A client has a history of sickle cell anemia with several sickle cell crises over the past 10 years. What blood component results in sickle cell anemia?

Hemoglobin A

Hemoglobin S

Hemoglobin M

Hemoglobin F

Answer and Explanation

The Correct Answer is B

Reasoning:

Choice A reason: Hemoglobin A is the normal adult hemoglobin, comprising two alpha and two beta chains. In sickle cell anemia, a mutation in the beta-globin gene produces hemoglobin S, not hemoglobin A, which does not cause sickling or the vaso-occlusive crises characteristic of the disease.

Choice B reason: Hemoglobin S is the abnormal hemoglobin in sickle cell anemia, resulting from a point mutation in the beta-globin gene. This causes red blood cells to sickle under stress, leading to hemolysis and vaso-occlusion, resulting in pain, organ damage, and the clinical features of sickle cell crises.

Choice C reason: Hemoglobin M is a rare hemoglobin variant causing methemoglobinemia, not sickle cell anemia. It results from mutations affecting heme iron, leading to cyanosis, not the sickling and vaso-occlusion seen with hemoglobin S, making it irrelevant to the client’s condition.

Choice D reason: Hemoglobin F, or fetal hemoglobin, is present in newborns and persists in small amounts in adults. In sickle cell anemia, increased hemoglobin F can reduce sickling, but it is not the cause. Hemoglobin S drives the disease’s pathophysiology, not hemoglobin F.

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Correct Answer is C

Explanation

Reasoning:

Choice A reason: Offering large quantities of liquids frequently increases aspiration risk in clients with dysphagia from neurological disorders. Large volumes can overwhelm swallowing mechanisms, leading to choking or pneumonia. Controlled, small sips with proper positioning are safer to ensure nutrition without compromising airway safety.

Choice B reason: Allowing physical activity before meals may improve appetite but does not address swallowing difficulties. Activity does not facilitate safe swallowing in neurological disorders, where muscle coordination is impaired. Proper positioning and pacing during feeding are more effective to prevent aspiration and ensure nutritional intake.

Choice C reason: Helping the client sit upright and feeding slowly minimizes aspiration risk in neurological dysphagia. Upright positioning aligns the airway to prevent food or liquid entry, and slow feeding allows better coordination of swallowing muscles, reducing choking and ensuring adequate nutrition, critical for safe intake.

Choice D reason: Instructing the client to lie down while eating is dangerous in dysphagia, as it increases aspiration risk. Lying down allows food or liquids to enter the airway, potentially causing pneumonia. Upright positioning is essential to facilitate safe swallowing and prevent complications in neurological disorders.

A. Explain that the client’s physical changes are a result of excessive corticosteroids B. Offer clothing or bedding that’s cool and comfortable C. Explain the rationale for increasing salt and fluid intake in times of illness, increased stress, and very hot weather D. Suggest a high-carbohydrate, low-protein diet

Correct Answer is A

Explanation

Reasoning:

Choice A reason: Explaining that physical changes in Cushing’s syndrome, like moon face and weight gain, result from excessive corticosteroids helps the client understand their condition. Cortisol excess causes fat redistribution and metabolic changes, and education promotes adherence to treatment and coping with body image changes, improving psychological and physical management.

Choice B reason: Offering cool, comfortable clothing or bedding addresses symptoms like heat intolerance in Cushing’s syndrome due to cortisol’s metabolic effects. However, it is less critical than education about the condition, as it does not address the underlying cause or promote understanding and adherence to long-term management strategies.

Choice C reason: Increasing salt and fluid intake is appropriate for Addison’s disease, not Cushing’s syndrome, where cortisol’s mineralocorticoid effects cause fluid retention and hypertension. This intervention could worsen fluid overload and hyponatremia, making it inappropriate and potentially harmful for managing Cushing’s syndrome symptoms.

Choice D reason: A high-carbohydrate, low-protein diet is not recommended for Cushing’s syndrome. Cortisol excess causes protein catabolism and hyperglycemia, so a balanced diet with adequate protein supports muscle maintenance and glucose control. This dietary suggestion does not address the metabolic needs of the condition.

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A client has a history of sickle cell anemia with several sickle cell crises over the past 10 years. What blood component results in sickle cell anemia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a neurological disorder has difficulty swallowing. The nurse should take special care with the client’s diet because of a potential risk of imbalanced nutrition. Which measure may be taken by the nurse to ensure that the client’s diet allows for easy swallowing?

Correct Answer is C

Explanation

A nurse should perform which intervention for a client with Cushing's syndrome?

Correct Answer is A

Explanation

A client had gastric bypass surgery 3 years ago and now, experiencing fatigue, visits the clinic to determine the cause. The client takes pantoprazole for the treatment of frequent heartburn. What type of anemia is this client at risk for?

A client with Addison's disease comes to the clinic for a follow-up visit. When assessing this client, the nurse should stay alert for signs and symptoms of:

The nurse observes the laboratory studies for a client in the hospital with fatigue, feeling cold all of the time, and hemoglobin of 8.6 g/dL and a hematocrit of 28%. What finding would be an indicator of iron-deficiency anemia?

Which disorder is characterized by a group of symptoms produced by an excess of free circulating cortisol from the adrenal cortex?

The nurse is caring for a client with an exacerbation of sickle cell disease (SCD). Which finding indicates to the nurse that the client is experiencing a liver complication from this condition?

A client who suffered a spinal cord injury is experiencing an exaggerated autonomic response. What aspect of the client’s current health status is most likely to have precipitated this event?

A client who is in the third trimester of pregnancy has been experiencing an exacerbation of iron-deficiency anemia in recent weeks. When providing the client with nutritional guidelines and meal suggestions, what foods would be most likely to increase the client’s iron stores?

A client's electronic health record notes that the client has previously undergone treatment for secondary polycythemia. The nurse should assess for which factor?