A nurse is assessing a client 1 week after a successful bone marrow transplant. The client reports peeling of skin on her hands and feet. The nurse should recognize this desquamation as an indication of which of the following complications?

Failure to engraft

Veno-occlusive disease

Graft-versus-host disease

Pancytopenia

Answer and Explanation

The Correct Answer is B

A. Failure to engraft typically presents with symptoms such as persistent neutropenia, thrombocytopenia, and anemia, rather than skin peeling.

B. Veno-occlusive disease, also known as sinusoidal obstruction syndrome, can lead to liver dysfunction and subsequent skin manifestations such as peeling, especially on the palms and soles.

C. Graft-versus-host disease (GVHD) typically presents with symptoms such as skin rash, diarrhea, and liver dysfunction, but peeling skin is not a hallmark manifestation.

D. Pancytopenia refers to a deficiency of all types of blood cells (red blood cells, white blood cells, and platelets) and is not typically associated with skin peeling as a primary symptom.

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Correct Answer is A

Explanation

- A) Hyperreflexia is a common symptom of opioid withdrawal, as the nervous system reacts to the absence of the drug. Patients may experience increased reflex actions and muscle spasms due to the sudden change in opioid levels.
- B) Meiosis, or pupil constriction, is not typically a withdrawal symptom; it is more commonly associated with opioid use. During withdrawal, pupils are likely to dilate rather than constrict.
- C) Euphoria is a feeling of intense happiness or excitement, which is often experienced after taking opioids. During withdrawal, individuals are more likely to experience dysphoria, which is a state of unease or dissatisfaction.
- D) Hypothermia is not a recognized symptom of opioid withdrawal. Instead, individuals may experience fever or chills as the body adjusts to the lack of opioids.

A. "Brush teeth immediately after eating." B. "Lay down for 30 min after meals." C. "Drink 12 oz of water with each meal." D. "Eat a dry carbohydrate before getting out of bed."

Correct Answer is D

Explanation

A. Brushing teeth immediately after eating may exacerbate nausea in some individuals. It is recommended to wait a while after eating before brushing teeth, or rinse the mouth with water.

B. Lying down after meals can worsen symptoms of nausea and reflux. Remaining upright or sitting up after meals may help alleviate symptoms.

C. Drinking large amounts of water with meals may exacerbate feelings of fullness and contribute to nausea. Sipping small amounts of fluids between meals is recommended.

D. Eating a dry carbohydrate, such as crackers or toast, before getting out of bed can help alleviate morning sickness by stabilizing blood sugar levels and absorbing stomach acid.

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A nurse is assessing a client 1 week after a successful bone marrow transplant. The client reports peeling of skin on her hands and feet. The nurse should recognize this desquamation as an indication of which of the following complications?

Nursing Test Bank

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Correct Answer is A

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