To prevent further sickle cell crisis, the nurse would advise the parents of a child with sickle cell anemia to:
Administer an iron supplement daily.
Encourage the child to participate in school activities such as long-distance running.
Prevent the child from drinking an excessive amount of fluids per day.
Notify a health care provider if the child develops an upper respiratory infection.
The Correct Answer is D
Choice A rationale
Administering an iron supplement daily is contraindicated unless the child has a diagnosed iron deficiency. Sickle cell anemia is characterized by a hemolytic process, where red blood cells are destroyed prematurely. This leads to a higher-than-normal iron level in the body, as the iron from the destroyed cells is released. Unnecessary iron supplementation can lead to iron overload, which can be toxic to the body.
Choice B rationale
Encouraging long-distance running is not advised for a child with sickle cell anemia. Strenuous physical activity can lead to dehydration and hypoxemia, which are major triggers for a sickle cell crisis. The increased metabolic demand on the body during such activities can promote sickling of red blood cells, leading to vaso-occlusion and severe pain.
Choice C rationale
Limiting the child's fluid intake is a dangerous practice. Dehydration is a major trigger for sickling of red blood cells. When the body is dehydrated, the blood becomes more concentrated, and the red blood cells are more likely to deform into the characteristic sickle shape. Adequate hydration is essential to maintain blood volume and prevent a crisis.
Choice D rationale
An upper respiratory infection can be a trigger for a sickle cell crisis. Infections, especially those that cause fever, increase the body's metabolic rate and can lead to dehydration and acidosis. These physiological changes promote the sickling of red blood cells, which can block blood vessels and cause a painful crisis. Prompt medical attention is crucial to manage the infection and prevent a crisis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
A cesarean section is a major surgical procedure that creates an incision through the abdominal wall and uterus. The most crucial assessment post-operatively is for signs of infection at the incision site. This involves inspecting the site for erythema, warmth, purulent drainage, or dehiscence, which are indicators of surgical site infection. Surgical infections can lead to significant morbidity and mortality, making this assessment paramount.
Choice B rationale
A client's plan to return to work postpartum is an important consideration for discharge planning and psychosocial support. However, it is not a direct physiological or safety assessment in the immediate postpartum period. The priority in the acute recovery phase is to monitor for potential medical complications related to the surgery and childbirth, such as infection, hemorrhage, or thrombosis.
Choice C rationale
While a perineal assessment is necessary after a vaginal delivery, it is not the most important assessment for a client who had a cesarean section. The surgical incision is the primary site of potential complications, such as infection or hemorrhage. The focus should be on the surgical site as it poses the greatest risk for immediate postoperative complications.
Choice D rationale
Breast engorgement, or the filling of breasts with milk, typically occurs between the third and fifth postpartum days. It is a normal physiological process. Assessing for this on the first postpartum day is not a priority. The most critical assessments immediately following a cesarean section involve monitoring for surgical complications, maternal vital signs, and uterine status.
Correct Answer is C
Explanation
Choice A rationale
Throwing away all stuffed animals is an unnecessary and extreme measure. The lice and nits are unlikely to survive for an extended period off the host. Sealing the items in an airtight bag for a specific duration is a more cost-effective and practical method to ensure any lice or nits are suffocated and die, preventing re-infestation.
Choice B rationale
Changing bed linen every 12 hours is not scientifically necessary. Lice and nits can survive for a limited time off the scalp, but not long enough to warrant such frequent changes. Changing and washing bedding and clothing in hot water and drying them on high heat once a day for a few days is sufficient to kill any lice or nits that may have fallen off.
Choice C rationale
Sealing all non-washable items in airtight bags for two weeks is a highly effective method. Lice and nits require a human host for survival, feeding on blood. Without a host, they will die from starvation within one to two weeks. Sealing items suffocates any remaining lice and ensures that any nits that may hatch will also die without a food source.
Choice D rationale
Soaking all hair items in alcohol is not a standard or recommended practice. While alcohol can be a disinfectant, it is not the primary method for treating lice and may damage the items. Combing with a fine-toothed nit comb, washing in hot water, or sealing items are more proven and safer methods for eradicating lice from personal belongings and preventing re-infestation.
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