Nokea
The nurse is caring for a client who is undergoing bone marrow aspiration to determine the blood cell formation status. What nursing intervention should the nurse provide to the client during the test?
- A. Administer oral radioactive vitamin Bâ??â?? to the client.
- B. Administer a nonradioactive Bâ??â?? injection.
- C. Collect urine for 24 to 48 hours after the client receives the nonradioactive Bâ??â??.
- D. Support the client and monitor the status.
Correct Answer: D
Rationale: When a client undergoes a bone marrow aspiration, the nurse assists the physician, supports the client during the procedure, and monitors the condition afterward. The client needs to be administered oral radioactive vitamin Bâ??â?? or a nonradioactive Bâ??â?? injection in case of the Schilling test, which helps in determining pernicious anemia and macrocytic anemia. Collecting urine for 24 to 48 hours after administering nonradioactive Bâ??â?? is also applicable to the Schilling test.
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A client is scheduled for a bone marrow aspiration and is extremely apprehensive about having the procedure done. The nurse explains that there may be a feeling of pressure or discomfort when puncturing the bone. What intervention can the nurse provide to assist with this concern?
- A. Inform the client that he will not be able to move and will have to tolerate the discomfort for 20 minutes.
- B. Inform the client that if he is concerned that he will move when the bone is punctured, soft wrist restraints can be used if the client approves.
- C. Assist the client with focused imagery to avoid focusing on the procedure and any discomfort associated with it.
- D. Suggest chewing gum or eating candy in order to focus on something other than the discomfort.
Correct Answer: C
Rationale: Suggest distraction techniques to avoid focusing on the pressure or discomfort associated with puncturing the bone that may take approximately 20 minutes. Restraints should not be applied during the procedure because the client may not be able to determine if they are too tight. The client has a right to pain relief and should not have to 'tolerate' pain for 20 minutes. Chewing gum or eating candy may increase the client's risk for aspiration during the procedure.
The nurse is discussing vitamin replacement with a client in the clinic. Which vitamin should the nurse discuss with the client in order to increase the absorption of folic acid and iron?
- A. Vitamin Bâ??â??
- B. Vitamin C
- C. Vitamin B6
- D. Vitamin E
Correct Answer: B
Rationale: Vitamin C enhances the absorption of folic acid and iron. Vitamin Bâ??â?? and folic acid are essential for the maturation of red blood cells. Vitamin B6 serves as a coenzyme in hemoglobin formation. Vitamin E protects blood cells from vitamin E-deficient hemolytic anemia.
A nurse is providing care to a cancer client. Which protein in plasma functions primarily as immunologic agents?
- A. Gamma globulins
- B. Albumin
- C. Fibrinogen
- D. Beta globulins
Correct Answer: A
Rationale: Globulins are divided into three groups: alpha, beta, and gamma. The gamma globulins are also called immunoglobulins. Globulins function primarily as immunologic agents; they prevent or modify some types of infectious diseases. The other options are incorrect.
Undifferentiated cells that migrate to the thymus gland develop into which of the following?
- A. A lymphocytes
- B. D lymphocytes
- C. T lymphocytes
- D. S lymphocytes
Correct Answer: C
Rationale: The thymus gland is lymphatic tissue in the upper chest that contains undifferentiated stem cells released from bone marrow. Once the undifferentiated cells migrate to the thymus gland, they develop into T lymphocytes because they are thymus derived. The other options are distractors for this question.
The nursing instructor is teaching her clinical group about laboratory blood tests. What is the major function of erythrocytes?
- A. Act as mediators for the immune system
- B. Destroy invading organisms
- C. Transportation of Oâ?? to the tissues and removal of COâ?? from the tissues
- D. Oxygenation of the brain
Correct Answer: C
Rationale: Erythrocytes (or RBCs) are flexible, anuclear (lacking a nucleus), biconcave disks covered by a thin membrane through which oxygen (Oâ??) and carbon dioxide (COâ??) pass freely. The flexibility of erythrocytes allows them to change shape as they travel through capillaries. Their major function is to transport Oâ?? to and remove COâ?? from the tissues. The RBCs are not involved in immunological functions, so choices A and B are not correct. Oxygenation of the brain is important but that is not a major function of RBCs.