The nurse is assessing a Client who presented with fatigue, weakness, and a low hemoglobin level. Which of the following Signs and symptoms would lead the nurse to Suspect hemolytic anemia?

History of menorrhagia

Yellowing of the skin and eyes

Long-term use of omeprazole

History of frequent hospital visits for vaso-occlusive crises

Answer and Explanation

The Correct Answer is B

A. Menorrhagia (heavy menstrual bleeding) is more indicative of iron deficiency anemia.

B. Hemolytic anemia involves increased red blood cell destruction, leading to the release of bilirubin and causing jaundice (yellowing of the skin and eyes).

C. Long-term omeprazole use is associated with vitamin B12 deficiency anemia, not hemolytic anemia.

D. Frequent hospital visits for vaso-occlusive crises are characteristic of sickle cell disease, which can cause hemolytic anemia but has a distinct pathophysiology.

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Correct Answer is A

Explanation

A. The priority action is to stop the transfusion immediately and disconnect the blood tubing to prevent further infusion of the possibly incompatible blood product. The nurse should then maintain IV access with normal saline using new tubing.

B. Slowing the transfusion is inappropriate; any signs of a transfusion reaction require stopping it immediately.

C. The provider and blood bank should be notified, but stopping the transfusion is the priority.

D. Epinephrine is used for anaphylactic reactions with airway involvement. The nurse should assess further before administering it.

A. Advise the client that they are currently at high risk for transmitting the disease. B. Encourage adequate nutrition. exercise, sleep. and standard infection prevention practices. C. Encourage antibiotic prophylaxis to keep viral load from elevating, D. Inform the client that they have been cured of their condition and will no longer require treatment.

Correct Answer is B

Explanation

A. An "undetectable" viral load means the risk of HIV transmission is significantly reduced ("Undetectable = Untransmittable" or U=U), though precautions should still be followed.

B. Clients with a low CD4+ count (<200 cells/µL) are at increased risk for opportunistic infections. Encouraging a healthy lifestyle and infection prevention helps maintain immune function.

C. Antibiotic prophylaxis is considered for clients with CD4+ counts <200 cells/µL, but it does not prevent viral load elevation.

D. There is no cure for HIV; lifelong ART is required to maintain viral suppression.

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