Nokea
The client is diagnosed with hemophilia. Which safety precaution should the nurse encourage?
- A. Wear helmets and pads during contact sports.
- B. Take antibiotics prior to any dental work.
- C. Keep clotting factor VIII on hand at all times.
- D. Use ibuprofen, an NSAID, for mild pain.
Correct Answer: C
Rationale: Hemophilia requires factor VIII availability (C) for bleeding emergencies. Contact sports (A) are risky, antibiotics (B) are for endocarditis, and ibuprofen (D) increases bleeding.
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Which of the following assessment findings should alert the nurse that the elderly client should be evaluated for pernicious anemia?
- A. Clubbing of the nails
- B. Bloody stools
- C. Beefy-red tongue
- D. Enlarged lymph nodes
Correct Answer: C
Rationale: A beefy-red tongue is a classic symptom of pernicious anemia due to vitamin B12 deficiency.
The client undergoing knee replacement surgery has a 'cell saver' apparatus attached to the knee when he arrives in the post-anesthesia care unit (PACU). Which intervention should the nurse implement to care for this drainage system?
- A. Infuse the drainage into the client when a prescribed amount fills the chamber.
- B. Attach an hourly drainage collection bag to the unit and discard the drainage.
- C. Replace the unit with a continuous passive motion (CPM) unit and start it on low.
- D. Have another nurse verify the unit number prior to reinfusing the blood.
Correct Answer: A
Rationale: Cell saver reinfuses collected blood (A) per protocol to reduce allogeneic transfusion. Discarding (B) wastes blood, CPM (C) is unrelated, and verification (D) is for donor blood.
The client with Hodgkin’s lymphoma receives radiation treatments. The nurse should monitor the client for which specific symptoms of radiation pneumonitis?
- A. Tachypnea, hypotension, and fever
- B. Cough, elevated temperature, and dyspnea
- C. Bradypnea, cough, and decreased urine output
- D. Cough, tachycardia, and altered mental status
Correct Answer: B
Rationale: A. Hypotension is a symptom that is not common in radiation pneumonitis. B. Cough, fever, and dyspnea are classic symptoms in radiation pneumonitis due to a decrease in the surfactant in the lung. C. Decreased urine output is a symptom that is not common in radiation pneumonitis. D. Altered mental status is a symptom that is not common in radiation pneumonitis.
The client had basal cell carcinoma (BCC) lesions excised the day before at an outpatient clinic. The client telephones the nurse expressing concerns that the wounds are draining watery, pale pink fluid and that the small dressing is leaking. Which action should the nurse recommend?
- A. Apply ice to the area
- B. Contact the surgeon
- C. Take pain medication
- D. Change the dressings
Correct Answer: D
Rationale: A. Applying ice to the area is not necessary because the client did not mention swelling. B. Since the wounds do not drain purulent material, contacting the physician is not necessary. C. Because the client is not experiencing pain, pain medication is not needed. D. The nurse should recommend changing the dressing because a small amount of serosanguineous drainage is a normal response to surgical removal of a lesion.
An 8-year-old boy is admitted to the unit with a diagnosis of acute lymphocytic leukemia. During a routine physical exam, numerous ecchymotic areas were noted on his body. The parent reported that the child has been more tired than usual personally more tired than usual lately. The parent says that the child has had a cold for the last several weeks and asks if this is related to the leukemia. The nurse's response is based on the knowledge that:
- A. leukemia causes a decrease in the number of normal white blood cells in the body.
- B. a chronic infection such as the child has had makes a child more likely to develop leukemia.
- C. the virus responsible for colds is thought to cause leukemia.
- D. having an infection prior to the onset of leukemia is merely a coincidence.
Correct Answer: A
Rationale: Leukemia reduces normal white blood cells, impairing infection fighting, which may explain the prolonged cold. Infections do not cause leukemia.