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 A
Explanation
A. Prolonged bleeding or easy bruising is a characteristic feature of hemophilia, a genetic
disorder characterized by deficient or defective blood clotting proteins, leading to impaired blood clotting and prolonged bleeding after injury or trauma.
B. Excessive blood clotting is not a characteristic feature of hemophilia; rather, it is the opposite.
Hemophilia is characterized by a deficiency in clotting factors, which results in impaired clot formation.
C. Hemophilia does not typically result in increased platelet count. Platelets are involved in the initial stages of blood clotting, but hemophilia primarily affects clotting factor proteins.
D. Delayed wound healing is not a characteristic feature of hemophilia. Hemophilia primarily affects blood clotting, leading to prolonged bleeding, but it does not directly affect wound
healing processes.
Correct Answer is C
Explanation
A. Presence of Bence-Jones protein in the urine is indicative of multiple myeloma, but hypercalcemia is a more urgent issue to address.
B. Severe back pain is common in multiple myeloma due to bone involvement, but it is not as immediately life-threatening as hypercalcemia.
C. Elevated serum calcium levels (hypercalcemia) are a common complication of multiple myeloma and can lead to various complications, including kidney damage, altered mental status, and cardiac arrhythmias. Therefore, it is crucial to report significantly elevated serum calcium levels promptly to the health care provider for appropriate management.
D. Patient reports no stool for 5 days may indicate constipation, which is important to address but is not as urgent as hypercalcemia in the context of multiple myeloma.
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