A nurse is assisting with the care of a 7-year-old child.

Exhibits
The nurse is reviewing the data collection findings and diagnostic results. For each data collection finding, click to specify if the finding is consistent with leukemia, sickle cell anemia, or hemophilia. Each finding may support more than 1 disease process.

Reported pain

Bleeding

Temperature

Bruising

WBC count

Answer and Explanation

The Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A,C"},"C":{"answers":"A,B"},"D":{"answers":"A"},"E":{"answers":"A"}}

Reported pain

Leukemia: Possible, as bone pain can occur due to marrow involvement.
Sickle Cell Anemia: Yes, common due to vaso-occlusive crises.
Hemophilia: No, hemophilia typically causes bleeding rather than pain from blood cell abnormalities.

Bleeding

Leukemia: Yes, due to thrombocytopenia.
Sickle Cell Anemia: No, bleeding is not typical in sickle cell crises.
Hemophilia: Yes, hemophilia is a bleeding disorder due to a clotting factor deficiency.

Temperature

Leukemia: Yes, fever can indicate infection due to immunosuppression.
Sickle Cell Anemia: Yes, fever can be a sign of infection during crises.
Hemophilia: No, hemophilia does not cause fever unless there is an infection.

Bruising

Leukemia: Yes, thrombocytopenia can lead to easy bruising.
Sickle Cell Anemia: No, bruising is not typical in sickle cell crises.
Hemophilia: Yes, due to a clotting factor deficiency, easy bruising is common.

WBC count

Leukemia: Yes, often elevated due to immature or abnormal white cells.
Sickle Cell Anemia: No, WBC count is usually normal unless there is an infection.
Hemophilia: No, WBC count is typically normal in hemophilia.

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Correct Answer is D

Explanation

A. Malformed RBCs: Malformed RBCs are not caused by a transfusion reaction; they are generally a result of bone marrow abnormalities or genetic conditions.

B. A deficiency in vitamin B12: Vitamin B12 deficiency causes megaloblastic anemia, not hemolysis. It is unrelated to transfusion reactions.

C. An abundance of immature RBCs: Immature RBCs, or reticulocytes, can increase as a compensatory response to anemia but are not a direct result of a transfusion reaction. The primary issue is RBC destruction.

D. Destruction of RBCs: A hemolytic reaction occurs when the immune system attacks incompatible red blood cells, leading to their destruction.

A. Explain the procedure to the patient’s family B. Observe the patient for bleeding C. Drape the biopsy site D. Administer an analgesic to the patient

Correct Answer is D

Explanation

A. Explain the procedure to the patient’s family: While helpful, this is not as crucial as ensuring patient comfort and pain management during the procedure itself.

B. Observe the patient for bleeding: Observing for bleeding is important post-procedure rather than beforehand.

C. Drape the biopsy site: Draping is part of the procedure setup, but pain management is more critical for patient preparation.

D. Administer an analgesic to the patient: Administering an analgesic is essential to manage pain and discomfort during a bone marrow biopsy. This ensures the patient is as comfortable as possible.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient receiving treatment for a hemolytic reaction from a mismatched blood transfusion. The nurse understands that this the incompatible blood is causing what?

Correct Answer is D

Explanation

The nurse is preparing to assist the physician with a bone marrow biopsy. Which of the following interventions is most important for the nurse to carry out before the procedure?

Correct Answer is D

Explanation

The nurse is caring for the patient who is 1-day status post splenectomy. The patient complains of pain of a 3 on inspiration. What would be the most appropriate priority nursing intervention for this patient?

The nurse is reviewing laboratory values for a patient with thrombocytopenia associated with ITP. Which result would concern the nurse the most?

A nurse is assisting with the discharge of a child who has sickle cell anemia and is recovering from an acute sickle cell crisis. Which of the following instructions should the nurse reinforce with the child's parents?

A nurse is reinforcing teaching with a client has a new diagnosis of aplastic anemia. When discussing the pathology of this disease, which of the following instructions should the nurse include in the teaching?

The nurse is caring for a patient in sickle cell crisis. What is the rationale for providing warm compresses and blankets for this patient?

The nurse is caring for a patient with stage IV Hodgkin disease. Where should the nurse expect to find enlarged lymph nodes during the assessment?

The nurse is triaging several patients in an urgent care center. One patient states that he has hemophilia and is bleeding, with no apparent signs of bleeding. Which priority action by the nurse is most appropriate at this time?

The nurse is reviewing laboratory values for a female patient and notes a hemoglobin level of 8.2 g/100 mL (12-16) and a hematocrit level of 21% (37% -47%). These levels are found in patients with which condition?