A patient who has sickle cell disease was admitted with a vaso-occlusive crisis and reports severe abdominal and flank pain. Which of the following analgesic medications will be MOST appropriate to administer to the patient?

Morphine Sulfate 4 mg IV ATC

Fentanyl 25 mcg/hr transdermal patch Now

Ibuprofen 800 mg PO

Hydromorphone liquid 5 mg PO

Answer and Explanation

The Correct Answer is A

A.   Morphine is a strong opioid analgesic that is effective for managing severe pain, especially in acute situations like a vaso-occlusive crisis. Administering it intravenously allows for rapid onset of pain relief, which is critical given the severity of the patient’s symptoms. Continuous dosing (ATC—around the clock) ensures that pain is managed effectively.
B.   Fentanyl patches are typically used for chronic pain management and take time to reach effective levels in the bloodstream (up to 12 hours or longer). In the case of acute severe pain from a vaso- occlusive crisis, this option would not provide immediate relief.
C.   While ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can help relieve mild to moderate pain, it is not adequate for severe pain management. Additionally, in the setting of sickle cell disease, patients may be at risk for renal issues, making high doses of NSAIDs potentially harmful.
D.   Hydromorphone is also a strong opioid analgesic; however, administering it orally may not be effective for severe pain management in an acute situation. IV administration of opioids is preferred for immediate and potent pain relief during a vaso-occlusive crisis.

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Correct Answer is A

Explanation

A. Leukocytosis refers to an elevated white blood cell (WBC) count, typically above the normal range (approximately 4,000 to 10,000 WBCs per microliter of blood). A count of 22,000 indicates leukocytosis, which may be due to infection, inflammation, stress, or other conditions.
B. A left shift refers to an increase in immature white blood cells, particularly neutrophil precursors, in the bloodstream. It often indicates an acute infection or inflammatory response. While the WBC count of 22,000 may suggest a left shift, it does not confirm it without further analysis of the differential count of the WBCs.
C. Erythrocytosis is an increase in red blood cells (RBCs), not white blood cells. Therefore, this option is incorrect. A high WBC count does not indicate changes in red blood cell levels.
D. Neutropenia refers to a decreased number of neutrophils, which are a type of white blood cell. Given the WBC count of 22,000, neutropenia is not applicable and is therefore incorrect.

A. Malar rash B. Morning stiffness C. Swan neck deformities D. Bilateral joint deformities E. Joint pain at rest

Correct Answer is ["B","C","D"]

Explanation

A. This is primarily associated with Systemic Lupus Erythematosus (SLE), not Rheumatoid Arthritis. While some RA patients may have skin changes, a malar rash is not a typical manifestation of RA.
B. Morning stiffness is a hallmark symptom of Rheumatoid Arthritis. Patients often experience stiffness in their joints after periods of inactivity, particularly in the morning, which typically lasts for at least 30 minutes and can improve with movement.
C. Swan neck deformities are specific joint deformities seen in RA, where there is hyperextension of the proximal interphalangeal joints and flexion of the distal interphalangeal joints. This is a common feature in advanced cases of RA.
D. : RA typically presents with symmetrical joint involvement. This means that if one side is affected, the opposite side is likely to be similarly affected, leading to bilateral joint deformities.
E. While joint pain can occur at rest, RA is more characterized by pain and stiffness during periods of inactivity and improvement with movement. However, as the disease progresses, patients may experience pain even at rest.

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A patient who has sickle cell disease was admitted with a vaso-occlusive crisis and reports severe abdominal and flank pain. Which of the following analgesic medications will be MOST appropriate to administer to the patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a WBC count of 22,000. The nurse should conclude that the client has which of the following?

Correct Answer is A

Explanation

Which of the following are common signs and symptoms that can be present when your patient has Rheumatoid Arthritis? (Select all that apply)

Correct Answer is ["B","C","D"]

Explanation

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