A 21-year-old patient with a known history of sickle cell anemia presents to the emergency department with severe pain in the lower back and joints, fatigue, and fever. What is the most likely cause of these symptoms?
Acute lymphoblastic leukemia
Iron-deficiency anemia
Vaso-occlusive crisis
Pneumonia
The Correct Answer is C
Choice A Reason:
Acute lymphoblastic leukemia (ALL) is a type of cancer that affects the blood and bone marrow. While it can cause symptoms such as fatigue and fever, it is less likely to cause severe pain in the lower back and joints, which are more characteristic of a vaso-occlusive crisis in sickle cell anemia. ALL typically presents with symptoms like frequent infections, easy bruising or bleeding, and bone pain, but the combination of severe pain, fatigue, and fever in a patient with sickle cell anemia points more towards a vaso-occlusive crisis.
Choice B Reason:
Iron-deficiency anemia is a condition where there is a lack of adequate iron to form healthy red blood cells. Symptoms include fatigue, weakness, and pale skin, but it does not typically cause severe pain in the lower back and joints or fever. The presence of severe pain and fever in a patient with sickle cell anemia is more indicative of a vaso-occlusive crisis rather than iron-deficiency anemia.
Choice C Reason:
Vaso-occlusive crisis is a common and painful complication of sickle cell anemia. It occurs when sickled red blood cells block blood flow to parts of the body, causing severe pain, often in the back, joints, and abdomen. This condition can also lead to fever and fatigue due to the body’s inflammatory response and the reduced oxygen delivery to tissues. Given the patient’s history of sickle cell anemia and the described symptoms, a vaso-occlusive crisis is the most likely cause.
Choice D Reason:
Pneumonia is an infection that inflames the air sacs in one or both lungs, which can cause symptoms such as fever, chills, and difficulty breathing. While pneumonia can occur in patients with sickle cell anemia, it is less likely to cause severe pain in the lower back and joints. The combination of severe pain, fatigue, and fever in this patient is more consistent with a vaso-occlusive crisis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Testing blood glucose levels every 6 hours during illness is crucial for managing type 1 diabetes. Illness can cause blood glucose levels to fluctuate unpredictably, and frequent monitoring helps in making timely adjustments to insulin doses and dietary intake. This practice helps prevent both hyperglycemia and hypoglycemia, ensuring better overall control of diabetes during periods of illness.
Choice B Reason:
Administering the usual daily dose of insulin is important even during illness. Skipping insulin doses can lead to dangerously high blood glucose levels and increase the risk of diabetic ketoacidosis (DKA). It is essential to continue taking insulin as prescribed and to consult with a healthcare provider if any adjustments are needed based on blood glucose readings.
Choice C Reason:
Limiting juices, soda, and gelatin is not typically recommended during illness for patients with type 1 diabetes. These items can be useful for maintaining hydration and providing quick sources of carbohydrates if the patient is unable to eat solid foods. Instead of limiting these items, it is more important to monitor carbohydrate intake and adjust insulin doses accordingly.
Choice D Reason:
Reporting a blood glucose level greater than 300 is critical for preventing complications. High blood glucose levels can indicate the onset of DKA, a serious condition that requires immediate medical attention. Promptly reporting elevated blood glucose levels allows for timely intervention and management to prevent severe complications.
Correct Answer is B
Explanation
Choice A Reason:
Advising the patient to increase their screen time to exercise their eye muscles is not appropriate for managing macular degeneration. Increased screen time can cause eye strain and does not benefit the condition. Instead, patients should be encouraged to engage in activities that do not exacerbate eye strain.
Choice B Reason:
Encouraging the patient to quit smoking is a crucial intervention for managing macular degeneration. Smoking is a significant risk factor for the progression of macular degeneration. Quitting smoking can help slow the progression of the disease and improve overall eye health. This intervention addresses a modifiable risk factor and can have a positive impact on the patient’s condition.
Choice C Reason:
Suggesting the patient avoid all physical activities to prevent further eye damage is not necessary for managing macular degeneration. Physical activity is important for overall health and does not directly impact the progression of macular degeneration. Patients should be encouraged to maintain a healthy lifestyle, including regular physical activity.
Choice D Reason:
Informing the patient to reduce their water intake to prevent fluid accumulation in the eyes is not relevant for managing macular degeneration. Adequate hydration is important for overall health, and there is no evidence to suggest that reducing water intake will benefit patients with macular degeneration. This advice could potentially lead to dehydration and other health issues.
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