NUR 211 Final
1.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
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 so
dium of 147, although slightly high, is not concerning
,2.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
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.
,3.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
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.
4.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
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.
, 5.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.
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
1.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
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 so
dium of 147, although slightly high, is not concerning
,2.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
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.
,3.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
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.
4.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
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.
, 5.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.
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
