A nurse is caring for a client who has sickle cell disease.
Client reports fatigue, muscle weakness, joint pain, and dyspnea. Sclera is jaundiced. A 2.5 cm (1 in) by 2.5 cm (1 in) open ulcer is noted on the inner left ankle.
For each client finding, click to specify if the finding is consistent with sickle cell disease, iron deficiency anemia, or leukemia. Each finding may support more than one disease process.
Joint pain
Heart Rate at 1000
Respiratory status
Jaundice
Ankle ulcer
The Correct Answer is {"A":{"answers":"A,C"},"B":{"answers":"A,B,C"},"C":{"answers":"A,B,C"},"D":{"answers":"A,C"},"E":{"answers":"A"}}
Joint Pain
Sickle Cell Disease: Joint pain is a common symptom of sickle cell disease due to vaso-occlusive crises, where sickle- shaped red blood cells block blood flow to the joints, causing pain and inflammation. These episodes can be severe and recurrent, leading to chronic pain and joint damage over time.
Leukemia: Joint pain can also be a symptom of leukemia, particularly in children. This occurs because leukemia cells can infiltrate the bone marrow, causing bone and joint pain. The pain is often due to the expansion of the marrow cavity by the leukemic cells.
Heart Rate at 1000
Sickle Cell Disease: An increased heart rate (tachycardia) can occur in sickle cell disease due to anemia. The body compensates for the reduced oxygen-carrying capacity of the blood by increasing the heart rate.
Iron Deficiency Anemia: Tachycardia is also a common symptom of iron deficiency anemia. The heart works harder to pump more blood to deliver adequate oxygen to tissues, resulting in an increased heart rate.
Leukemia: In leukemia, anemia can develop due to the replacement of normal bone marrow cells with leukemic cells, leading to a reduced number of red blood cells and subsequent tachycardia as the body attempts to compensate.
Respiratory Status
Sickle Cell Disease: Dyspnea (difficulty breathing) and labored breathing can occur in sickle cell disease due to anemia and acute chest syndrome, a severe complication where sickle cells block blood flow in the lungs.
Iron Deficiency Anemia: Respiratory symptoms such as shortness of breath and labored breathing are common in iron deficiency anemia due to the reduced oxygen-carrying capacity of the blood.
Leukemia: Leukemia can cause respiratory symptoms due to anemia and the infiltration of leukemic cells into the lungs, leading to reduced oxygenation and labored breathing.
Jaundice
Sickle Cell Disease: Jaundice is a common symptom of sickle cell disease due to the increased breakdown of red blood cells (hemolysis), leading to elevated bilirubin levels.
Leukemia: Jaundice can also occur in leukemia if the liver is infiltrated by leukemic cells or if there is significant hemolysis.
Ankle Ulcer
Sickle Cell Disease: Ankle ulcers are a common complication of sickle cell disease. They result from poor blood flow and oxygen delivery to the skin, leading to chronic, non-healing ulcers.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","E"]
Explanation
Choice A reason: The preschooler mispronounces words can be a sign of a speech sound disorder. While some mispronunciation is normal in early speech development, persistent difficulty with articulation may indicate a need for speech therapy to improve clarity and communication skills.
Choice B reason: The preschooler speaks in three-word sentences may indicate a delay in expressive language development. By preschool age, children typically use longer sentences and more complex language structures. Limited sentence length can suggest a need for further evaluation and intervention.
Choice C reason: The preschooler stutters when speaking can be a sign of a fluency disorder. Stuttering involves disruptions in the flow of speech, such as repetitions, prolongations, or blocks. Early intervention with speech therapy can help manage and reduce stuttering.
Choice D reason: The preschooler talks to himself when reading is generally not a concern. Self-talk can be a normal part of development and learning, as children often verbalize their thoughts and actions. It does not typically indicate a need for speech therapy.
Choice E reason: The preschooler speaks in a nasally tone can indicate a resonance disorder, which affects the quality of the voice. A nasally tone may result from structural issues or improper use of the vocal tract. Speech therapy can help address these issues and improve vocal quality.
Correct Answer is C
Explanation
Choice A reason:
The statement “I will take this medication with an antacid” is incorrect. Sucralfate should not be taken simultaneously with antacids because antacids can interfere with the effectiveness of sucralfate. If antacids are needed, they should be taken at least 30 minutes before or after sucralfate.
Choice B reason:
The statement “I will reduce my fluid intake with this medication” is incorrect. There is no need to reduce fluid intake while taking sucralfate. In fact, maintaining adequate hydration is important for overall health and can help with the medication’s effectiveness.
Choice C reason:
The statement “I will take this medication 1 hour before meals and at bedtime” is correct. Sucralfate works best when taken on an empty stomach, typically 1 hour before meals and at bedtime. This timing helps the medication form a protective barrier over the ulcer, promoting healing.
Choice D reason:
The statement “I will take this medication as needed to reduce pain” is incorrect. Sucralfate is not intended to be taken on an as-needed basis for pain relief. It should be taken regularly as prescribed to effectively treat and heal the ulcer.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.