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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The nurse and an unlicensed assistive personnel (UAP) are caring for clients in a bone marrow transplantation unit. Which nursing task should the nurse delegate?
- A. Take the hourly vital signs on a client receiving blood transfusions.
- B. Monitor the infusion of antineoplastic medications.
- C. Transcribe the HCP’s orders onto the medication administration record (MAR).
- D. Determine the client’s response to the therapy.
Correct Answer: A
Rationale: Taking vital signs (A) is within UAP scope during transfusions. Monitoring chemo (B), transcribing orders (C), and evaluating response (D) require nursing judgment.
The client asks the nurse to look at a lesion on the client’s body. Which characteristics should prompt the nurse to consider that the client may have a basal cell carcinoma (BCC)?
- A. Nodular in appearance, depression in the center, and has a “pearly” characteristic
- B. Irregular color, surface, and border, less than one centimeter, and appears eroded
- C. Dry, hyperkeratotic scaly-like papule and has the appearance similar to a wart
- D. Vesiculopustular lesion with a thick, honey-colored crust and pruritic in nature
Correct Answer: A
Rationale: BCC is nodular and ulcerative. Clinical manifestations include small, slowly enlarging papule; borders are translucent or “pearly” with overlying telangiectasia; erosion, ulceration, and depression of center. B. Clinical manifestations of malignant melanoma (not BCC) include irregular color, surface, and border; variegation of color including red, white, blue, black, gray, brown; flat or elevated; eroded or ulcerated. C. Actinic keratosis (not BCC) is characterized by being horny and “wartlike.” D. Impetigo is characterized by thick, honey-colored crusts and is treated with antibiotics and topical treatment.
The client diagnosed with esophageal cancer is having work-related problems that are interfering with the client's treatment. Which organization should the nurse advise the client to contact for assistance with these issues?
- A. National Cancer Institute
- B. Leukemia Society of America
- C. Corporate Angel Network
- D. Patient Advocate Foundation
Correct Answer: D
Rationale: A. The National Cancer Institute answers questions and has free information about cancer. B. The Leukemia Society of America provides education regarding leukemia. C. The Corporate Angel Network provides free plane transportation for cancer clients going to and from treatment centers. D. The Patient Advocate Foundation provides counseling to resolve job-related problems.
The client diagnosed with end-stage renal disease (ESRD) has developed anemia. Which would the nurse anticipate the HCP prescribing for this client?
- A. Place the client in reverse isolation.
- B. Discontinue treatments until blood count improves.
- C. Monitor CBC daily to assess for bleeding.
- D. Give client erythropoietin, a biologic response modifier.
Correct Answer: D
Rationale: ESRD causes erythropoietin deficiency; prescribing erythropoietin (D) treats anemia. Isolation (A), stopping treatment (B), and daily CBC (C) are inappropriate.
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.