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
Explanation
A. Alcohol can directly suppress the production of red blood cells (erythropoiesis) in the bone marrow, leading to anemia.
B. While alcoholics may indeed be deficient in folate due to poor nutrition, folate deficiency is not the primary mechanism for anemia in alcoholic liver disease.
C. Liver dysfunction can lead to decreased production of clotting factors, contributing to coagulopathy, but it is not the primary mechanism for anemia in alcoholic liver disease.
D. Gastric ulcers may indeed lead to chronic blood loss, contributing to anemia, but it is not specific to alcoholic liver disease.
E. While alcohol-induced inflammation may contribute to various complications, including liver damage, it is not the primary mechanism for anemia in alcoholic liver disease.
Correct Answer is A
Explanation
A. Schilling test. The symptoms described are suggestive of pernicious anemia, which is typically diagnosed through a Schilling test to assess vitamin B12 absorption.
B. Erythrocyte Indices. Erythrocyte indices are used to evaluate various aspects of red blood cell characteristics and are not specific to diagnosing pernicious anemia.
C. Bone Marrow Biopsy. While bone marrow biopsy may be used to diagnose certain types of anemia, it is not the primary diagnostic test for pernicious anemia.
D. Radiologic Studies. Radiologic studies are not typically used in the diagnosis of pernicious anemia.
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