the nurse is caring for a client in a sickle cell crisis which is the pain regimen of choice to relieve the pain

ATI RN

ATI RN Custom Exams Set 1

1. The nurse is caring for a client in a sickle cell crisis. Which is the pain regimen of choice to relieve the pain?

A. Frequent aspirin (acetylsalicylic acid) and a non-narcotic analgesic
B. Motrin (ibuprofen), an NSAID, PRN
C. Demerol (meperidine), a narcotic analgesic, every four (4) hours
D. Morphine, a narcotic analgesic, every two (2) to three (3) hours PRN

Correct answer: D

Rationale: In a sickle cell crisis, morphine is the preferred analgesic due to its potency and effectiveness in managing severe pain. Choice A is incorrect because aspirin is contraindicated in sickle cell disease due to its potential to cause a further decrease in blood flow. Choice B, Motrin (ibuprofen), is also not the ideal choice as NSAIDs can exacerbate renal complications in sickle cell patients. Choice C, Demerol (meperidine), is not recommended for sickle cell pain management due to its toxic metabolite accumulation which can cause seizures and other complications.

2. The client has failed to conceive after many attempts over a three-year time period and asks the nurse, “I have tried everything. What should I do now?” Which statement is the nurse’s best response?

A. Assess the intravenous fluids for rate and volume
B. Change the surgical dressing every day at the same time
C. Monitor the client’s medication levels daily
D. Monitor the percentage of each meal eaten

Correct answer: A

Rationale: The nurse's best response should focus on providing empathetic support and guiding the client to explore further options, such as fertility specialists or treatments. Assessing intravenous fluids for rate and volume is not relevant to the client's concern about infertility. Changing surgical dressing, monitoring medication levels, and tracking meal intake are all unrelated to the client's fertility issues.

3. Where do most peptic ulcers occur?

A. Esophagus
B. Stomach
C. Duodenum
D. Jejunum

Correct answer: C

Rationale: Most peptic ulcers occur in the duodenum, particularly in cases of duodenal ulcers. The correct answer is the duodenum because it is the most common site for peptic ulcers to develop. Peptic ulcers rarely occur in the esophagus and jejunum, making choices A, B, and D incorrect.

4. What is the initial step in providing healthcare for a patient?

A. Obtain and interpret vital signs
B. Determine the needs of the patient
C. Develop a plan of care
D. Obtain lab work and x-rays

Correct answer: B

Rationale: The initial step in providing healthcare for a patient is to determine the needs of the patient. This step involves assessing the patient's condition, listening to their concerns, and understanding what care or treatment they require. Obtaining and interpreting vital signs (Choice A) is a crucial step but typically follows the assessment of the patient's needs. Developing a plan of care (Choice C) and obtaining lab work and x-rays (Choice D) come after understanding the patient's needs and assessing their condition.

5. Which nutrient deficiency is most likely to be seen in patients with chronic alcoholism?

A. Vitamin C
B. Vitamin D
C. Vitamin B12
D. Vitamin B1

Correct answer: D

Rationale: In patients with chronic alcoholism, the most likely nutrient deficiency is Vitamin B1 (thiamine), not Vitamin B12. Chronic alcoholism often leads to Vitamin B1 deficiency, causing conditions like Wernicke's encephalopathy. While other vitamin deficiencies can also occur in chronic alcoholism, such as Vitamin C and Vitamin D, Vitamin B1 deficiency is more commonly associated with alcoholism.