, Sickle Cell Anemia
Page 1
1. Disease Etiology
When Mary's paternal grandmother, Earlene, is informed that she has a 7-year-
old granddaughter, she immediately agrees to care for Mary. Earlene is a waitress
and lives alone in a middle-class neighborhood in a small town about 85 miles
from where Mary currently lives. Before placing Mary in a new home, CPS
evaluates Earlene's physical, financial, and psychological ability to care for Mary.
Earlene is not familiar with SCA. A nurse from CPS meets with her to discuss
Mary's health condition. Earlene says to the nurse, "I have heard of sickle cell
anemia, and I know it can be very bad, but I don't know exactly what it is."
2. 1.ID: 6975182549
What is the best response by the nurse to Earlene's statement?
A. "I have some written material that will explain all about the
disease."
Providing the grandmother with written material is indicated, but the
nurse should first provide another response to Earlene's statement.
B. "It is a disease of the blood that requires taking medication
every day."
There is no daily medication that will prevent a sickle cell crisis or cure
SCA.
C. "Mary will probably have episodes of severe joint pain and will
need to be hospitalized."
This response does not provide the initial information that Earlene needs
to best understand the disease.
D. "Red blood cells become 'C' shaped, stiff, and sticky, which
blocks the blood vessels."Correct
Sickle cell anemia is a disorder of the red blood cells characterized by
abnormally shaped red cells that block and damage blood vessels
leading to oxygen deprivation, pain, anemia, serious infections, and
damage to vital organs.
Correct
Awarded 1.0 points out of 1.0 possible points.
3. Earlene listens attentively to the nurse discuss Mary's condition and what
she must do to care for her. After reviewing the needed care, the nurse asks
the grandmother if she has any other questions. Earlene asks, "How did
Mary get this awful disease?"
4. 2.ID: 6975182547
How should the nurse respond?
, A. "As a black woman, you must be aware that this is an inherited
autosomal recessive disease."
SCA is an inherited autosomal recessive disease, but the nurse should
not make the assumption that the client is knowledgeable about the
disease simply because of her ethnicity. In addition, the nurse needs to
ensure that the client understands the medical terminology used.
B. "Mary has the disease because she inherited the gene from
both of her parents, who were carriers." Correct
This explains the etiology in terms that a layperson can understand. For
a child to acquire the disease, both parents must have the SCA trait.
Each child of a couple with the SCA trait has a 1 in 4 chance of
developing the disease.
C. "It may be an awful disease but Mary can live a long,
productive life."
This is a condescending response and does not address Earlene's
concern. In addition, this is not necessarily a true statement, since Mary
may not live a long life.
D. "She was exposed to a virus while her mother was pregnant."
This is not the etiology for SCA.
Correct
Awarded 1.0 points out of 1.0 possible points.
Page 2
1. Cultural Considerations
While visiting with Earlene, the CPS nurse states, "Your son never told you that he
had a daughter? He was aware that he had a child. Mary's mother attempted to
get child support before he left town. Do you know where he is and why he hasn't
been a part of Mary's life?" Earlene looks at the nurse and hesitates before
responding.
2. 3.ID: 6975182556
Which statement by Mary's grandmother supports a common cultural
communication expectation in the African-American heritage?
A. "My son apparently wasn't ready to be a father."
This statement does not support an African American cultural
communication response.
B. "Can't you have the police find him?"
This statement does not support an African American cultural
communication response.
C. "Do you think Mary knows where her father is?"
Page 1
1. Disease Etiology
When Mary's paternal grandmother, Earlene, is informed that she has a 7-year-
old granddaughter, she immediately agrees to care for Mary. Earlene is a waitress
and lives alone in a middle-class neighborhood in a small town about 85 miles
from where Mary currently lives. Before placing Mary in a new home, CPS
evaluates Earlene's physical, financial, and psychological ability to care for Mary.
Earlene is not familiar with SCA. A nurse from CPS meets with her to discuss
Mary's health condition. Earlene says to the nurse, "I have heard of sickle cell
anemia, and I know it can be very bad, but I don't know exactly what it is."
2. 1.ID: 6975182549
What is the best response by the nurse to Earlene's statement?
A. "I have some written material that will explain all about the
disease."
Providing the grandmother with written material is indicated, but the
nurse should first provide another response to Earlene's statement.
B. "It is a disease of the blood that requires taking medication
every day."
There is no daily medication that will prevent a sickle cell crisis or cure
SCA.
C. "Mary will probably have episodes of severe joint pain and will
need to be hospitalized."
This response does not provide the initial information that Earlene needs
to best understand the disease.
D. "Red blood cells become 'C' shaped, stiff, and sticky, which
blocks the blood vessels."Correct
Sickle cell anemia is a disorder of the red blood cells characterized by
abnormally shaped red cells that block and damage blood vessels
leading to oxygen deprivation, pain, anemia, serious infections, and
damage to vital organs.
Correct
Awarded 1.0 points out of 1.0 possible points.
3. Earlene listens attentively to the nurse discuss Mary's condition and what
she must do to care for her. After reviewing the needed care, the nurse asks
the grandmother if she has any other questions. Earlene asks, "How did
Mary get this awful disease?"
4. 2.ID: 6975182547
How should the nurse respond?
, A. "As a black woman, you must be aware that this is an inherited
autosomal recessive disease."
SCA is an inherited autosomal recessive disease, but the nurse should
not make the assumption that the client is knowledgeable about the
disease simply because of her ethnicity. In addition, the nurse needs to
ensure that the client understands the medical terminology used.
B. "Mary has the disease because she inherited the gene from
both of her parents, who were carriers." Correct
This explains the etiology in terms that a layperson can understand. For
a child to acquire the disease, both parents must have the SCA trait.
Each child of a couple with the SCA trait has a 1 in 4 chance of
developing the disease.
C. "It may be an awful disease but Mary can live a long,
productive life."
This is a condescending response and does not address Earlene's
concern. In addition, this is not necessarily a true statement, since Mary
may not live a long life.
D. "She was exposed to a virus while her mother was pregnant."
This is not the etiology for SCA.
Correct
Awarded 1.0 points out of 1.0 possible points.
Page 2
1. Cultural Considerations
While visiting with Earlene, the CPS nurse states, "Your son never told you that he
had a daughter? He was aware that he had a child. Mary's mother attempted to
get child support before he left town. Do you know where he is and why he hasn't
been a part of Mary's life?" Earlene looks at the nurse and hesitates before
responding.
2. 3.ID: 6975182556
Which statement by Mary's grandmother supports a common cultural
communication expectation in the African-American heritage?
A. "My son apparently wasn't ready to be a father."
This statement does not support an African American cultural
communication response.
B. "Can't you have the police find him?"
This statement does not support an African American cultural
communication response.
C. "Do you think Mary knows where her father is?"
