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 ["A","B","E"]

Explanation

A. A positive antinuclear antibody (ANA) titer is a common finding in SLE. This test is often used as a screening tool for autoimmune diseases, and most patients with SLE will have a positive ANA. Therefore, this finding is expected.
B. The presence of protein in the urine (proteinuria) is indicative of kidney involvement, which can occur in SLE due to lupus nephritis. Given the client's difficulty urinating and other symptoms, this finding would be anticipated.
C. This statement is unlikely to be correct. In SLE, anemia is common due to various factors, including chronic disease, bone marrow involvement, or hemolysis. Therefore, an increased hemoglobin level would not be expected in this scenario.
D. This finding is not typically associated with SLE. SLE is primarily an autoimmune disease affecting the connective tissues, and thyroid function tests (like T3 and T4) would not show increased levels unless there is an underlying thyroid disorder. Therefore, this finding is not expected in SLE.
E. An elevated blood urea nitrogen (BUN) level may be anticipated, especially if there is kidney involvement due to lupus nephritis. Increased BUN can indicate impaired kidney function, which aligns with the client's symptoms of difficulty urinating.

A. Chronic blood loss B. Liver problems C. Decreased folic acid absorption in the gut D. Low dietary intake of Iron

Correct Answer is C

Explanation

A. Chronic blood loss is one of the most common causes of iron deficiency anemia. Conditions such as gastrointestinal bleeding (e.g., from ulcers, polyps, or cancer), heavy menstrual periods, or chronic blood donation can lead to a gradual loss of iron, resulting in anemia.
B. While liver problems can lead to various blood disorders, they are not a direct cause of iron deficiency anemia. Liver disease can affect iron metabolism and storage but does not typically cause iron deficiency unless accompanied by chronic blood loss or malnutrition.
C. Decreased folic acid absorption leads to folate deficiency anemia, not iron deficiency anemia. While folate is important for red blood cell production, it does not directly influence iron levels. This option is not a common cause of iron deficiency anemia.
D. Low dietary intake of iron is a well-known cause of iron deficiency anemia. Diets lacking in iron-rich foods (such as red meat, beans, and fortified cereals) can lead to insufficient iron stores and subsequent anemia.

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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?

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing the plan of care for a client who has systemic lupus erythematosus (SLE). The client reports fatigue, joint tenderness, swelling, and difficulty urinating. Which of the following laboratory findings should the nurse anticipate? (Select all that apply)

Correct Answer is ["A","B","E"]

Explanation

All of the following are common causes of Iron deficiency anemia, EXCEPT?

Correct Answer is C

Explanation

Which of the following are common signs or symptoms of GI bleeding? (Select all that apply)

The nurse admits a patient who is in a sickle cell crisis. The nurse should prepare for which intervention as the top priority in the management of the patient?

A patient with iron deficiency anemia who is taking oral iron supplements is evaluated by the nurse in the outpatient clinic. Which finding by the nurse is of MOST concern?

Which of the following is are appropriate nursing interventions to ensure the safety of a patient who is receiving Total Parenteral Nutrition (TPN)? (Select all that apply)

A nurse is caring for a client who has pneumonia. Assessment findings include T 100.4 deg F, RR 30, BP 130/76, HR 100, and SpO2 91% on room air. Which of the following is the PRIORITY intervention?

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?

Your patient with Iron deficiency anemia is receiving Iron Dextran when their blood pressure suddenly starts to drop, their respiratory rate increases, and their breath becomes wheezy- sounding. Your PRIORITY intervention will be:

The nurse is reviewing lab results for a patient and the white blood cell (WBC) count is elevated at 12,000. Which of the following is a cause of increasing WBC count? (Select all that apply)