Nokea
A young man who has infectious mononucleosis asks what the treatment is for his condition. What is the best response for the nurse to make?
- A. You will receive large doses of antibiotics for the next 10 days.'
- B. Rest and good nutrition are the best things you can do.'
- C. You will be given an antiviral agent that will help to control the symptoms.'
- D. You will probably be given steroid medications for several months.'
Correct Answer: B
Rationale: Rest and good nutrition support recovery from infectious mononucleosis, a viral illness with no specific antiviral or steroid treatment.
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Which collaborative treatment would the nurse anticipate for the client diagnosed with DIC?
- A. Administer oral anticoagulants.
- B. Prepare for plasmapheresis.
- C. Administer frozen plasma.
- D. Calculate the intake and output.
Correct Answer: C
Rationale: Frozen plasma (C) replaces clotting factors in DIC. Oral anticoagulants (A) worsen bleeding, plasmapheresis (B) is rare, and I&O (D) is routine.
The nurse is caring for multiple 25-year-old female clients. The nurse should plan to consult the HCP about a referral for genetic counseling and family planning for which clients?
- A. Client diagnosed with thalassemia major
- B. Client diagnosed with sickle cell anemia
- C. Client diagnosed with hemophilia A
- D. Client diagnosed with autoimmune hemolytic anemia
- E. Client diagnosed with hemophilia B
Correct Answer: A, B, C, E
Rationale: Thalassemia is a hereditary disorder; the client could benefit from a referral for genetic counseling. B. Sickle cell anemia is a hereditary disorder; the client could benefit from a referral for genetic counseling. C. Hemophilia A is a hereditary disorder; the client could benefit from a referral for genetic counseling. D. Autoimmune hemolytic anemia is an acquired hemolytic anemia. E. Hemophilia B is a hereditary disorder; the client could benefit from a referral for genetic counseling.
The client who received 50 mL from a unit of whole blood has low back pain. In response to this client’s symptom, which action should be taken by the nurse first?
- A. Reposition the client.
- B. Assess the pain further.
- C. Administer an analgesic.
- D. Stop the blood transfusion.
Correct Answer: D
Rationale: A. Repositioning focuses on treating the client’s back pain and not on the blood transfusion, which could be the cause of the back pain. B. Further assessment should occur after stopping the blood transfusion. C. The client may need an analgesic for pain control, but this should occur after stopping the blood transfusion. D. Low back pain is a symptom of a potentially life-threatening acute hemolytic reaction. The pain is caused from agglutination of RBCs in the kidneys and renal vasoconstriction. Hemolytic reactions occur most often within the first 50 mL of the infusion.
The client diagnosed with end-stage renal disease (ESRD) has developed anemia. Which would the nurse anticipate the HCP prescribing for this client?
- A. Place the client in reverse isolation.
- B. Discontinue treatments until blood count improves.
- C. Monitor CBC daily to assess for bleeding.
- D. Give client erythropoietin, a biologic response modifier.
Correct Answer: D
Rationale: ESRD causes erythropoietin deficiency; prescribing erythropoietin (D) treats anemia. Isolation (A), stopping treatment (B), and daily CBC (C) are inappropriate.
The male client with sickle cell anemia comes to the emergency department with a temperature of 101.4°F and tells the nurse that he is having a sickle cell crisis. Which diagnostic test should the nurse anticipate the emergency department doctor ordering for the client?
- A. Spinal tap.
- B. Hemoglobin electrophoresis.
- C. Sickle-turbidity test (Sickledex).
- D. Blood cultures.
Correct Answer: D
Rationale: Fever (101.4°F) in SCA crisis suggests infection; blood cultures (D) identify the cause. Spinal tap (A) is for meningitis, electrophoresis (B) confirms SCA, and Sickledex (C) screens for sickle trait.