Nokea
After receiving a stem cell transplant, the patient develops a rash and diarrhea. This most likely indicates:
- A. Neutropenia
- B. Radiation toxicity
- C. Gastroenteritis
- D. Graft Vs. Host disease
Correct Answer: D
Rationale: The correct answer is D: Graft Vs. Host disease. This occurs when donor immune cells attack the recipient's tissues, leading to symptoms like rash and diarrhea. Neutropenia (A) is low neutrophil count, not typically causing rash and diarrhea. Radiation toxicity (B) would cause different symptoms, not typically rash and diarrhea. Gastroenteritis (C) typically presents with nausea, vomiting, and abdominal pain, not necessarily rash.
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The nurse understands that the pathophysiology of a thermal injury includes (Select All that Apply):
- A. Hematuria
- B. Edema
- C. Hypovolemia
- D. Anemia
Correct Answer: B,C
Rationale: The correct answers are B: Edema and C: Hypovolemia. Edema occurs due to increased capillary permeability after a thermal injury, leading to fluid leakage into tissues. Hypovolemia results from fluid shift out of the blood vessels into the injured tissues, causing decreased blood volume. Hematuria (A) is not typically associated with thermal injuries. Anemia (D) is a decrease in the number of red blood cells or hemoglobin, not a direct result of thermal injury.
A nurse is caring for a baby that may have sickle cell disease. Which of the following tests should be performed to distinguish sickle cell trait from sickle cell disease?
- A. Hemoglobin electrophoresis
- B. Sickle solubility test
- C. Complete Blood Count (CBC)
- D. International Normalized Ratio (INR)
Correct Answer: A
Rationale: The correct answer is A: Hemoglobin electrophoresis. This test is used to distinguish sickle cell trait from sickle cell disease by separating different types of hemoglobin based on their electrical charge. Sickle cell trait will show a different hemoglobin pattern compared to sickle cell disease.
B: Sickle solubility test is not specific enough to differentiate between sickle cell trait and disease.
C: Complete Blood Count (CBC) provides general information about blood cells but does not specifically differentiate between sickle cell trait and disease.
D: International Normalized Ratio (INR) is used to monitor blood clotting and is not relevant for distinguishing sickle cell trait from disease.
Which is the most accurate genetic explanation for a family with hemophilia?
- A. It is an X-linked recessive disorder
- B. It is an autosomal recessive disorder
- C. It is equally distributed among males and females
- D. It is a Y-linked dominant disorder
Correct Answer: A
Rationale: The correct answer is A: It is an X-linked recessive disorder. Hemophilia is caused by a mutation in genes located on the X chromosome. Males inherit the disorder from their mothers, as they only inherit one X chromosome. Females can be carriers if they inherit one mutated X chromosome. Autosomal recessive disorders (choice B) require both parents to pass on the mutated gene. Hemophilia is not equally distributed among males and females (choice C) because males are more likely to exhibit symptoms. Y-linked disorders (choice D) are inherited only by males and are passed from father to son.
A 3-year-old patient is taking therapeutic doses of Digoxin and Lasix for heart failure and has an order for daily labs to be drawn. What side effect of this drug combination would the nurse find most concerning?
- A. Hypernatremia
- B. Hypokalemia
- C. Hyponatremia
- D. Hyperkalemia
Correct Answer: B
Rationale: The correct answer is B: Hypokalemia. Digoxin and Lasix can both cause potassium loss, leading to hypokalemia. In this case, hypokalemia is concerning as it can increase the risk of Digoxin toxicity, resulting in life-threatening arrhythmias. Hypernatremia (A), hyponatremia (C), and hyperkalemia (D) are not common side effects of this drug combination and would not pose the same level of risk as hypokalemia.
While caring for a hospitalized child, which of the following signs would lead the nurse to suspect the child has diabetes insipidus?
- A. Increased urination
- B. Fruity breath
- C. Weight gain
- D. Slurred speech
Correct Answer: A
Rationale: The correct answer is A: Increased urination. Diabetes insipidus is characterized by excessive urination (polyuria) due to the inability of the kidneys to concentrate urine. This leads to a large volume of dilute urine being produced. The other options are not indicative of diabetes insipidus. Fruity breath (B) is a sign of diabetic ketoacidosis, not diabetes insipidus. Weight gain (C) is not a typical symptom of diabetes insipidus, as patients may even experience weight loss due to dehydration. Slurred speech (D) is not directly related to diabetes insipidus.