The nurse admits a patient who is in a sickle cell crisis. The nurse should prepare for which intervention as the top priority in the management of the patient?

Oxygen administration

Blood transfusion

Intravenous fluid therapy

Pain management

Answer and Explanation

The Correct Answer is D

A.   Oxygen therapy may be indicated if the patient shows signs of respiratory distress or has low oxygen saturation levels, but it does not address the underlying pain or dehydration associated with the crisis.
B.   Blood transfusions can be an effective treatment for severe complications of sickle cell disease, including acute chest syndrome or severe anemia. However, transfusions are not typically the immediate priority in the early management of a sickle cell crisis unless there is a clear indication of severe anemia or complications.
C.   IV fluid therapy is crucial for managing dehydration, which can exacerbate sickle cell crises. Adequate hydration helps reduce blood viscosity and can alleviate some symptoms. However, while important, fluid therapy alone does not address the immediate and often severe pain that patients experience.
D.   Pain management is the top priority in the management of a patient in a sickle cell crisis. Patients often experience severe pain due to vaso-occlusive events, and addressing pain is essential for patient comfort and quality of care.

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Correct Answer is D

Explanation

A. Methotrexate (MTX) is a disease-modifying antirheumatic drug (DMARD) that helps slow disease progression but does not provide immediate pain relief. NSAIDs and steroids may be used for symptomatic relief, but MTX alone can manage both pain and disease progression over time.
B. This response is unprofessional and dismissive. It implies that the medication regimen is based solely on the patient's insurance coverage rather than their medical needs. It does not address the patient’s question and could undermine trust in the healthcare team.
C. Methotrexate does not primarily treat nausea; rather, it is used to manage rheumatoid arthritis. While some patients may experience nausea as a side effect of MTX or other medications, this is not its primary purpose.
D. Methotrexate is indeed a DMARD that can take weeks to months to show its full benefits in controlling inflammation and slowing disease progression. Meanwhile, NSAIDs or corticosteroids may be prescribed to provide quicker relief from symptoms such as pain and swelling.

A. Client report of intense feeling of heat in the fingers B. Pallor of the toes with cold exposure C. Feet that become reddened with ambulation D. Swelling of the joints of the fingers

Correct Answer is B

Explanation

A. This is not typical for Raynaud's phenomenon. Instead, Raynaud's is characterized by episodes of reduced blood flow to the extremities, often triggered by cold or stress, leading to sensations of coldness or numbness rather than warmth.
B. This finding aligns with Raynaud's phenomenon. During an episode, the blood vessels constrict in response to cold or stress, leading to pallor (whiteness) in the affected areas, such as the toes and fingers. This is a classic symptom of the condition.
C. While feet can become reddened due to increased blood flow after rewarming or after exposure to warmth, this is not a characteristic feature of Raynaud's phenomenon. In Raynaud's, the affected areas typically exhibit color changes from white (pallor) to blue (cyanosis) and then red (hyperemia) as blood flow returns, but redness upon ambulation is not specifically indicative of the phenomenon.
D. Swelling of the joints can occur in SLE due to arthritis or inflammation but is not a direct symptom of Raynaud's phenomenon. Raynaud's primarily affects blood flow and does not inherently cause joint swelling; however, a client with SLE may experience joint symptoms due to other underlying inflammatory processes.

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The nurse admits a patient who is in a sickle cell crisis. The nurse should prepare for which intervention as the top priority in the management of the patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Your patient has just received a new diagnosis of Rheumatoid Arthritis. They are confused about their prescriptions, however. They ask you "Why am I receiving so many medications? I thought this 'MTX' drug was the one that would treat my arthritis?". What is your BEST response?

Correct Answer is D

Explanation

A nurse is caring for a client who has SLE and is experiencing an episode of Raynaud's phenomenon. Which of the following findings should the nurse anticipate?

Correct Answer is B

Explanation

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