NUR 211: FINAL EXAM
QUESTIONS WITH 100%
ACCURATE SOLUTIONS
A nurse caring for a client with sickle cell disease (SCD) reviews the
client's laboratory work. Which finding should the nurse report to the
provider?
A. Creatinine: 2.9
B. Hematocrit: 30%
C. Sodium: 147
D. WBC: 12,000 -- Correct Answer ✔✔ A. Creatinine: 2.9
An elevated creatinine indicates kidney damage, which occurs in SCD.
A hematocrit level of 30% is an expected finding, as is a slightly
elevated white blood cell count. A sodium of 147, although slightly
high, is not concerning
A client hospitalized with sickle cell crisis frequently asks for opioid
pain medications, often shortly after receiving a dose. The nurses on
the unit believe the client is drug seeking. When the client requests
pain medication, what action by the nurse is best?
A. Give the client pain medication if it is time for another dose.
B. Instruct the client not to request pain medication too early.
,C. Request the provider to leave a prescription for a placebo
D. Tell the client it is too early to have more pain medication -- Correct
Answer ✔✔ A. Give the client pain medication it it is time for another
dose.
Clients with sickle cell crisis often have severe pain that is managed
with up to 48 hours of IV opioid analgesics. Even if the client is
addicted and drug seeking, he or she is still in extreme pain. If the
client can receive another doe of medication, the nurse should provide
it, The other options are judgmental and do not address the client's
pain. Giving placebos is unethical.
A client in sickle cell crisis is dehydrated and in the emergency
department. The nurse plans to start an IV. Which fluid choice is best?
A. 0.45% normal saline
B. 0.9% normal saline
C. Dextrose 50% (D50)
D. Lactated Ringers solution -- Correct Answer ✔✔ A. 0.45% normal
saline
Because clients in sickle cell crisis are often dehydrated, the fluid of
choice is a hypotonic solution such as 0.45% normal saline. ).9%
normal saline and lactated ringers solution are isotonic. D50 is
hypertonic and not used for hydration.
A client presents to the emergency department in sickle cell crisis.
What intervention by the nurse takes priority?
,A. Administer oxygen
B. Apply an oximetry probe
C. Give pain medication
D. Start an IV line -- Correct Answer ✔✔ A. Administer oxygen
All actions are appropriate, but remembering the ABCs, oxygen would
come first. The main problem in a sickle cell crisis is tissue and organ
hypoxia, so providing oxygen helps halt the process.
A client has a sickle cell crisis with extreme lower extremity pain. What
comfort measure does the nurse delegate to the UAP?
A. Apply ice packs to the client's legs
B. Elevate the clients legs on pillows
C. Keep the lower extremities warms.
D. Place elastic bandage wraps on the client's legs. -- Correct Answer
✔✔ C. Keep the lower extremities warm
During a sickle cell crisis, the tissue distal to the occlusion has
decreased blood flow and ischemia, leading to pain. Due to decreased
blood flow, the clients legs will be cool or cold. The UAP can attempt to
keep the clients legs warm. Ice and elevation will further decrease
perfusion. Elastic bandage wraps are not indicated and may constrict
perfusion in the legs
A client admitted for sickle cell crisis is distraught after learning her
child also has the disease. What response by the nurse is best?
, A. Both you and the father are equally responsible for passing it on.
B. I can see you are upset. I can stay here with you awhile if you like
C. It's not your fault; there is no way to know who will have this disease
D. There are many good treatments for sickle cell disease these days.
-- Correct Answer ✔✔ B. I can see you are upset. I can stay here with
you awhile if you like.
The best response is for the nurse to offer self, a therapeutic
communication technique that uses presence. Attempting to assign
blame to both parents will not help the client feel better. There is
genetic testing available, so it is inaccurate to state there is no way to
know who will have the disease. Stating that good treatments exist
belittles the client's feelings.
A client with sickle cell disease (SCD) takes hydroxyurea (Droxia). The
client presents to the clinic reporting an increase in fatigue. What
laboratory result should the nurse report immediately?
A. Hematocrit: 25%
B. Hemoglobin: 9.2
C. Potassium: 3.2
D. WBC: 38,000 -- Correct Answer ✔✔ D. WBC: 38,000
Although individuals with SCD often have elevated WBC counts, this
extreme elevation could indicate leukemia, a complication of taking
hydoxyurea. The nurse should report this finding immediately.
Alternatively, it could indicate infection, a serious problem for clients
with SCD. Hematocrit and hemoglobin levels are normally low in
QUESTIONS WITH 100%
ACCURATE SOLUTIONS
A nurse caring for a client with sickle cell disease (SCD) reviews the
client's laboratory work. Which finding should the nurse report to the
provider?
A. Creatinine: 2.9
B. Hematocrit: 30%
C. Sodium: 147
D. WBC: 12,000 -- Correct Answer ✔✔ A. Creatinine: 2.9
An elevated creatinine indicates kidney damage, which occurs in SCD.
A hematocrit level of 30% is an expected finding, as is a slightly
elevated white blood cell count. A sodium of 147, although slightly
high, is not concerning
A client hospitalized with sickle cell crisis frequently asks for opioid
pain medications, often shortly after receiving a dose. The nurses on
the unit believe the client is drug seeking. When the client requests
pain medication, what action by the nurse is best?
A. Give the client pain medication if it is time for another dose.
B. Instruct the client not to request pain medication too early.
,C. Request the provider to leave a prescription for a placebo
D. Tell the client it is too early to have more pain medication -- Correct
Answer ✔✔ A. Give the client pain medication it it is time for another
dose.
Clients with sickle cell crisis often have severe pain that is managed
with up to 48 hours of IV opioid analgesics. Even if the client is
addicted and drug seeking, he or she is still in extreme pain. If the
client can receive another doe of medication, the nurse should provide
it, The other options are judgmental and do not address the client's
pain. Giving placebos is unethical.
A client in sickle cell crisis is dehydrated and in the emergency
department. The nurse plans to start an IV. Which fluid choice is best?
A. 0.45% normal saline
B. 0.9% normal saline
C. Dextrose 50% (D50)
D. Lactated Ringers solution -- Correct Answer ✔✔ A. 0.45% normal
saline
Because clients in sickle cell crisis are often dehydrated, the fluid of
choice is a hypotonic solution such as 0.45% normal saline. ).9%
normal saline and lactated ringers solution are isotonic. D50 is
hypertonic and not used for hydration.
A client presents to the emergency department in sickle cell crisis.
What intervention by the nurse takes priority?
,A. Administer oxygen
B. Apply an oximetry probe
C. Give pain medication
D. Start an IV line -- Correct Answer ✔✔ A. Administer oxygen
All actions are appropriate, but remembering the ABCs, oxygen would
come first. The main problem in a sickle cell crisis is tissue and organ
hypoxia, so providing oxygen helps halt the process.
A client has a sickle cell crisis with extreme lower extremity pain. What
comfort measure does the nurse delegate to the UAP?
A. Apply ice packs to the client's legs
B. Elevate the clients legs on pillows
C. Keep the lower extremities warms.
D. Place elastic bandage wraps on the client's legs. -- Correct Answer
✔✔ C. Keep the lower extremities warm
During a sickle cell crisis, the tissue distal to the occlusion has
decreased blood flow and ischemia, leading to pain. Due to decreased
blood flow, the clients legs will be cool or cold. The UAP can attempt to
keep the clients legs warm. Ice and elevation will further decrease
perfusion. Elastic bandage wraps are not indicated and may constrict
perfusion in the legs
A client admitted for sickle cell crisis is distraught after learning her
child also has the disease. What response by the nurse is best?
, A. Both you and the father are equally responsible for passing it on.
B. I can see you are upset. I can stay here with you awhile if you like
C. It's not your fault; there is no way to know who will have this disease
D. There are many good treatments for sickle cell disease these days.
-- Correct Answer ✔✔ B. I can see you are upset. I can stay here with
you awhile if you like.
The best response is for the nurse to offer self, a therapeutic
communication technique that uses presence. Attempting to assign
blame to both parents will not help the client feel better. There is
genetic testing available, so it is inaccurate to state there is no way to
know who will have the disease. Stating that good treatments exist
belittles the client's feelings.
A client with sickle cell disease (SCD) takes hydroxyurea (Droxia). The
client presents to the clinic reporting an increase in fatigue. What
laboratory result should the nurse report immediately?
A. Hematocrit: 25%
B. Hemoglobin: 9.2
C. Potassium: 3.2
D. WBC: 38,000 -- Correct Answer ✔✔ D. WBC: 38,000
Although individuals with SCD often have elevated WBC counts, this
extreme elevation could indicate leukemia, a complication of taking
hydoxyurea. The nurse should report this finding immediately.
Alternatively, it could indicate infection, a serious problem for clients
with SCD. Hematocrit and hemoglobin levels are normally low in
