A patient who has sickle cell disease was admitted with a vaso-occlusive crisis and reports severe abdominal and flank pain. Which of the following analgesic medications will be MOST appropriate to administer to the patient?

Morphine Sulfate 4 mg IV ATC

Fentanyl 25 mcg/hr transdermal patch Now

Ibuprofen 800 mg PO

Hydromorphone liquid 5 mg PO

Answer and Explanation

The Correct Answer is A

A.   Morphine is a strong opioid analgesic that is effective for managing severe pain, especially in acute situations like a vaso-occlusive crisis. Administering it intravenously allows for rapid onset of pain relief, which is critical given the severity of the patient’s symptoms. Continuous dosing (ATC—around the clock) ensures that pain is managed effectively.
B.   Fentanyl patches are typically used for chronic pain management and take time to reach effective levels in the bloodstream (up to 12 hours or longer). In the case of acute severe pain from a vaso- occlusive crisis, this option would not provide immediate relief.
C.   While ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can help relieve mild to moderate pain, it is not adequate for severe pain management. Additionally, in the setting of sickle cell disease, patients may be at risk for renal issues, making high doses of NSAIDs potentially harmful.
D.   Hydromorphone is also a strong opioid analgesic; however, administering it orally may not be effective for severe pain management in an acute situation. IV administration of opioids is preferred for immediate and potent pain relief during a vaso-occlusive crisis.

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Correct Answer is B

Explanation

A. Neutrophils are the most abundant type of WBC and are primarily involved in responding to bacterial infections. While they may increase during a viral infection, their primary function is to combat bacteria and fungi. Therefore, they are not the most specific indicator of viral illnesses.
B. Lymphocytes, which include T cells and B cells, are the most directly associated with viral infections. They play a crucial role in the adaptive immune response, recognizing and responding to viral pathogens. A significant increase in lymphocytes, particularly T cells, is commonly seen during viral infections.
C. Basophils are involved in allergic reactions and responses to parasites, releasing histamine and other mediators. They are not significantly involved in the response to viral infections and typically do not show a notable increase in these situations.
D. Eosinophils primarily respond to parasitic infections and allergic reactions. While they may be elevated in some allergic conditions and certain parasitic infections, they are not directly involved in the immune response to viral infections.

A. "I will rinse raw fruits with water before eating them" B. “I will wear gloves while changing the kitty litter box" C. "I will wear a N95 mask when around sick family members" D. “I will cook vegetables before eating them"

Correct Answer is B

Explanation

A. While rinsing fruits is good practice, it may not fully eliminate the risk of pathogens, especially for someone with a compromised immune system.
B. This statement is the best indication of understanding how to prevent infections. Changing kitty litter can expose the client to Toxoplasma gondii, which is particularly risky for immunocompromised individuals. Wearing gloves is a direct and effective precaution.
C. Although wearing an N95 mask can be appropriate in certain situations, it may not be necessary for all interactions with sick family members. A standard surgical mask is often sufficient.
D. Cooking vegetables is a good practice for food safety, especially for immunocompromised individuals, but this statement is more general than specifically addressing a particular risk.

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A patient who has sickle cell disease was admitted with a vaso-occlusive crisis and reports severe abdominal and flank pain. Which of the following analgesic medications will be MOST appropriate to administer to the patient?

Nursing Test Bank

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