Nokea
A nurse is caring for a young male client with lymphoma who is to begin treatment. What teaching topic is a priority?
- A. Genetic testing
- B. Sperm banking
- C. Treatment options
- D. Lifestyle changes
Correct Answer: B
Rationale: All teaching topics are important to the client with lymphoma, but for a young male, sperm banking is of appropriate concern if the client is going to have radiation to the lower abdomen or pelvis.
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A nurse working with clients with sickle cell disease (SCD) teaches about self-management to prevent exacerbation and sickle cell crises. What factors should clients be taught to avoid? (Select all that apply.)
- A. Dehydration
- B. Radiation
- C. Extreme stress
- D. High altitudes
- E. Pregnancy
Correct Answer: A,C,D,E
Rationale: Several factors cause red blood cells to sickle in SCD, including dehydration, extreme stress, high altitudes, and pregnancy, as they can trigger vaso-occlusive crises. Radiation is not a specific trigger unless related to extreme physical stress.
A client with sickle cell disease (SCD) takes hydroxyurea (Droxia). The client presents to the clinic reporting an increase in fatigue. What laboratory result should the nurse report immediately?
- A. Hematocrit: 25%
- B. Hemoglobin: 2.2 mg/dL
- C. Potassium: 3.2 mEq/L
- D. White blood cell count: 38,000/mm3
Correct Answer: D
Rationale: Although individuals with SCD often have elevated white blood cell counts, an extreme elevation like 38,000/mm3 could indicate leukemia, a serious complication of hydroxyurea, or a severe infection, both critical in SCD patients. Hematocrit and hemoglobin levels are typically low in SCD, and the potassium level, while slightly low, is less urgent.
A student studying leukemia learns the risk factors for developing this disorder. Which risk factors does this include? (Select all that apply.)
- A. Chemical exposure
- B. Genetically modified foods
- C. Ionizing radiation exposure
- D. Vaccinations
- E. Viral infections
Correct Answer: A,C,E
Rationale: Chemical exposure, ionizing radiation, and viral infections are known risk factors for leukemia. Genetically modified foods and vaccinations have not been established as risk factors.
A client has received a bone marrow transplant and is waiting for engraftment. What actions by the nurse are most appropriate? (Select all that apply.)
- A. Not allowing any visitors until engraftment
- B. Limiting the protein in the client's diet
- C. Having the client wear a mask
- D. Teaching visitors appropriate hand hygiene
- E. Telling visitors not to bring live flowers or plants
Correct Answer: C,D,E
Rationale: Clients awaiting engraftment are immunocompromised, requiring protective precautions like wearing a mask, strict hand hygiene for visitors, and avoiding fresh flowers or plants due to infection risks. Limiting protein is not beneficial, and completely barring visitors is overly restrictive.
A client admitted for sickle cell crisis is distraught after learning her child also has the disease. What response by the nurse is best?
- A. Both you and the father are equally responsible for passing it on.
- B. I can see you are upset. I can stay here with you a while if you like.
- C. I am sorry you have to go through this. I will be here to help you.
- D. There are many good treatments for sickle cell disease these days.
Correct Answer: B
Rationale: The best response is for the nurse to offer self, a therapeutic communication technique that uses presence to provide emotional support. Assigning blame or focusing on treatments does not address the client's emotional distress, and while offering help is supportive, staying with the client is the most immediate and effective response.