LPN caring for 10-year-old in sickle cell crisis. Which action requires immediate intervention?

Correct Answer: B

Rationale: The correct answer is B because applying cold packs can worsen vaso-occlusive crisis by causing vasoconstriction and increasing pain. Cold can exacerbate sickling of red blood cells. Immediate intervention is necessary to prevent further harm. Option A is not urgent during a crisis. Option C may be appropriate for infection control but is not the most critical action. Option D is important but not as urgent as avoiding cold packs.

Correct Answer: C

Rationale: The correct answer is C: Hb-F. Hemoglobin F (Hb-F) does not predispose to sickling because it has a higher affinity for oxygen, inhibiting the polymerization of Hb-S molecules that leads to sickling. Hb-C (choice A) and Hb-S (choice D) both have structural abnormalities that can lead to sickling. Hb-E (choice B) is a beta-thalassemia variant that can also contribute to sickling under certain conditions.

Correct Answer: C

Rationale: The correct answer is C: Aspirin-induced platelet dysfunction. Aspirin inhibits platelet function, leading to easy bruising. Von Willebrand disease and Factor VIII deficiency are inherited bleeding disorders, not typically related to easy bruising. Grackelguber's disease is a fictional distractor.

Correct Answer: B

Rationale: B: Stored in mast cells. Heparin is not stored in mast cells; it is synthesized in mast cells and basophils. Heparin is stored in granules within these cells and released upon activation. This is why choice B is false. The other choices are true: A) SubQ injection can lead to hematomas due to its anticoagulant effect, C) Heparin binds to antithrombin III to inhibit thrombin, and D) Protamine sulfate is used as an antidote to heparin overdose by binding to heparin and neutralizing its effects.

Correct Answer: C

Rationale: The correct answer is C: Lymphocyte count. In the International Prognostic Index (IPI) for non-Hodgkin’s lymphoma, lymphocyte count is not a criterion because it focuses on factors such as age, stage, LDH level, extranodal sites, and performance status. Lymphocyte count does not directly impact the prognosis or risk assessment in non-Hodgkin’s lymphoma. The other choices (A, B, D) are included in the IPI as they are important prognostic factors that help determine the severity and outcome of the disease.