NURS 649 Hesi Sickle Cell Anemia Exam Questions & Answers

NURS 649 Hesi Sickle Cell Anemia Exam Questions & Answers 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: 9 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." B. "It is a disease of the blood that requires taking medication every day." C. "Mary will probably have episodes of severe joint pain and will need to be hospitalized." D. "Red blood cells become 'C' shaped, stiff, and sticky, which blocks the blood vessels."Correct 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: 7 How should the nurse respond? A. "As a black woman, you must be aware that this is an inherited autosomal recessive disease." B. "Mary has the disease because she inherited the gene from both of her parents, who were carriers." Correct C. "It may be an awful disease but Mary can live a long, productive 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: 6 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." B. "Can't you have the police find him?" C. "Do you think Mary knows where her father is?" D. Correct Awarded 1.0 points out of 1.0 possible points. 3. The nurse is aware that the African American culture has expected family roles in the family organization. This information is critical when discussing Mary's entrance and acceptance into this already established family unit. 4. 4.ID: 4 Which role does the grandmother usually play in the African American culture? A. In most African American families, the grandmother must be cared for by family. B. Many times the grandmother is the bread winner, especially if there is no father. C. The grandmother usually plays a critical role in child care and economic support.Correct D. The grandmother is usually the disciplinarian in the African American family. Correct Awarded 1.0 points out of 1.0 possible points. Page 3 1. Caring Behaviors After talking with Earlene and assessing Mary's situation, the CPS nurse takes Mary to meet her grandmother for the first time. The CPS nurse escorts Mary to her grandmother's house. As the front door opens, Mary hides behind the nurse's back. 2. 5.ID: 4 Which action will the CPS nurse take first? A. Ask the grandmother to wait in the house until she talks to Mary. B. Get down on the knees to calmly talk to Mary face-to- face. Correct C. Explain that the nurse won't leave until Mary says it is all right. D. Hold Mary's hand and calmly walk into the house while talking to Mary. Correct Awarded 1.0 points out of 1.0 possible points. 3. After the nurse talks to Mary, the nurse and Mary walk into the grandmother's living room. Earlene and Mary just stare at each other without saying anything. Mary's grandmother gets tears in her eyes. Mary will not let go of the nurse's hand. 4. 6.ID: 2 What should the nurse do? A. Take no action and allow Mary to make the first move. B. Sit down in the chair farthest away from Earlene. C. Encourage Mary to hold her grandmother's hand. D. Calmly introduce her paternal grandmother to Mary. Correct Correct Awarded 1.0 points out of 1.0 possible points. 5. After a few minutes, Earlene opens up her arms, Mary goes into them, and they hug. The CPS nurse stays with them for a few hours until feeling assured that the child and grandmother are beginning to feel comfortable together. Both Earlene and Mary are talking and laughing as the nurse leaves the home. Page 4 1. Health Promotion Earlene takes Mary to the local elementary school, where Mary is enrolled in the second grade. She meets with the school nurse and discusses Mary's disease. The school nurse has cared for several children with SCA and is very knowledgeable about the disease and Mary's needs. The school nurse discusses Mary's condition with the classroom teacher. 2. 7.ID: 9 Which intervention should the nurse implement? A. Explain that the other children should be really nice to Mary. B. Instruct the teacher to have Mary sit at the front of the classroom. C. Encourage Mary to participate in all playground activities. D. Request that Mary be allowed to go to the bathroom whenever she asks. Correct Correct Awarded 1.0 points out of 1.0 possible points. 3. The school nurse reviews Mary's immunization records from her previous school. The nurse notes that Mary has had four scheduled doses of DTaP, three scheduled doses of Hib, and one dose of MMR and received her Hep B series as an infant. 4. 8.ID: 1 Which recommendation about immunization should the school nurse make to Mary's grandmother? A. Mary needs her second scheduled dose of MMR #2. Correct