A nurse is collecting data from a child who has sickle-cell disease and is experiencing a vaso-occlusive crisis. Which of the following findings should the nurse expect?
Constipation
Vomiting
Pain
Bradycardia
The Correct Answer is C
A. Constipation: Vaso-occlusive crisis in sickle-cell disease is characterized by severe pain due to ischemia from blocked blood flow, rather than gastrointestinal symptoms like constipation.
B. Vomiting: Vomiting is not typically associated with vaso-occlusive crisis but may occur due to pain or other causes.
C. Pain: Pain is the hallmark symptom of vaso-occlusive crisis in sickle-cell disease, caused by ischemia and tissue damage.
D. Bradycardia: Bradycardia is not a typical finding in vaso-occlusive crisis; instead, tachycardia might be present due to pain or stress.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Remove clothing. Removing clothing is important to prevent further injury from retained heat or chemicals, but it is not the first priority compared to ensuring a patent airway and adequate breathing.
B. Administer pain medication. Pain management is important but comes after ensuring the child's airway and respiratory status are stable.
C. Assess respiratory status. Burns on the face and chest can compromise the airway and breathing. Assessing respiratory status is the first priority to ensure the child’s airway is not obstructed and that they are receiving adequate oxygen.
D. Insert a Foley catheter. Inserting a Foley catheter may be necessary to monitor urine output and assess kidney function in severe burns, but it is not the first priority compared to assessing respiratory status.
Correct Answer is C
Explanation
A. Wash bed linens in cold water. Washing bed linens in cold water is ineffective for killing pinworm eggs. Hot water should be used to properly sanitize linens and kill the eggs.
B. Clean the bathroom with bleach solution. While cleaning the bathroom with bleach can help reduce contamination, it is not a primary or effective measure for preventing pinworm spread and reinfection in a household setting.
C. Keep children's nails short. Keeping nails short reduces the likelihood of the child scratching the perianal area, where pinworm eggs are deposited, and then ingesting the eggs through hand-to-mouth contact. This helps prevent the spread and reinfection of pinworms.
D. Dress child in loose-fitting underwear. Loose-fitting underwear does not specifically help in preventing the spread or reinfection of pinworms. Tight-fitting underwear may actually be better to prevent the spread of eggs to other surfaces.
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