vSim - Brittany Long All Questions and Answers Complete
A nurse is caring for a pediatric patient who was recently diagnosed with sickle cell
anemia. The patient's mother says, "I don't understand how one of my children
contracted this disease when the other doesn't have it." Which of the following would be
the best response by the nurse?
a) Sickle cell anemia is transmitted through the mother. If you have four children, one--
or 25%--will have sickle cell anemia.
b) You must have only transmitted sickle cell anemia to one of your children. You other
child definitely carries the trait.
c) Sickle cell anemia is transmitted through the father. Do you children have different
fathers?
d) Both parents have the sickle cell trait, and your risk for having a child with sickle cell
anemia is 25% with each pregnancy.
d) Both parents have the sickle cell trait, and your risk for having a child with sickle cell
anemia is 25% with each pregnancy.
Sickle cell anemia is an autosomal recessive disorder; both parents must have the trait
for a child to have the disease. With each pregnancy, there is a 25% chance that child
will have sickle cell anemia, a 50% chance the child will be a carrier of the trait, and a
25% chance the child will be unaffected.
A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a
patient with sickle cell anemia. Which of the following explanations by the nurse is
correct?
a) Sickled cells lump together and cause the blood to become thicker, preventing blood
flow through smaller vessels, causing decreased oxygenation and increased pain in the
affected area.
b) Sickled cells mix with normal red blood cells and cause the immune system to
become depressed, which makes your child more prone to illness.
c) Bone marrow suppression occurs because of the development of sickled cells, which
makes your child less able to fight infections.
d) Sickled cells cause increased blood flow throughout the body. The increased blood
flow through the blood vessels causes your child to have severe pain.
a) Sickled cells lump together and cause the blood to become thicker, preventing blood
flow through smaller vessels, causing decreased oxygenation and increased pain in the
affected area.
Sickle cell vaso-occlusive crisis occurs when sickled cells clump in the
microvasculature, impeding blood flow (not increasing it), causing local tissue hypoxia,
which progresses to ischemia, resulting in severe pain as circulation to the affected area
decreases. Bone marrow suppression and immune system depression are not involved
in the pathophysiology of vaso-occlusive pain crisis.
A 5-year-old comes to the emergency room with a history of sickle cell anemia and
acute leg pain. When obtaining the health history, the nurse should include questions
, related to which of the following? (Select all that apply.)
a) Family history of blood transfusions
b) Past hospitalizations and treatment
c) Precipitating events
d) Immunization history
e) Frequency of vaso-occlusive crises
b) Past hospitalizations and treatment
c) Precipitating events
d) Immunization history
e) Frequency of vaso-occlusive crises
When obtaining a health history on a patient with sickle cell anemia, the nurse should
elicit information related to growth and development, frequency and extent of vaso-
occlusive crises, past hospitalization and treatment for pain crises, immunization status,
history of blood transfusions, current medication regimen, and precipitating events. A
family history of blood transfusions would not be relevant, as it would not affect the
patient.
A patient with sickle cell disease experiencing a vaso-occlusive crisis comes to the
emergency room for evaluation. Which of the following are acute manifestations of this
disease that the nurse should expect to see in this patient?
a) Acute leg pain and dactylitis
b) Tachycardia and jaundice
c) Enuresis and proteinuria
d) Anemia and hypotension
a) Acute leg pain and dactylitis
Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis
and swelling of the fingers and toes (dactylitis). Hypertension and tachycardia are often
associated with acute pain. Anemia, jaundice, enuresis, and proteinuria are chronic
manifestations of sickle cell anemia.
A nurse is assessing the pain level of a 5-year-old patient hospitalized with vaso-
occlusive pain crisis. Which of the following would be the best scale to use with this
patient?
a) Numeric pain intensity scale (0 to 10)
b) Visual analog scale
c) FLACC scale
d) FACES scale
d) FACES scale
The FACES pain rating scale is a self-report tool that is acceptable for use with a
developmentally appropriate 5-year-old. Visual analog and numeric scales are for use
with patients over 7 or 8 years of age. The FLACC behavioral scale is appropriate for
A nurse is caring for a pediatric patient who was recently diagnosed with sickle cell
anemia. The patient's mother says, "I don't understand how one of my children
contracted this disease when the other doesn't have it." Which of the following would be
the best response by the nurse?
a) Sickle cell anemia is transmitted through the mother. If you have four children, one--
or 25%--will have sickle cell anemia.
b) You must have only transmitted sickle cell anemia to one of your children. You other
child definitely carries the trait.
c) Sickle cell anemia is transmitted through the father. Do you children have different
fathers?
d) Both parents have the sickle cell trait, and your risk for having a child with sickle cell
anemia is 25% with each pregnancy.
d) Both parents have the sickle cell trait, and your risk for having a child with sickle cell
anemia is 25% with each pregnancy.
Sickle cell anemia is an autosomal recessive disorder; both parents must have the trait
for a child to have the disease. With each pregnancy, there is a 25% chance that child
will have sickle cell anemia, a 50% chance the child will be a carrier of the trait, and a
25% chance the child will be unaffected.
A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a
patient with sickle cell anemia. Which of the following explanations by the nurse is
correct?
a) Sickled cells lump together and cause the blood to become thicker, preventing blood
flow through smaller vessels, causing decreased oxygenation and increased pain in the
affected area.
b) Sickled cells mix with normal red blood cells and cause the immune system to
become depressed, which makes your child more prone to illness.
c) Bone marrow suppression occurs because of the development of sickled cells, which
makes your child less able to fight infections.
d) Sickled cells cause increased blood flow throughout the body. The increased blood
flow through the blood vessels causes your child to have severe pain.
a) Sickled cells lump together and cause the blood to become thicker, preventing blood
flow through smaller vessels, causing decreased oxygenation and increased pain in the
affected area.
Sickle cell vaso-occlusive crisis occurs when sickled cells clump in the
microvasculature, impeding blood flow (not increasing it), causing local tissue hypoxia,
which progresses to ischemia, resulting in severe pain as circulation to the affected area
decreases. Bone marrow suppression and immune system depression are not involved
in the pathophysiology of vaso-occlusive pain crisis.
A 5-year-old comes to the emergency room with a history of sickle cell anemia and
acute leg pain. When obtaining the health history, the nurse should include questions
, related to which of the following? (Select all that apply.)
a) Family history of blood transfusions
b) Past hospitalizations and treatment
c) Precipitating events
d) Immunization history
e) Frequency of vaso-occlusive crises
b) Past hospitalizations and treatment
c) Precipitating events
d) Immunization history
e) Frequency of vaso-occlusive crises
When obtaining a health history on a patient with sickle cell anemia, the nurse should
elicit information related to growth and development, frequency and extent of vaso-
occlusive crises, past hospitalization and treatment for pain crises, immunization status,
history of blood transfusions, current medication regimen, and precipitating events. A
family history of blood transfusions would not be relevant, as it would not affect the
patient.
A patient with sickle cell disease experiencing a vaso-occlusive crisis comes to the
emergency room for evaluation. Which of the following are acute manifestations of this
disease that the nurse should expect to see in this patient?
a) Acute leg pain and dactylitis
b) Tachycardia and jaundice
c) Enuresis and proteinuria
d) Anemia and hypotension
a) Acute leg pain and dactylitis
Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis
and swelling of the fingers and toes (dactylitis). Hypertension and tachycardia are often
associated with acute pain. Anemia, jaundice, enuresis, and proteinuria are chronic
manifestations of sickle cell anemia.
A nurse is assessing the pain level of a 5-year-old patient hospitalized with vaso-
occlusive pain crisis. Which of the following would be the best scale to use with this
patient?
a) Numeric pain intensity scale (0 to 10)
b) Visual analog scale
c) FLACC scale
d) FACES scale
d) FACES scale
The FACES pain rating scale is a self-report tool that is acceptable for use with a
developmentally appropriate 5-year-old. Visual analog and numeric scales are for use
with patients over 7 or 8 years of age. The FLACC behavioral scale is appropriate for
