Sickle Cell Anemia NCLEX QUESTIONS

The nurse is caring for a child who is in the hospital experiencing sickle cell crisis. The parents are asking the nurse which treatment will help cure the child. The nurse responds with which of the following?

Treatment is aimed at pain control, oxygen therapy, and hydration, but does not provide a cure. Rationale: Treatment for sickle cell crisis is pain control, oxygenation, and fluid resuscitation. There is no cure for sickle cell disease. The nurse teaches families how to prevent sickle cell crisis.

A pregnant woman tells the nurse that there is a history of sickle cell disease in her family and she is afraid that the baby will have the disease. The nurse provides the client with which of the following information?

Both the mother and father must carry the gene for the baby to be affected. Rationale: Sickle cell is inherited as an autosomal recessive disorder. Both parents must carry the gene for the baby to be affected. The other statements are inaccurate.

A newly admitted client has sickle cell crisis. The nurse is planning care based on assessment of the client. The client is complaining of severe pain in his feet and hands. The pulse oximetry is 89. Which of the following interventions would be implemented first? Assume that there are orders for each intervention. a. Adjust the room temperature b. Give a bolus of IV fluids c. Start O2 d. Administer meperidine (Demerol) 75mg IV push

C

The 24-year old African American female client tells the nurse she has a brother with sickle cell disease. She is engage to be married and is concerned about giving this disease to her future children. which information is most important to provide too the client? A. tell the client that she won't pass this on if she has never had symptoms B. Encourage the client to discuss this concern with her fiance C. Recommend that she and her fiance see a genetic counselor D. Discuss the possibility of adopting children after she gets married.

C

A 14 year old girl has been hospitalized with Sickle Cell Anemia in vasoocclusive crisis. Which of these Nursing diagnoses should receive priority in the Nursing plan of care? -- A. Impaired social interaction -- B. Alteration in body image -- C. Pain -- D. Alteration in tissue perfusion

D

A 43-year-old African American male is admitted with sickle cell anemia. The nurse plans to assess circulation in the lower extremities every 2 hours. Which of the following outcome criteria would the nurse use? A. Body temperature of 99°F or less B. Toes moved in active range of motion C. Sensation reported when soles of feet are touched D. Capillary refill of < 3 seconds

D

The male client with sickle cell anemia comes to the emergency room with a temperature of 101.4 F and tells the nurse that he is having a sickle cell crisis. Which diagnostic test should the nurse anticipate the emergency room doctor ordering for the client? -- A. Spinal tap. -- B. Hemoglobin electrophoresis. -- C. Sickle-turbidity test (Sickledex). -- D. Blood cultures.

D

The nurse is admitting a 7-year-old client who is experiencing sickle cell crisis and plans care based on which of the following nursing diagnoses?

Delayed Growth and Development Rationale: The child with sickle cell disease is often developmentally delayed due to the effects of physical disability, pain, and inpatient hospital stays. The nurse would plan activities that help maintain developmental levels the child has reached. The child in sickle cell crisis does not experience ineffective airway clearance, bleeding, or constipation as a result of sickle cell disease. The child may have an illness that could cause one of these symptoms, but they are not common to children with sickle cell disease.

The nurse is caring for a client in a sickle cell crisis. which is the pain regiment of choice to relieve the pain? 1. Frequent aspirin 2. Motrin 3. Demerol 4. Morphine

4. Morphine

Which s/s will the nurse expect to assess in the client diagnosed with a vaso-occlusive sickle cell crisis 1. lordosis 2.epistaxis 3. hematuria 4. petechia

3. Vaso-occlusive crisis, the most frequent crisis, is characterized by organ infarction, which will result in bloody urine secondary to kidney infarction.

The nurse is teaching a group of parents whose children have sickle cell anemia. When a parent asks the cause of the symptoms, the nurse responds with which of the following?

"Sickled cells clump in the smaller blood vessels and obstruct blood flow." Rationale: All the symptoms of sickle cell are a result of the clumping of the sickled cells in the microvasculature, causing obstruction of blood flow. The other statements are inaccurate.

A 25-year-old male is admitted in sickle cell crisis. Which of the following interventions would be of highest priority for this client? A. Taking hourly blood pressures with mechanical cuff B. Encouraging fluid intake of at least 200mL per hour C. Position in high Fowler's with knee gatch raised D. Administering Tylenol as ordered

B

A child with suspected sickle cell disease (SCD) is in the clinic for laboratory studies. The parents ask the nurse what results will tell the physician that their child has SCD. The nurse responds that which of the following is increased in this disease?

Reticulocyte count Rationale: The reticulocyte count will be increased because the life span of sickled red blood cells is shortened. Hemoglobin, hematocrit, and platelet levels will be decreased.

Which of the following foods would the nurse encourage the client in sickle cell crisis to eat? -- A. Peaches -- B. Cottage cheese -- C. Popsicles -- D. Lima beans

C

the student nurse asks the nurse, "what is sickle cell anemia?" which statement by the nurse would be the best answer to the student's question? 1. There is some written material at the desk 2. it is a congenital disease of the blood 3. the client has decreased synovial fluid 4. the blood becomes thick when the client is deprived of oxygen

4. sickle cell anemia is a disorder of the client rbcs characterized by abnormally shaped red cells that sickle or clump together, leading to oxygen deprivation and resulting in crisis and severe pain.

A Client in crisis should:

1. Management of Pain 2. Administration of oxygen 3. Promoting Hydration to decrease blood viscocity 4. Monitor for

the client diagnosed with sickle cell anemia comes to the ED c/o joint pain throughout the body. Oral temp 102.4, SpO2 91%. Which action should the nurse implement first: 1. Request ABGs 2. Administer oxygen 3. Start IV 4.Administer analgesic

2

the client's nephew has just been diagnosed with sickle cell anemia. the client asks the nurse, "how did my nephew get this disease? which statement would be the best response by the nurse? 1. sickle cell is an inherited autosomal recessive disorder 2. he was born with it and both his parents were carriers of the disease 3. at this time, the cause is unknown 4. your sister was exposed to a virus

2. explained in layman's terms

Client is experiencing vaso-occlusive sickle cell crisis secondary to infection. which medical tx should the nurse anticipate 1. administer demerol 2. admit the client to a private room 3. Infuse D5W 4. Insert a 22-french foley

3