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 D
Explanation
A. "Dietary supplements have not been tested and approved by the government." While this statement may be true, it is not directly related to the potential interaction between dietary supplements and nitroglycerin.
B. "Dietary supplements may be expensive and are not typically covered by insurance." While cost considerations are important, they are not directly related to the potential interaction
between dietary supplements and nitroglycerin.
C. "There is not enough evidence that dietary supplements are effective for erectile dysfunction."
While this statement may be true, it is not directly related to the potential interaction between dietary supplements and nitroglycerin.
D. "Dietary supplements can cause a drug-drug interaction with nitrates." Nitroglycerin is a medication commonly used for angina, and it interacts with erectile dysfunction medications
such as sildenafil (Viagra) due to its vasodilatory effects, potentially causing severe hypotension.
Therefore, it is crucial for the nurse to educate the client about the risk of interactions between dietary supplements and nitroglycerin.
Correct Answer is B
Explanation
A. Dusky mucous membranes are not typically associated with pernicious anemia.
B. A red tongue that is smooth and sore is a common finding in pernicious anemia due to vitamin B12 deficiency, which affects the epithelial cells of the tongue.
C. Shortness of breath on exertion can occur in many types of anemia but is not specific to pernicious anemia.
D. Dyspnea is also a common symptom in various anemias but is not as characteristic as the red, smooth, and sore tongue in pernicious anemia.
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