A nurse is caring for an oldest patient.
For each potential provider’s prescription, click to specify if the potential prescription is anticipated or contraindicated for the client.
Ice packs to affected area 15 minutes on, 15 minutes off
Intravenous fluids (IVF) at maintenance rate
Ketorolac IV for pain
Ambulate in hallway with supervision
Meperidine IV for pain
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"B"}}
Choice A: Ice packs to affected area 15 minutes on, 15 minutes off
Reason: Ice packs are generally contraindicated for patients with sickle cell disease (SCD). The use of ice packs can cause vasoconstriction, which narrows blood vessels and reduces blood flow. This can exacerbate the pain and potentially trigger a vaso-occlusive crisis (VOC) by further restricting blood flow to the already compromised areas. Studies have shown that cold exposure can worsen pain in SCD patients, making ice packs an unsuitable option.
Choice B: Intravenous fluids (IVF) at maintenance rate
Reason: Intravenous fluids are anticipated for patients with SCD, especially during a pain crisis. Hydration is crucial as it helps to reduce the viscosity of the blood, thereby improving blood flow and reducing the likelihood of sickling. Adequate hydration can help to alleviate pain and prevent further complications. The administration of IV fluids is a standard practice in managing acute pain episodes in SCD patients.
Choice C: Ketorolac IV for pain
Reason: Ketorolac, a nonsteroidal anti-inflammatory drug (NSAID), is anticipated for managing pain in SCD patients. It provides effective pain relief without the risks associated with opioids, such as respiratory depression and dependence. Ketorolac works by inhibiting the production of prostaglandins, which are involved in the inflammatory process and pain signaling. It is particularly useful for acute pain management in SCD patients.
Choice D: Ambulate in hallway with supervision
Reason: Ambulation during a pain crisis is generally contraindicated for SCD patients. Movement can increase pain and stress on the affected areas, potentially worsening the condition. During a VOC, patients are often advised to rest and avoid activities that could exacerbate the pain. While physical activity is important for overall health, it should be carefully managed and avoided during acute pain episodes.
Choice E: Meperidine IV for pain
Reason: Meperidine is contraindicated for pain management in SCD patients due to its potential for serious side effects. Meperidine can accumulate in the body and produce a toxic metabolite called normeperidine, which can cause seizures and other adverse effects. Additionally, meperidine is less effective than other opioids and has a higher risk of causing dependency and other complications. Therefore, it is not recommended for managing pain in SCD patients.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D"]
Explanation
Choice A reason: Add Cream to Soups
Adding cream to soups is an excellent way to increase both calorie and protein intake. Cream is rich in fat and calories, which can help in weight gain and provide the necessary energy for clients undergoing chemotherapy. Additionally, it enhances the flavor and texture of soups, making them more palatable for clients who may have a reduced appetite due to treatment.

Choice B reason: Dip Meats in Eggs and Bread Crumbs Before Cooking
Dipping meats in eggs and bread crumbs before cooking adds extra calories and protein. Eggs are a good source of high-quality protein, and bread crumbs add additional calories. This method also helps to create a more appealing texture and flavor, which can be beneficial for clients experiencing taste changes due to chemotherapy.
Choice C reason: Use Milk Instead of Water in Recipes
Using milk instead of water in recipes is another effective strategy to boost calorie and protein intake. Milk contains essential nutrients, including protein, calcium, and vitamins, which are important for maintaining strength and health during chemotherapy. This substitution can be applied to various recipes, such as oatmeal, mashed potatoes, and smoothies.
Choice D reason: Top Fruits with Yogurt
Topping fruits with yogurt not only increases calorie and protein intake but also adds beneficial probiotics. Yogurt is a good source of protein and calcium, and when combined with fruits, it provides a nutritious and appealing snack or dessert. This combination can help improve appetite and provide essential nutrients needed during chemotherapy.
Choice E reason: Increase Fluids During Meals
Increasing fluids during meals is not specifically aimed at increasing calorie and protein intake. While staying hydrated is important, excessive fluid intake during meals can sometimes lead to a feeling of fullness, which may reduce overall food intake. It is better to focus on nutrient-dense foods and beverages that provide both hydration and essential nutrients.
Correct Answer is D
Explanation
Choice A reason:
A client with a tracheostomy tube attached to humidified oxygen is not typically at risk for hypokalemia. The primary concerns for these clients are maintaining a patent airway, preventing infection, and ensuring adequate humidification to prevent mucus plugging.
Choice B reason:
A client with an indwelling urinary catheter to gravity drainage is not specifically at risk for hypokalemia. The main risks for these clients include urinary tract infections and ensuring proper catheter care to prevent blockages.
Choice C reason:
A client with a chest tube to water seal is primarily at risk for complications related to the chest tube itself, such as infection, pneumothorax, or improper drainage. Hypokalemia is not a common risk associated with chest tubes.
Choice D reason:
A client with a nasogastric tube to suction is at risk for hypokalemia. Continuous suctioning can lead to the loss of gastric contents, which contain potassium, leading to a decrease in potassium levels in the body. This can result in hypokalemia, which needs to be monitored and managed appropriately.

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