, and chills. Nausea and vomiting, diarrhea, diaphoresis, heat intolerance, and rash are not indicative of leukocytosis.
The nursing instructor is teaching her clinical group about laboratory blood tests. What is the major function of erythrocytes?
- A. Act as mediators for the immune system
- B. Destroy invading organisms
- C. Transportation of Oâ?? to the tissues and removal of COâ?? from the tissues
- D. Oxygenation of the brain
Correct Answer: C
Rationale: Erythrocytes (or RBCs) are flexible, anuclear (lacking a nucleus), biconcave disks covered by a thin membrane through which oxygen (Oâ??) and carbon dioxide (COâ??) pass freely. The flexibility of erythrocytes allows them to change shape as they travel through capillaries. Their major function is to transport Oâ?? to and remove COâ?? from the tissues. The RBCs are not involved in immunological functions, so choices A and B are not correct. Oxygenation of the brain is important but that is not a major function of RBCs.