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. Sulfamethoxazole is not the treatment of choice for Giardia lamblia infections.
B. Metronidazole is the first-line treatment for giardiasis in children. It is effective in eradicating the protozoal infection, alleviating symptoms such as diarrhea, abdominal pain, and nausea, and preventing transmission. Pediatric dosing should be weight-based, typically for 5–7 days.
C. Fluconazole (Diflucan) is an antifungal agent and not effective against protozoal infections like giardiasis.
D. Erythromycin/sulfisoxazole acetyl (Pediazole) is an antibiotic combination used for bacterial infections, not protozoal infections.
Correct Answer is D
Explanation
Rationale:
A. Blood type, Rh factor, and antibody screens are routinely performed in the first trimester to identify potential incompatibilities and plan appropriate management.
B. Screening for STDs, including HIV, syphilis, chlamydia, and gonorrhea, is recommended early in pregnancy to ensure maternal and fetal health.
C. A purified protein derivative (PPD) test for tuberculosis may be performed in the first trimester if the patient is at risk.
D. Alpha-fetoprotein (AFP) screening is typically performed during the second trimester (around 15–20 weeks gestation) to assess for neural tube defects and other fetal abnormalities. It is not a routine first-trimester test.
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