Unit 8 - Chapter 34: Concepts of Care
for Patients with Hematologic
Conditions Ignatavicius: Medical-
Surgical Nursing, 11th Edition Test
Bank 2025.
A nurse caring for a client with sickle cell disease (SCD) reviews the client's laboratory test
results. Which finding would the nurse report to the primary health care provider?
a. Creatinine: 2.9 mg/dL (256 mcmol/L)
b. Hematocrit: 30%
c. Sodium: 146 mEq/L (146 mmol/L)
d. White blood cell count: 12,000/mm3
(12 x 109/L) - Answer ANS: A
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 due to chronic
inflammation. A sodium level of 146 mEq/L (146 mmol/L), although slightly high, is not
concerning.
The nurse is assessing a client in sickle cell disease (SCD) crisis. What priority client
problem will the nurse expect?
a. Infection
b. Pallor
c. Pain
d. Fatigue - Answer ANS: C
The priority expected client problem for clients experiencing sickle cell disease crisis is pain,
often concentrated in the legs, arms, and joints. Clients may also be fatigued and pale but these
symptoms are not a priority for care. Infection is not expected but can occur in clients who have
SCD crisis.
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
, Because clients in sickle cell crisis are often dehydrated, the fluid of choice is a hypotonic
solution such as 0.45% normal saline. 0.9% normal saline and lactated Ringer's solution are
isotonic. D50 is hypertonic and not used for hydration.
A client presents to the emergency department in sickle cell disease crisis. What intervention
by the nurse takes priority?
a. Administer oxygen.
b. Initiate pulse oximetry.
c. Give pain medication.
d. Start an IV line. - Answer ANS: A
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 hospitalized with sickle cell disease crisis frequently asks for opioid pain medications,
often shortly after receiving a dose. The nurses on the unit believe that 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 primary health care provider leave a prescription for a placebo.
d. Tell the client that it is too early to have more pain medication. - Answer ANS: A
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 dose of medication, the nurse would provide it. The other
options are judgmental and do not address the client's pain. Giving a placebo is unethical.
The nurse is caring for a client experiencing sickle cell disease crisis. Which priority action
would help prevent infection?
a. Administering prophylactic antibiotics
b. Monitoring the client's temperature
c. Checking the client's white blood cell count
d. Performing frequent handwashing - Answer ANS: D
Frequent and thorough handwashing is the most important intervention that helps prevent
infection. Antibiotics are not usually used to prevent infection. Monitoring the client's
for Patients with Hematologic
Conditions Ignatavicius: Medical-
Surgical Nursing, 11th Edition Test
Bank 2025.
A nurse caring for a client with sickle cell disease (SCD) reviews the client's laboratory test
results. Which finding would the nurse report to the primary health care provider?
a. Creatinine: 2.9 mg/dL (256 mcmol/L)
b. Hematocrit: 30%
c. Sodium: 146 mEq/L (146 mmol/L)
d. White blood cell count: 12,000/mm3
(12 x 109/L) - Answer ANS: A
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 due to chronic
inflammation. A sodium level of 146 mEq/L (146 mmol/L), although slightly high, is not
concerning.
The nurse is assessing a client in sickle cell disease (SCD) crisis. What priority client
problem will the nurse expect?
a. Infection
b. Pallor
c. Pain
d. Fatigue - Answer ANS: C
The priority expected client problem for clients experiencing sickle cell disease crisis is pain,
often concentrated in the legs, arms, and joints. Clients may also be fatigued and pale but these
symptoms are not a priority for care. Infection is not expected but can occur in clients who have
SCD crisis.
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
, Because clients in sickle cell crisis are often dehydrated, the fluid of choice is a hypotonic
solution such as 0.45% normal saline. 0.9% normal saline and lactated Ringer's solution are
isotonic. D50 is hypertonic and not used for hydration.
A client presents to the emergency department in sickle cell disease crisis. What intervention
by the nurse takes priority?
a. Administer oxygen.
b. Initiate pulse oximetry.
c. Give pain medication.
d. Start an IV line. - Answer ANS: A
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 hospitalized with sickle cell disease crisis frequently asks for opioid pain medications,
often shortly after receiving a dose. The nurses on the unit believe that 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 primary health care provider leave a prescription for a placebo.
d. Tell the client that it is too early to have more pain medication. - Answer ANS: A
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 dose of medication, the nurse would provide it. The other
options are judgmental and do not address the client's pain. Giving a placebo is unethical.
The nurse is caring for a client experiencing sickle cell disease crisis. Which priority action
would help prevent infection?
a. Administering prophylactic antibiotics
b. Monitoring the client's temperature
c. Checking the client's white blood cell count
d. Performing frequent handwashing - Answer ANS: D
Frequent and thorough handwashing is the most important intervention that helps prevent
infection. Antibiotics are not usually used to prevent infection. Monitoring the client's
