The adoptive mother of a 5-month-old child born in another country brings the child to the nurse practitioner's office. The child's medical history is unknown. The mother states that over the past 2 days, the child has been experiencing frequent bouts of crying that are unrelieved by holding. The mother reports that the child's hands and feet are slightly swollen during these episodes. On examination, the child's temperature is 101°F with mild splenomegaly. Sickle cell disease is suspected. This diagnosis may be confirmed by:
a Sickledex blood test.
a complete blood count.
hemoglobin electrophoresis.
a sickle cell solubility test.
The Correct Answer is C
Rationale:
A. The Sickledex test is a rapid screening tool for sickle hemoglobin but cannot definitively diagnose sickle cell disease.
B. A complete blood count (CBC) may show anemia or other hematologic abnormalities but cannot confirm the specific hemoglobin type.
C. Hemoglobin electrophoresis is the definitive test to diagnose sickle cell disease. It identifies the specific types of hemoglobin present (e.g., HbS, HbA, HbF) and distinguishes between sickle cell trait and sickle cell disease.
D. The sickle cell solubility test can indicate the presence of HbS but cannot differentiate between trait and disease and is therefore not diagnostic.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Hypocalcemia in infants typically presents with tremors, jitteriness, positive Chvostek or Trousseau signs, and seizures, rather than a shrill cry.
B. A shrill or high-pitched cry is a classic neurologic sign that may indicate increased intracranial pressure (ICP) or central nervous system irritation. Additional signs may include lethargy, irritability, vomiting, and bulging fontanel.
C. Upper airway obstruction usually produces stridor, noisy breathing, or retractions, but not a shrill cry.
D. Vocal cord paralysis may cause a weak, hoarse, or breathy cry, not the high-pitched, shrill cry associated with neurologic issues.
Correct Answer is B
Explanation
Rationale:
A. Peritonsillar abscess may be evaluated with careful oral examination, though manipulation can be uncomfortable.
B. Acute epiglottitis is a medical emergency in which examination of the pharynx can precipitate complete airway obstruction. Therefore, direct visualization of the throat should be avoided, and airway management is the priority.
C. Uvulitis can be examined carefully; it is not an absolute contraindication.
D. Bacterial tracheitis affects the lower airway and does not specifically contraindicate pharyngeal examination, though caution is advised if airway compromise is present.
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