The nurse is caring for a client who has just been admitted for vaso-occlusive sickle cell crisis. The client's Vital signs are: HR 1 10/min, BP 138/82, RR 22, Sp02 97% on 2 liters oxygen by nasal cannula. T. 98.8. pain 10/10 to the left lower extremity. Which of the following actions should the nurse take first?

Increase oxygen to 6 liters per minute.

Administer PRN Morphine Sulfate IV push for pain.

Request an order for a PRN antihypertensive medication.

Begin administering prescribed IV fluids.

Answer and Explanation

The Correct Answer is B

A. The client’s SpO2 is already at 97%, so increasing oxygen is unnecessary. Oxygen is only required if hypoxia is present.

B. Pain management is the priority in vaso-occlusive crisis. Severe pain leads to stress, increasing oxygen demand and worsening sickling. IV opioids (e.g., morphine) are the standard treatment.

C. The BP is elevated but not critically high, and pain-related stress may be contributing. Treating pain first is the priority.

D. IV fluids help with hydration and reducing sickling, but pain management should be addressed first to provide immediate relief.

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Correct Answer is C

Explanation

A. Neutrophil count is not a direct measure of ART effectiveness; a decrease may indicate bone marrow suppression or infection.

B. A decreased CD4+ T-cell count suggests disease progression, not effective treatment.

C. A decreased viral load indicates that ART is effectively suppressing HIV replication. This is the primary goal of treatment to prevent disease progression and maintain immune function.

D. A decreased white blood cell count can result from various factors and does not indicate ART effectiveness.

A. Oral iron supplementation B. Transfusion Of packed red blood cells C. High-volume Infusion of 0.454 sodium chloride IV D. Intramuscular cyanocobalamin (B-12)

Correct Answer is A

Explanation

A. Oral iron supplementation is helpful for chronic anemia but is not effective for acute blood loss.

B. A hemoglobin of 6.3 g/dL in a hemorrhagic patient requires immediate transfusion of packed red blood cells (PRBCs) to restore oxygen-carrying capacity and prevent shock.

C. Hypovolemia should be managed with isotonic IV fluids (e.g., 0.9% NS or lactated Ringer’s), not hypotonic solutions like 0.45% sodium chloride.

D. Cyanocobalamin (B-12) is used for pernicious anemia but is not relevant for acute blood loss.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is monitoring the effectiveness of antiretroviral therapy (ART) for a patient with human immunodeficiency virus (HIV). What laboratory study result indicates the medications are effective?

Correct Answer is C

Explanation

The nurse is caring for a client who presented to the emergency room with hemorrhage from a motor vehicle accident. The client's hemoglobin is 6.3gfdL. Which Of the following treatments would the nurse anticipate the physician ordering?

Correct Answer is A

Explanation

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?

The nurse is providing discharge education for a client who will be taking ferrous sulfate orally. Which of the following statements should the nurse include in the teaching?

The nurse is providing discharge teaching to a client newly diagnosed With HIV. Which of the following statements would the nurse include in the teaching to reduce the risk of opportunistic infections? Select all that apply.

Eight years after beginning antiretroviral therapy (ART), a patient with human immunodeficiency virus infection has a CD4+ cell count of 81 cell/L and an "undetectable" viral load. Which intervention would the nurse include in the plan of care?

A client is tested for human immunodeficiency virus (HIV) infection with an enzyme-linked immunosorbent assay (ELISA), and the test result is positive. What would the nurse tell the client?

A client newly diagnosed with HIV asks, "Why did my sore throat and rash go away? Does this mean I'm better? Which is the best response to give to the client?