NSG 3800 & 3850 EXAM 1 QUESTIONS
AND ANSWERS WITH COMPLETE
SOLUTIONS 100% CORRECT!!!
Question 1: Which statement best describes the underlying genetic defect and
structural cellular change seen in sickle cell anemia?
A) An inherited disorder causing a shortage of white blood cells, leading to a
curved bone structure
B) A genetic condition that produces abnormal hemoglobin, causing red
blood cells to morph into an rigid, crescent shape ✔️✔️
C) An acquired bone marrow defect that creates oversized, brittle blood
platelets
D) A chromosomal abnormality resulting in the hyperproduction of highly
elastic plasma proteins
Question 2: What are the two primary physiological complications that occur
when red blood cells assume a sickle shape?
A) Severe thinning of the blood vessels and sudden drops in blood sugar
B) Accelerated destruction of bone marrow and reduced hormone circulation
C) Decreased systemic oxygenation due to inefficient oxygen transport, and
painful blood vessel obstructions (occlusions) ✔️✔️
D) Excessive blood clotting in large arteries paired with localized fluid
retention
Question 3: What pattern of laboratory values is typically expected in a patient
living with sickle cell anemia during their baseline chronic state?
A) Elevated hemoglobin, low bilirubin, and standard low platelet counts
B) Chronically low hemoglobin and hematocrit, elevated bilirubin, and
elevated white blood cell and platelet counts ✔️✔️
C) Markedly depressed white blood cells, low bilirubin, and high hematocrit
, D) Perfectly normal red blood cell counts that drop only during periods of
rapid weight loss
Question 4: How can a state of severe dehydration mask the true underlying
anemia in a patient with sickle cell disease during a laboratory evaluation?
A) It triggers the bone marrow to instantly double its production of healthy
hemoglobin molecules
B) It causes a hemoconcentration that creates a "false" or artificial elevation
in measured hemoglobin and hematocrit levels ✔️✔️
C) It rapidly neutralizes circulating bilirubin, causing blood tests to appear
completely normal
sickle cell anemia clinical manifestations & expected findings?
Joint Pain
Fatigue
Tachycardia/Murmurs/Cardiomegaly (big heart)
Jaundice (Due to excess bilirubin)
Low O2 Saturation
HEADACHE THAT WON'T SUBSIDE
Why does sickle cell anemia cause higher levels of bilirubin?
Sickle cell patient's RBCs do not have as long as a life span as normal RBCs,
therefore they are dying out faster than the liver can filter them out.
sickle cell crisis: Acute Vaso-Occlusive Crisis
Entrapment of erythrocytes & leukocytes leading to tissue hypoxia, inflammation,
and necrosis. It is VERY painful.
,Sickle cell crisis: Acute Chest Syndrome
This is the leading cause of death in patients with sickle cell.
a severe lung-related complication of sickle cell disease that affects both children
and adults. It creates a pneumonia like illness.
Sickle cell crisis: Aplastic Crisis
Results from the human parvovirus.
Hemoglobin levels will fall rapidly and bone marrow cannot compensate, AS
EVIDENCE BY THE ABSENCE OF RETICULOCYTES (immature RBCs)
Sickle cell crisis: Sequestration Crisis
Results when organs pool the sickled cells. Can effect the liver, spleen, and
LUNGS.
Complications of Sickle cell disease?
Stroke, Kidney/liver Failure, HF, Pulmonary HTN, Acute Chest Syndrome,
Infection, & Reproductive Issues.
remember these patients are at risk for occlusions in blood vessels.
, Sickle Cell Nursing Interventions
H.ydration
O.xygenation
P.ain Management
Keep the patient warm. Cold temperatures can send these patients into a crisis.
YOU NEED AN ORDER TO GIVE PRN BREAKTHROUGH PAIN
MEDICATIONS.
Sickle Cell Nursing Care
educate on PCA pump, incentive spirometry.
Cluster care as much as possible.
Allow patients to take breaks during activities.
Infection prevention: Hand hygiene & Antibiotic Prophylaxis
Sickle Cell Medical Management
Hematopoietic Stem-Cell Transplant
Aspirin to help relieve mild/moderate pain, Hydromorphine for sever pain.
Chemotherapy: hydroxyurea- this decreases formation of sickled cells.
Blood Transfusions
Corticosterioids
Iron Supplements
AND ANSWERS WITH COMPLETE
SOLUTIONS 100% CORRECT!!!
Question 1: Which statement best describes the underlying genetic defect and
structural cellular change seen in sickle cell anemia?
A) An inherited disorder causing a shortage of white blood cells, leading to a
curved bone structure
B) A genetic condition that produces abnormal hemoglobin, causing red
blood cells to morph into an rigid, crescent shape ✔️✔️
C) An acquired bone marrow defect that creates oversized, brittle blood
platelets
D) A chromosomal abnormality resulting in the hyperproduction of highly
elastic plasma proteins
Question 2: What are the two primary physiological complications that occur
when red blood cells assume a sickle shape?
A) Severe thinning of the blood vessels and sudden drops in blood sugar
B) Accelerated destruction of bone marrow and reduced hormone circulation
C) Decreased systemic oxygenation due to inefficient oxygen transport, and
painful blood vessel obstructions (occlusions) ✔️✔️
D) Excessive blood clotting in large arteries paired with localized fluid
retention
Question 3: What pattern of laboratory values is typically expected in a patient
living with sickle cell anemia during their baseline chronic state?
A) Elevated hemoglobin, low bilirubin, and standard low platelet counts
B) Chronically low hemoglobin and hematocrit, elevated bilirubin, and
elevated white blood cell and platelet counts ✔️✔️
C) Markedly depressed white blood cells, low bilirubin, and high hematocrit
, D) Perfectly normal red blood cell counts that drop only during periods of
rapid weight loss
Question 4: How can a state of severe dehydration mask the true underlying
anemia in a patient with sickle cell disease during a laboratory evaluation?
A) It triggers the bone marrow to instantly double its production of healthy
hemoglobin molecules
B) It causes a hemoconcentration that creates a "false" or artificial elevation
in measured hemoglobin and hematocrit levels ✔️✔️
C) It rapidly neutralizes circulating bilirubin, causing blood tests to appear
completely normal
sickle cell anemia clinical manifestations & expected findings?
Joint Pain
Fatigue
Tachycardia/Murmurs/Cardiomegaly (big heart)
Jaundice (Due to excess bilirubin)
Low O2 Saturation
HEADACHE THAT WON'T SUBSIDE
Why does sickle cell anemia cause higher levels of bilirubin?
Sickle cell patient's RBCs do not have as long as a life span as normal RBCs,
therefore they are dying out faster than the liver can filter them out.
sickle cell crisis: Acute Vaso-Occlusive Crisis
Entrapment of erythrocytes & leukocytes leading to tissue hypoxia, inflammation,
and necrosis. It is VERY painful.
,Sickle cell crisis: Acute Chest Syndrome
This is the leading cause of death in patients with sickle cell.
a severe lung-related complication of sickle cell disease that affects both children
and adults. It creates a pneumonia like illness.
Sickle cell crisis: Aplastic Crisis
Results from the human parvovirus.
Hemoglobin levels will fall rapidly and bone marrow cannot compensate, AS
EVIDENCE BY THE ABSENCE OF RETICULOCYTES (immature RBCs)
Sickle cell crisis: Sequestration Crisis
Results when organs pool the sickled cells. Can effect the liver, spleen, and
LUNGS.
Complications of Sickle cell disease?
Stroke, Kidney/liver Failure, HF, Pulmonary HTN, Acute Chest Syndrome,
Infection, & Reproductive Issues.
remember these patients are at risk for occlusions in blood vessels.
, Sickle Cell Nursing Interventions
H.ydration
O.xygenation
P.ain Management
Keep the patient warm. Cold temperatures can send these patients into a crisis.
YOU NEED AN ORDER TO GIVE PRN BREAKTHROUGH PAIN
MEDICATIONS.
Sickle Cell Nursing Care
educate on PCA pump, incentive spirometry.
Cluster care as much as possible.
Allow patients to take breaks during activities.
Infection prevention: Hand hygiene & Antibiotic Prophylaxis
Sickle Cell Medical Management
Hematopoietic Stem-Cell Transplant
Aspirin to help relieve mild/moderate pain, Hydromorphine for sever pain.
Chemotherapy: hydroxyurea- this decreases formation of sickled cells.
Blood Transfusions
Corticosterioids
Iron Supplements
