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 D

Explanation

A. Prednisone can lead to sodium and fluid retention, which can result in hypertension and edema. While this is an important consideration, it is not the most critical point to emphasize initially. Managing weight and blood pressure is essential, but there are more immediate concerns with the medication's use.
B. Long-term use of prednisone can result in changes such as fat redistribution, leading to a "moon face," buffalo hump, and increased abdominal fat. This is significant for understanding the side effects of prolonged therapy, but it is not the most urgent information for the client to know.
C. Prednisone can cause side effects such as mood changes, anxiety, or jitteriness, especially when initiating treatment or adjusting dosages. While this is relevant, the potential for emotional or psychological effects is secondary to the critical management of the medication.
D. This is the most critical point to emphasize. Prednisone is a corticosteroid that can suppress the body's natural adrenal function. Abrupt discontinuation can lead to adrenal crisis, which can be life- threatening.

A. A bunion and bone deformity of the foot B. Ulnar deviation C. Nodules on the fingers D. Bone spurs on either knee

Correct Answer is A

Explanation

A. Hallux Valgus refers to a deformity where the big toe (hallux) angles towards the second toe, often accompanied by a bony bump (bunion) on the side of the foot. This condition can cause pain, discomfort, and difficulty in finding properly fitting footwear.
B. Ulnar deviation refers to the movement of the wrist where the hand deviates towards the ulnar bone (the side of the little finger). It is often associated with rheumatoid arthritis and not related to foot deformities.
C. Nodules on the fingers can occur in various conditions, including rheumatoid arthritis (called rheumatoid nodules). This term does not relate to Hallux Valgus or any deformity of the foot.
D. Bone spurs are bony projections that develop along the edges of bones, often related to osteoarthritis. While they can occur in the knees, they are not associated with Hallux Valgus.

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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

A nurse is teaching the client with systemic lupus erythematosus about prednisone. What information is the priority?

Correct Answer is D

Explanation

You are reading the Physician's notes on your patient when you notice that the Dr. wrote that the patient has a Hallux Valgus deformity. What is this describing?

Correct Answer is A

Explanation

A nurse is teaching a client who has SLE (Lupus) about self-care. Which of the following statements by the client indicates an understanding of the teaching?

Which of the following factors are known to commonly trigger a crisis in patients with sickle cell disease? (Select all that apply)

Which of the following lab tests is NOT commonly ordered to ascertain whether the patient is experiencing large amounts of inflammation?

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