Nokea
The nurse is caring for a child who has hemophilia. He is admitted with a bleeding episode. Which of the following should the nurse expect will be given to stop the bleeding?
- A. Heparin
- B. Cryoprecipitate
- C. Packed cells
- D. Whole blood
Correct Answer: B
Rationale: Cryoprecipitate contains clotting factors, such as factor VIII, essential for stopping bleeding in hemophilia.
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The client diagnosed with sickle cell anemia asks the nurse, 'Why should I take those shots? I hate shots.' Which statement by the nurse is the best response?
- A. These vaccines promote health in clients with chronic illnesses.'
- B. You are susceptible to infections. These shots may help prevent a crisis.'
- C. The vaccines will help your blood from sickling secondary to viruses.'
- D. The doctor wanted to make sure that I discussed the vaccines with you.'
Correct Answer: B
Rationale: Flu/pneumonia vaccines (B) reduce infection risk, a common SCA crisis trigger. General health (A) is vague, sickling (C) is indirect, and HCP mention (D) avoids explanation.
A child who is being treated for leukemia develops stomatitis. Which of the following nursing care measures is essential?
- A. Using dental floss to clean the teeth
- B. Frequent cleaning of the mouth with an astringent mouthwash
- C. Use of an overbed cradle
- D. Swabbing the mouth with moistened cotton swabs
Correct Answer: D
Rationale: Swabbing the mouth with moistened cotton swabs gently cleans the mouth without irritating stomatitis. Flossing or astringent mouthwash may worsen irritation, and an overbed cradle is unrelated.
The new nurse requests information about chronic lymphocytic leukemia (CLL). Which statements should an experienced nurse include?
- A. CLL is a malignancy of activated B lymphocytes.
- B. CLL is the most common malignancy of older adults.
- C. CLL is unresponsive to chemotherapy treatment.
- D. Clients are monitored in its early stages and often not treated.
- E. In CLL immature lymphocytes accumulate in the bone marrow.
- F. Clients with CLL often have no symptoms of the disorder.
Correct Answer: A, B, D, F
Rationale: CLL derives from a malignant clone of B lymphocytes. T-lymphocytic CLL is rare. B. Two-thirds of all persons with CLL are older than 60 years at diagnosis. C. Treatment for CLL includes chemotherapy with fludarabine (Fludara), but a major side effect is prolonged bone marrow suppression. D. Clients with CLL are monitored, and treatment is initiated when symptoms are severe (night sweats, painful lymphadenopathy) or the disease progresses to later stages. E. In CLL there is an accumulation of mature-appearing but functionally inactive lymphocytes, and not immature lymphocytes. Excessive accumulation of immature lymphocytes occurs in ALL. F. Because many persons are asymptomatic, it is often diagnosed during a routine physical or during treatment for another condition.
The nurse is assessing a client diagnosed with acute myeloid leukemia. Which assessment data support this diagnosis?
- A. Fever and infections.
- B. Nausea and vomiting.
- C. Excessive energy and high platelet counts.
- D. Cervical lymph node enlargement and positive acid-fast bacillus.
Correct Answer: A
Rationale: AML causes neutropenia, leading to fever/infections (A). Nausea (B) is nonspecific, high platelets/energy (C) are incorrect (AML causes thrombocytopenia/fatigue), and acid-fast bacillus (D) indicates TB, not AML.
Which of the following would be the best lunch for a client with folic acid deficiency anemia?
- A. Bologna sandwich and vegetable soup
- B. Grilled cheese sandwich and tomato soup
- C. Coleslaw and cream of mushroom soup
- D. Spinach salad and bean soup
Correct Answer: D
Rationale: Spinach and beans are rich in folate, making this lunch ideal for folic acid deficiency anemia.