TJ, a 30-year-old client is admitted in sickle cell crisis with symptoms of dyspnea and leg pain. TJ's significant other asks, "I don't really understand why he is hurting so badly." Which of the following responses by the nurse is best?
"Clumping of abnormal red blood cells blocks the flow of blood through the capillaries."
"Bleeding in the joints occurs because red blood cells are being rapidly destroyed by the bone marrow."
"The pain is due to a disturbance in cellular metabolism."
"The bone marrow is expanding with the sickled cells and that causes pain."
The Correct Answer is A
A. This response accurately describes the pathophysiology of sickle cell crisis. During a crisis, sickled red blood cells clump together, leading to microvascular occlusion and impaired blood flow to tissues, resulting in pain.
B. Bleeding in the joints is not a characteristic feature of sickle cell crisis. It may occur in other conditions such as hemophilia or osteoarthritis but not in sickle cell crisis.
C. Disturbance in cellular metabolism is not the primary mechanism underlying the pain experienced during sickle cell crisis.
D. Bone marrow expansion with sickled cells may contribute to bone pain in sickle cell disease, but it is not the primary cause of pain during a sickle cell crisis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D","E"]
Explanation
A. Feeling for changes in the underarm area is important as breast tissue extends into this region and lumps can form there.
B. Since menopausal women do not have periods, they can perform BSE at any consistent time each month to help remember to do it regularly.
C. Pressing the breasts too firmly could cause discomfort and is not necessary for detecting lumps.
D. Performing BSE in the shower is effective because the soapy water allows the fingers to move smoothly over the skin.
E. Using fingertips is the proper technique for checking breasts, as it allows for more sensitivity in detecting changes in the breast tissue.
Correct Answer is B
Explanation
A. Reticulocyte count: Reticulocyte count measures immature red blood cells and is not the primary measure for the effectiveness of filgrastim, which is used to boost white blood cells.
B. White blood count / Absolute neutrophil count: Filgrastim (Neupogen) is used to increase white blood cells, specifically neutrophils. Therefore, monitoring the white blood count (WBC) and absolute neutrophil count (ANC) is the appropriate way to determine the effectiveness of the drug.
C. Total lymphocyte count: While lymphocytes are a type of white blood cell, filgrastim primarily affects neutrophils, making WBC/ANC a better indicator.
D. Platelet count: Filgrastim does not directly impact platelet production, so platelet count is not the primary measure of its effectiveness.
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