Nokea
A patient has been diagnosed with pernicious anemia. When reinforcing instructions, the nurse explains this disorder results from which process?
- A. Poor nutritional intake of iron
- B. Lack of the intrinsic factor
- C. Blood loss due to hemorrhage
- D. Excess production of red blood cells
Correct Answer: B
Rationale: With pernicious anemia, the body lacks the intrinsic factor. Iron deficiency anemia is caused by poor nutritional iron intake. Blood loss associated anemia is due to hemorrhage. Pernicious anemia is not associated with excess production of red blood cells.
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The nurse will prepare the adult patient who will be undergoing bone marrow sampling by explaining the sample will be obtained from which site?
- A. Sternum
- B. Posterior superior iliac crest
- C. Posterior iliac crest
- D. Femur
Correct Answer: C
Rationale: The preferred site for bone marrow aspiration puncture in adults is the posterior iliac crest.
When the 14-year-old patient comes into the emergency room in sickle cell crisis, which should be the primary focus of care?
- A. Genetic counseling
- B. Applying ice packs
- C. Pain relief measures
- D. Providing iron replacements
Correct Answer: C
Rationale: Pain control during the crisis is the focus. Continuous opioids are the mainstay of pain management. Genetic counseling would not be appropriate during a crisis. Ice packs would constrict blood vessels, thus contributing to more pain. Iron replacement is not usually given with sickle cell anemia.
Which does the elevation in the eosinophil count to 10% indicate?
- A. Anemia
- B. Allergy
- C. Infection
- D. Hypoxia
Correct Answer: B
Rationale: Normal values of eosinophils are 1% to 4%. An elevation to 10% would indicate the presence of an allergic reaction.
Which mandatory practice is the most effective and significant nursing practice to prevent the spread of infection for a patient with agranulocytosis?
- A. Strict and frequent hand washing by all people having contact with the patient
- B. Placement of patients in private rooms with high-efficiency particulate air (HEPA) filtration
- C. Administration of combinations of prophylactic antibiotics
- D. Creation of a 'sterile' environment for the patient with the use of laminar airflow rooms
Correct Answer: A
Rationale: Meticulous hand washing by medical and nursing personnel and strict asepsis are mandatory.
The hematopoietic stem cell transplant (Bone marrow transplant) is used for a patient with which disease?
- A. Iron deficiency anemia
- B. Aplastic anemia
- C. Leukemia
- D. Pernicious anemia
- E. Myelodysplastic syndrome
Correct Answer: B,C,E
Rationale: Bone marrow transplant may be used for aplastic anemia, leukemia and myelodysplastic syndrome. It is not used for iron deficiency anemia or pernicious anemia.