Nokea
The client diagnosed with sickle cell anemia asks the nurse, 'Should I join the Sickle Cell Foundation? I received some information from the Sickle Cell Foundation. What kind of group is it?' Which statement is the best response by the nurse?
- A. It is a foundation that deals primarily with research for a cure for SCA.'
- B. It provides information on the disease and on support groups in this area.'
- C. I recommend joining any organization that will help deal with your disease.'
- D. The foundation arranges for families that have children with sickle cell to meet.'
Correct Answer: B
Rationale: The Sickle Cell Foundation offers education and support groups (B). Research (A) is partial, generic advice (C) is vague, and family meetings (D) are not primary.
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The client who has renal cancer that has metastasized rates pain at a 9 on a 0 to 10 pain scale. Which medication should the nurse plan to administer now and then schedule to be administered at the prescribed dosing interval?
- A. Meperidine
- B. Propoxyphene
- C. Pentazocine
- D. Oxycodone
Correct Answer: D
Rationale: A. Meperidine (Demerol) is not recommended because it causes CNS toxicity from metabolites. It should not be used for the treatment of chronic pain. B. Propoxyphene
The nurse writes a diagnosis of 'potential for fluid volume deficit related to bleeding' for a client diagnosed with disseminated intravascular coagulation (DIC). Which would be an appropriate goal for this client?
- A. The client’s clot formations will resolve in two (2) days.
- B. The saturation of the client’s dressings will be documented.
- C. The client will use lemon-glycerin swabs for oral care.
- D. The client’s urine output will be greater than 30 mL per hour.
Correct Answer: D
Rationale: DIC risks bleeding/fluid loss; urine output >30 mL/hr (D) indicates adequate volume. Clot resolution (A) is unrealistic, dressing saturation (B) is an intervention, and swabs (C) are unrelated.
The nurse has been teaching the parents of a child with hemophilia about the care he will need. Which statement by the parents indicates a need for more instruction?
- A. If my child needs something for pain or a fever, I will give him acetaminophen instead of aspirin.'
- B. I will take my child to the dentist for regular checkups.'
- C. I will keep my child in the house most of the time.'
- D. My son's Medic Alert Bracelet arrived.'
Correct Answer: C
Rationale: Overprotecting the child by keeping him indoors most of the time prevents normal development. Acetaminophen, dental care, and a Medic Alert bracelet are appropriate.
The client receiving a unit of PRBCs begins to chill and develops hives. Which action should be the nurse’s first response?
- A. Notify the laboratory and health-care provider.
- B. Administer the histamine-1 blocker, Benadryl, IV.
- C. Assess the client for further complications.
- D. Stop the transfusion and change the tubing at the hub.
Correct Answer: D
Rationale: Chills/hives suggest a transfusion reaction; stopping the transfusion at the hub (D) prevents further reaction. Assessment (C), Benadryl (B), and notification (A) follow.
The client diagnosed with thalassemia, a hereditary anemia, is to receive a transfusion of packed RBCs. The crossmatch reveals the presence of antibodies that cannot be crossmatched. Which precaution should the nurse implement when initiating the transfusion?
- A. Start the transfusion at 10 to 15 mL/hr for 15 to 30 minutes.
- B. Re-crossmatch the blood until the antibodies are identified.
- C. Have the client sign a permit to receive uncrossmatched blood.
- D. Have the unlicensed assistive personnel stay with the client.
Correct Answer: A
Rationale: Uncrossmatched blood requires slow infusion (10–15 mL/hr) initially (A) to monitor reactions. Re-crossmatching (B) is impractical, consent (C) is for emergencies, and UAP (D) cannot monitor.