Nokea
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.
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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.
Cup of decatfeinated coffee for breakfast and lunch, 90 mL apple juice, 120 mL ice cream, 180 mL chicken broth, mashed potatoes, few bites of chicken, bowl of carrots, 240 mL milk, and 90 mL gelatin. How many milliliters should the nurse record for the client’s 8-hour fluid intake? __________ L (Record your answer as a whole number.)
Correct Answer: 2200
Rationale: First convert to milliliters: l L = 1000 mL;
1 oz = 30 mL
Next add the values for fluids: 1000 + 240 + 240 + 90 + 120 + 180 + 240 + 90 = 2200
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 completed teaching the client who had a bone marrow transplant (BMT). Which statement by the client indicates the client misunderstood the expected changes following a BMT?
- A. “I may gain weight from my immunosuppressant medication.”
- B. “Sterility can occur from the chemotherapy and radiation.”
- C. “I may have vision changes from the total body irradiation.”
- D. “Changes to my mouth could include a white, patchy tongue.”
Correct Answer: D
Rationale: A. A common side effect of immunosuppressant medications is weight gain. B. Sterility can occur as a result of chemotherapy and the total body irradiation after BMT. C. Changes in vision are common as a result of the total body irradiation after BMT. D. A white, patchy tongue is a sign of a fungal infection with Candidiasis albicans and would not be an expected change.
The client’s laboratory values are RBCs 5.5 (x106/mm3), WBCs 8.9 (x103/mm3), and platelets 189 (x103/mm3). Which intervention should the nurse implement?
- A. Prepare to administer packed red blood cells.
- B. Continue to monitor the client.
- C. Request an order for Neupogen, a biologic response modifier.
- D. Institute bleeding precautions.
Correct Answer: B
Rationale: Labs are normal (RBC 5.5, WBC 8.9, platelets 189); continue monitoring (B). Transfusions (A), Neupogen (C), and bleeding precautions (D) are unnecessary.