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The nurse is assessing a client diagnosed with vaso-occlusive crisis. Which indicates the client is not meeting an appropriate stage of growth and development according to Erikson?
- A. The 32-year-old client does not have a significant other and is on disability.
- B. The 28-year-old client is actively involved in the care of a six (6)-year-old child.
- C. The 40-year-old client has a full-time job and cares for an aged parent.
- D. The 19-year-old client is a full-time college student and has many friends.
Correct Answer: A
Rationale: At 32 (Intimacy vs. Isolation), lack of a significant other and disability (A) suggest isolation, not meeting Erikson’s stage. Parenting (B), caregiving (C), and socializing (D) align with Generativity, Generativity, and Identity stages.
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A child with leukemia bruises easily. This is most likely due to which of the following?
- A. Decreased fibrinogen levels
- B. Excessive clotting elsewhere in the body
- C. Decreased platelets
- D. Decreased erythrocytes
Correct Answer: C
Rationale: Leukemia causes bone marrow failure, leading to decreased platelets, which results in easy bruising.
The client has a hematocrit of 22.3% and a hemoglobin of 7.7 g/dL. The HCP has ordered two (2) units of packed red blood cells to be transfused. Which interventions should the nurse implement? Select all that apply.
- A. Obtain a signed consent.
- B. Initiate a 22-gauge IV.
- C. Assess the client’s lungs.
- D. Check for allergies.
- E. Hang a keep-open IV of D5W.
Correct Answer: A,C,D
Rationale: Consent (A), lung assessment (C), and allergy checks (D) ensure safe transfusion. A 22-gauge IV (B) is too small (18-gauge preferred), and D5W (E) is incompatible (use NS).
The nurse is discussing dietary sources of iron with a client who has iron deficiency anemia. Which menu, if selected by the client, indicates the best understanding of the diet?
- A. Milkshake, hot dog, and beets
- B. Beef steak, spinach, and grape juice
- C. Chicken salad, green peas, and coffee
- D. Macaroni and cheese, coleslaw, and lemonade
Correct Answer: B
Rationale: Beef, spinach, and grape juice contain iron. Milk contains no iron, and the other options have lower iron content.
Which medication is contraindicated for a client diagnosed with leukemia?
- A. Bactrim, a sulfa antibiotic.
- B. Morphine, a narcotic analgesic.
- C. Epogen, a biologic response modifier.
- D. Gleevec, a genetic blocking agent.
Correct Answer: C
Rationale: Epogen (C) stimulates RBC production, risky in leukemia due to blast proliferation. Bactrim (A) treats infections, morphine (B) manages pain, and Gleevec (D) targets CML.
The client diagnosed with non-Hodgkin's lymphoma is scheduled for a lymphangiogram. Which information should the nurse teach?
- A. The scan will identify any malignancy in the vascular system.
- B. Radiopaque dye will be injected between the toes.
- C. The test will be done similar to a cardiac angiogram.
- D. The test will be completed in about five (5) minutes.
Correct Answer: B
Rationale: Lymphangiogram involves dye injection between toes (B) to visualize lymphatics. It’s not vascular (A), unlike cardiac angiogram (C), and takes longer than 5 minutes (D).