Nokea
Which of the following would be the best lunch for a client with folic acid deficiency anemia?
- A. Bologna sandwich and vegetable soup
- B. Grilled cheese sandwich and tomato soup
- C. Coleslaw and cream of mushroom soup
- D. Spinach salad and bean soup
Correct Answer: D
Rationale: Spinach and beans are rich in folate, making this lunch ideal for folic acid deficiency anemia.
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The client is admitted to the emergency department after a motor-vehicle accident. The nurse notes profuse bleeding from a right-sided abdominal injury. Which intervention should the nurse implement first?
- A. Type and crossmatch for red blood cells immediately (STAT).
- B. Initiate an IV with an 18-gauge needle and hang normal saline.
- C. Have the client sign a consent for an exploratory laparotomy.
- D. Notify the significant other of the client’s admission.
Correct Answer: B
Rationale: Profuse bleeding requires immediate IV access with 18-gauge and NS (B) to stabilize hemodynamics. Crossmatch (A), consent (C), and notification (D) follow.
The client asks the nurse, 'They say I have cancer. How can they tell if I have Hodgkin's disease from a biopsy?' The nurse’s answer is based on which scientific rationale?
- A. Biopsies are nuclear medicine scans that can detect cancer.
- B. A biopsy is a laboratory test that detects cancer cells.
- C. It determines which kind of cancer the client has.
- D. The HCP takes a small piece out of the tumor and looks at the cells.
Correct Answer: C
Rationale: A biopsy identifies Hodgkin’s via Reed-Sternberg cells (C). It’s not a scan (A), not just a lab test (B), and involves microscopic cell analysis (D is partial but less precise).
Ferrous sulfate is prescribed for a client. She returns to the clinic in two weeks. Which assessment by the nurse indicates that she has NOT been taking iron as ordered?
- A. The client's cheeks are flushed.
- B. The client reports having more energy.
- C. The client complains of nausea.
- D. The client's stools are light brown.
Correct Answer: D
Rationale: Iron turns stool black. Light brown stools indicate the client has not been taking iron as prescribed. Flushed cheeks, increased energy, and nausea can be associated with iron therapy compliance.
Laboratory tests are prescribed for the client who has a smooth and reddened tongue and ulcers at the corners of the mouth. Which result would the nurse find if the client has iron-deficiency anemia?
- A. Low hemoglobin and hematocrit
- B. Elevated red blood cells (RBCs)
- C. Prolonged prothrombin time (PT)
- D. Elevated white blood cells (WBCs)
Correct Answer: A
Rationale: A. A smooth, red tongue, ulcers at the corners of the mouth (angular cheilosis), and a low Hgb are signs of iron-deficiency anemia. B. Excess RBCs are associated with polycythemia vera. C. Prolonged PT is seen with clients taking antico-agulants or experiencing a coagulation disorder. D. Elevated WBCs are not associated with iron-deficiency anemia but with an infection. Ulcers, if infected, would elevate the WBCs.
The nurse identifies a concept of hematologic regulation for a client diagnosed with leukemia. Which clinical manifestations support the concept?
- A. The client has petechiae on the trunk and extremities.
- B. The client complains of pain and swelling in the joints.
- C. The client has an Hbg of 9.7 and Hct of 32%.
- D. The client complains of a headache and slurred speech.
Correct Answer: A,C
Rationale: Petechiae (A) and low Hb/Hct (C) reflect leukemia’s impact on hematologic regulation (thrombocytopenia, anemia). Joint pain (B) is less common, and headache/slurred speech (D) suggest stroke.