You are caring for a patient who has Sickle Cell Disease (SCD) who is in the hospital for an acute worsening of their disease. Your patient is receiving ATC opioids for their severe pain, when they suddenly report a new sharp pain in their left shoulder. What is your BEST action?

Call the MD to report a potential Emergency

Call the MD to request a X-ray of the shoulder

Perform a head to toe assessment and then chart your findings

Call the MD to request an increase to their opioid dosage

Answer and Explanation

The Correct Answer is A

A.   A sudden new pain in a patient with SCD can be a sign of a serious complication, such as acute chest syndrome or stroke. Prompt medical evaluation is crucial to identify and address any underlying complications.
B.   While an X-ray may be helpful to rule out other causes of shoulder pain, it is not the most urgent priority in this case. The patient's sudden onset of pain could be a sign of a serious complication that requires immediate attention.
C.   While a head-to-toe assessment is important for any patient, it is not the most urgent priority in this case. The patient's new pain could be a sign of a serious complication that requires immediate medical attention.
D.   Increasing the opioid dosage may provide temporary relief from the pain, but it does not address the underlying cause of the new pain.

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Correct Answer is C

Explanation

A. Epoetin Alfa is typically used to treat anemia, and it is often indicated when hemoglobin (Hgb) levels are below 11 g/dL. Therefore, if the Hgb is less than 11, it would be appropriate to administer the medication to help increase red blood cell production.
B. Do not hold. An activated partial thromboplastin time (aPTT) of 120 seconds indicates a prolonged coagulation time, which increases the risk of bleeding. However, Epoetin Alfa does not have a direct impact on coagulation, so this value alone would not warrant holding the medication.
C. Epoetin Alfa is generally not indicated if the Hgb level is already above 11 g/dL, particularly if there’s a risk of increasing the Hgb above the recommended therapeutic range (often above 12 g/dL). If the Hgb exceeds this level, the medication should be held to prevent complications such as thromboembolic events.
D. A PT/INR of 3.5 indicates a significantly prolonged prothrombin time, suggesting a high risk of bleeding. However, Epoetin Alfa does not directly cause bleeding.

A. Neutrophils B. Lymphocytes C. Basophils D. Eosinophils

Correct Answer is B

Explanation

A. Neutrophils are the most abundant type of WBC and are primarily involved in responding to bacterial infections. While they may increase during a viral infection, their primary function is to combat bacteria and fungi. Therefore, they are not the most specific indicator of viral illnesses.
B. Lymphocytes, which include T cells and B cells, are the most directly associated with viral infections. They play a crucial role in the adaptive immune response, recognizing and responding to viral pathogens. A significant increase in lymphocytes, particularly T cells, is commonly seen during viral infections.
C. Basophils are involved in allergic reactions and responses to parasites, releasing histamine and other mediators. They are not significantly involved in the response to viral infections and typically do not show a notable increase in these situations.
D. Eosinophils primarily respond to parasitic infections and allergic reactions. While they may be elevated in some allergic conditions and certain parasitic infections, they are not directly involved in the immune response to viral infections.

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You are caring for a patient who has Sickle Cell Disease (SCD) who is in the hospital for an acute worsening of their disease. Your patient is receiving ATC opioids for their severe pain, when they suddenly report a new sharp pain in their left shoulder. What is your BEST action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Your cancer patient has bone marrow suppression from their chemotherapy treatments, and is scheduled to receive Epoetin Alfa shots 3 times per week. Which of the following lab values would cause you to hold the administration of the medication for safety concerns?

Correct Answer is C

Explanation

The medical team believes that your patient has been suffering from a severe Viral infection, and has ordered blood to be drawn for laboratory analysis. You know that which of the following types of white blood cells is MOST associated with a Viral illness?

Correct Answer is B

Explanation

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