Nokea
The nurse is completing a care plan for a client diagnosed with leukemia. Which independent problem should be addressed?
- A. Infection.
- B. Anemia.
- C. Nutrition.
- D. Grieving.
Correct Answer: A
Rationale: Infection (A) is critical in leukemia due to neutropenia, requiring independent nursing actions (e.g., hygiene). Anemia (B), nutrition (C), and grieving (D) are collaborative or secondary.
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The male client with sickle cell anemia comes to the emergency department with a temperature of 101.4°F and tells the nurse that he is having a sickle cell crisis. Which diagnostic test should the nurse anticipate the emergency department doctor ordering for the client?
- A. Spinal tap.
- B. Hemoglobin electrophoresis.
- C. Sickle-turbidity test (Sickledex).
- D. Blood cultures.
Correct Answer: D
Rationale: Fever (101.4°F) in SCA crisis suggests infection; blood cultures (D) identify the cause. Spinal tap (A) is for meningitis, electrophoresis (B) confirms SCA, and Sickledex (C) screens for sickle trait.
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 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.
The client’s laboratory values are RBCs 5.5 (x106/mm3), WBCs 8.9 (x103/mm3), and platelets 189 (x103/mm3). Which intervention should the nurse implement?
- A. Prepare to administer packed red blood cells.
- B. Continue to monitor the client.
- C. Request an order for Neupogen, a biologic response modifier.
- D. Institute bleeding precautions.
Correct Answer: B
Rationale: Labs are normal (RBC 5.5, WBC 8.9, platelets 189); continue monitoring (B). Transfusions (A), Neupogen (C), and bleeding precautions (D) are unnecessary.
The client is scheduled to have a total hip replacement in two (2) months and has chosen to prepare for autologous transfusions. Which medication would the nurse administer to prepare the client?
- A. Prednisone, a glucocorticoid.
- B. Zithromax, an antibiotic.
- C. Ativan, a tranquilizer.
- D. Epogen, a biologic response modifier.
Correct Answer: D
Rationale: Epogen (D) stimulates RBC production for autologous donation. Prednisone (A), Zithromax (B), and Ativan (C) are unrelated.