Nokea
The nurse is caring for multiple 25-year-old female clients. The nurse should plan to consult the HCP about a referral for genetic counseling and family planning for which clients?
- A. Client diagnosed with thalassemia major
- B. Client diagnosed with sickle cell anemia
- C. Client diagnosed with hemophilia A
- D. Client diagnosed with autoimmune hemolytic anemia
- E. Client diagnosed with hemophilia B
Correct Answer: A, B, C, E
Rationale: Thalassemia is a hereditary disorder; the client could benefit from a referral for genetic counseling. B. Sickle cell anemia is a hereditary disorder; the client could benefit from a referral for genetic counseling. C. Hemophilia A is a hereditary disorder; the client could benefit from a referral for genetic counseling. D. Autoimmune hemolytic anemia is an acquired hemolytic anemia. E. Hemophilia B is a hereditary disorder; the client could benefit from a referral for genetic counseling.
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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.
Which of the following would be the most appropriate snack for a client who has iron deficiency anemia?
- A. Half of a grapefruit
- B. A carrot raisin salad
- C. A cup of yogurt
- D. Apple slices and cheese
Correct Answer: B
Rationale: Carrot raisin salad contains raisins, which are a good source of iron, making it appropriate for iron deficiency anemia.
The client who received 50 mL from a unit of whole blood has low back pain. In response to this client’s symptom, which action should be taken by the nurse first?
- A. Reposition the client.
- B. Assess the pain further.
- C. Administer an analgesic.
- D. Stop the blood transfusion.
Correct Answer: D
Rationale: A. Repositioning focuses on treating the client’s back pain and not on the blood transfusion, which could be the cause of the back pain. B. Further assessment should occur after stopping the blood transfusion. C. The client may need an analgesic for pain control, but this should occur after stopping the blood transfusion. D. Low back pain is a symptom of a potentially life-threatening acute hemolytic reaction. The pain is caused from agglutination of RBCs in the kidneys and renal vasoconstriction. Hemolytic reactions occur most often within the first 50 mL of the infusion.
Which interrelated psychological concept is priority for the nurse caring for a client diagnosed with leukemia?
- A. Comfort.
- B. Stress.
- C. Grieving.
- D. Coping.
Correct Answer: C
Rationale: Leukemia’s life-threatening nature makes grieving (C) a priority, addressing loss of health. Comfort (A), stress (B), and coping (D) are secondary.
The client diagnosed with leukemia has received a bone marrow transplant. The nurse monitors the client’s absolute neutrophil count (ANC). What is the client’s neutrophil count if the WBCs are 2.2 (x103/mm3), neutrophils are 25%, and bands are 5%?
Correct Answer: 660
Rationale: ANC = WBC × (neutrophils% + bands%). WBC = 2,200/mm3, neutrophils = 25%, bands = 5%. ANC = 2,200 × (0.25 + 0.05) = 2,200 × 0.3 = 660/mm3.