Nokea
When the 14-year-old patient comes into the emergency room in sickle cell crisis, which should be the primary focus of care?
- A. Genetic counseling
- B. Applying ice packs
- C. Pain relief measures
- D. Providing iron replacements
Correct Answer: C
Rationale: Pain control during the crisis is the focus. Continuous opioids are the mainstay of pain management. Genetic counseling would not be appropriate during a crisis. Ice packs would constrict blood vessels, thus contributing to more pain. Iron replacement is not usually given with sickle cell anemia.
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The nurse is reading the results of a white blood cell count differential. Which abnormal reading indicates a severe allergic reaction?
- A. Increased basophil count
- B. Increased lymphocyte count
- C. Increased monocyte count
- D. Increased neutrophil count
Correct Answer: A
Rationale: An increased basophil count may indicate a severe allergic reaction.
The nurse examines the complete blood count (CBC) to assess which level?
- A. hematocrit.
- B. red cell count.
- C. differential white blood cell count.
- D. plasma level.
- E. blood type.
- F. hemoglobin.
Correct Answer: A,B,C,F
Rationale: The CBC gives information relative to RBC, WBC, hematocrit, hemoglobin, erythrocyte indexes, WBC differential, and examination of the peripheral blood cells.
In caring for a patient with multiple myeloma, which should the nurse prioritize from the plan of care?
- A. Limit fluid intake to less than 1000 mL/day
- B. Closely supervise and assist when ambulating
- C. Strain all urine for kidney crystals
- D. Limit the use of an analgesic
Correct Answer: B
Rationale: Because of the constant threat of pathologic fractures, ambulation should be carefully supervised and assisted. Fluids are not restricted. Uric acid is increased and may crystalize in the kidney, but straining is not necessary. Analgesia is necessary for relief of bone pain.
The hematopoietic stem cell transplant (Bone marrow transplant) is used for a patient with which disease?
- A. Iron deficiency anemia
- B. Aplastic anemia
- C. Leukemia
- D. Pernicious anemia
- E. Myelodysplastic syndrome
Correct Answer: B,C,E
Rationale: Bone marrow transplant may be used for aplastic anemia, leukemia and myelodysplastic syndrome. It is not used for iron deficiency anemia or pernicious anemia.
The 9-year-old child with leukemia who is on palliative care has drawn a picture of a boy under a huge black cloud that has lightning coming out of it. Which would be an appropriate intervention for the nurse?
- A. What is this picture about?'
- B. Are you afraid of lightning?'
- C. I bet this is a picture of you, isn't it?'
- D. Is it about to rain in your picture?'
Correct Answer: A
Rationale: Asking what the child has drawn is a neutral and nonthreatening question. Drawings can give a clue to perceptions and emotions that a young child may not be able to verbalize. The nurse should not try to interpret the drawing.