Nokea
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.
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A client has Hodgkin's lymphoma, Ann Arbor stage Ib. For what manifestations should the nurse assess the client? (Select all that apply.)
- A. Headaches
- B. Night sweats
- C. Persistent fever
- D. Urinary frequency
- E. Weight loss
Correct Answer: B,C,E
Rationale: In Ann Arbor stage Ib, Hodgkin's lymphoma may present with systemic symptoms like night sweats, persistent fever, and weight loss, known as B symptoms. Headaches and urinary frequency are not typical manifestations of this stage.
A nurse is preparing to hang a blood transfusion. Which action is most important?
- A. Documenting the transfusion
- B. Placing the client in NPO status
- C. Checking the blood product label
- D. Putting on a pair of gloves
Correct Answer: D
Rationale: To prevent bloodborne illness, the nurse should don a pair of gloves prior to hanging the blood, prioritizing infection control. Documentation is important but not the priority at this point. NPO status is not required, and checking the blood product label, while critical, is secondary to standard precautions like wearing gloves.
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.
A client has been admitted after sustaining a humerus fracture that occurred when picking up the family cat. What test result would the nurse correlate to this condition?
- A. Bence-Jones protein in urine
- B. Epstein-Barr virus positive
- C. Hemoglobin: 18 mg/dL
- D. Red blood cell count 8.2/mm3
Correct Answer: A
Rationale: This client has possible multiple myeloma. A positive Bence-Jones protein finding would correlate with this condition. The Epstein-Barr virus is associated with infectious mononucleosis and some cancers, not directly with multiple myeloma. Hemoglobin of meaningful correlation. Similarly, a red blood cell count of 8.2/mm3 is high but requires further information for specific correlation.
A client receiving a blood transfusion develops anxiety and low back pain. After stopping the transfusion, what action by the nurse is most important?
- A. Correctly identifying client using two identifiers
- B. Double-checking client and blood type information
- C. Placing the client on strict bedrest until the pain subsides
- D. Reviewing the client's medical record for known allergies
Correct Answer: B
Rationale: This client has a hemolytic transfusion reaction, most commonly caused by blood type or Rh incompatibility. The nurse should double-check all identifying information for both the client and blood type to confirm the error. Documentation occurs after the client is stable. Bedrest may not be needed, and allergies to medications or environmental items are not related.