A nurse is teaching the parents of a school-age child who has sickle cell anemia about managing the disease at home.
Which of the following instructions should the nurse include?

Report sudden, persistent headaches.

Apply cold compresses to painful areas.

Restrict fluid intake during times of stress.

Avoid meningococcal immunizations.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

The nurse should instruct the parents to report sudden, persistent headaches in a child with sickle cell anemia because it could be a sign of a cerebrovascular accident (stroke) Sickle cell anemia predisposes individuals to vaso-occlusive crises, which can lead to stroke due to impaired blood flow. Early detection and intervention are crucial in preventing complications.

Choice B rationale:

Applying cold compresses to painful areas may help in managing pain during vaso-occlusive crises, but it is not as critical as identifying signs of more severe complications such as stroke. This instruction does not address the urgency of reporting sudden, persistent headaches.

Choice C rationale:

Restricting fluid intake during times of stress is not appropriate for a child with sickle cell anemia. In fact, maintaining adequate hydration is important to prevent vaso-occlusive crises. Dehydration can exacerbate sickling of red blood cells, leading to more pain and complications.

Choice D rationale:

Avoiding meningococcal immunizations is not appropriate for a child with sickle cell anemia. In fact, children with sickle cell disease are at an increased risk of infections, including meningitis. Immunizations, including those for meningococcus, are essential to prevent life-threatening infections in these individuals.

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Correct Answer is ["A","C","E","G","H"]

Explanation

The correct answer is:Choices c, e, g, h, and a.

Choice A rationale (Current medications): The client is taking Ibuprofen 800 mg three times daily as needed for arthritis pain.Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can cause gastrointestinal irritation, ulcers, and bleeding, especially when used at high doses or for a prolonged period 1 2. Given the client’s symptoms of abdominal pain and a history of dark, tarry stool, the medication could be contributing to these symptoms and warrants further investigation.

Choice B rationale (Temperature): The client’s temperature is 37.5° C (99.5° F), which is within the normal range 3 4. Therefore, it does not require immediate follow-up.

Choice C rationale (Hemoglobin and hematocrit): The client’s hemoglobin level is 9.1 g/dL, which is lower than the normal range of about 13.0 to 17.5 g/dL for adult males and 12.0 to 15.5 g/dL for adult females 5 6.The client’s hematocrit is 27%, which is also lower than the normal range of about 38.3% to 48.6% for adult males and 35.5% to 44.9% for adult females 7.Low hemoglobin and hematocrit levels can indicate anemia, which could explain the client’s reported fatigue and pale mucous membranes 8 7.

Choice D rationale (WBC count): The client’s WBC count is 6,700/mm3, which falls within the normal range of about 4,500 to 11,000 WBCs per microliter 9 10. Therefore, it does not require immediate follow-up.

Choice E rationale (Blood pressure): The client’s blood pressure is 90/50 mm Hg, which is lower than the normal range 11. Low blood pressure can cause symptoms such as dizziness, fainting, or blurred vision and requires immediate follow-up.

Choice F rationale (Respiratory rate): The client’s respiratory rate is 18 breaths per minute, which is within the normal range for adults of about 12 to 20 breaths per minute 4 12. Therefore, it does not require immediate follow-up.

Choice G rationale (Stool results): The client’s stool tested positive for blood (Hemoccult positive), which could indicate gastrointestinal bleeding 13. This finding, combined with the client’s reported abdominal pain and history of dark, tarry stool, requires immediate follow-up.

Choice H rationale (Heart rate): The client’s heart rate is 118 beats per minute, which is higher than the normal range for adults of about 60 to 100 beats per minute 14.A high heart rate, or tachycardia, can be caused by factors such as stress, anxiety, physical exertion, dehydration, and certain medical conditions 14. Given the client’s reported symptoms and medical history, this finding warrants immediate follow-up.

A. Nonreactive pupils B. Smacking lips C. Serpentine limb movement D. Shuffling gait

Correct Answer is D

Explanation

A. Nonreactive pupils are not typically associated with pseudoparkinsonism.

B. Smacking lips is not typically associated with pseudoparkinsonism.

C. Serpentine limb movement is not typically associated with pseudoparkinsonism.

D. Correct. Pseudoparkinsonism is a side effect of antipsychotic medications like haloperidol. It is characterized by motor symptoms similar to Parkinson's disease, including a shuffling gait, rigidity, bradykinesia (slowed movement), and resting tremor.

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A nurse is teaching the parents of a school-age child who has sickle cell anemia about managing the disease at home.Which of the following instructions should the nurse include?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is ["A","C","E","G","H"]

Explanation

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Correct Answer is D

Explanation

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Which of the following instructions should the nurse include?