TJ, a 30-year-old client is admitted in sickle cell crisis with symptoms of dyspnea and leg pain. TJ's significant other asks, "I don't really understand why he is hurting so badly." Which of the following responses by the nurse is best?
"Clumping of abnormal red blood cells blocks the flow of blood through the capillaries."
"Bleeding in the joints occurs because red blood cells are being rapidly destroyed by the bone marrow."
"The pain is due to a disturbance in cellular metabolism."
"The bone marrow is expanding with the sickled cells and that causes pain."
The Correct Answer is A
A. This response accurately describes the pathophysiology of sickle cell crisis. During a crisis, sickled red blood cells clump together, leading to microvascular occlusion and impaired blood flow to tissues, resulting in pain.
B. Bleeding in the joints is not a characteristic feature of sickle cell crisis. It may occur in other conditions such as hemophilia or osteoarthritis but not in sickle cell crisis.
C. Disturbance in cellular metabolism is not the primary mechanism underlying the pain experienced during sickle cell crisis.
D. Bone marrow expansion with sickled cells may contribute to bone pain in sickle cell disease, but it is not the primary cause of pain during a sickle cell crisis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Cyclosporine. While cyclosporine is used to treat aplastic anemia, particularly in cases of immune-mediated aplastic anemia, it is not considered a potential cure.
B. Stem cell transplantation. Stem cell transplantation is both a standard treatment and a potential cure for aplastic anemia, especially for younger patients with a suitable donor.
C. Plasmapheresis. Plasmapheresis is not a standard treatment for aplastic anemia.
D. Transfusions. Blood transfusions are a supportive treatment for aplastic anemia but not a cure.
Correct Answer is B
Explanation
A. Reticulocyte count: Reticulocyte count measures immature red blood cells and is not the primary measure for the effectiveness of filgrastim, which is used to boost white blood cells.
B. White blood count / Absolute neutrophil count: Filgrastim (Neupogen) is used to increase white blood cells, specifically neutrophils. Therefore, monitoring the white blood count (WBC) and absolute neutrophil count (ANC) is the appropriate way to determine the effectiveness of the drug.
C. Total lymphocyte count: While lymphocytes are a type of white blood cell, filgrastim primarily affects neutrophils, making WBC/ANC a better indicator.
D. Platelet count: Filgrastim does not directly impact platelet production, so platelet count is not the primary measure of its effectiveness.
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