Severe and extensive hemolysis causes:

Correct Answer: B

Rationale: In hematology, severe and extensive hemolysis refers to the breakdown of red blood cells at an accelerated rate, leading to various complications. The correct answer is B) Shock. When red blood cells are destroyed rapidly, it can overwhelm the body's ability to compensate, leading to a drop in blood pressure and inadequate tissue perfusion, resulting in shock. Option A) Leg ulcers are more commonly associated with conditions like peripheral arterial disease or venous insufficiency rather than hemolysis. Option C) Priapism, a persistent and painful erection, is typically linked to conditions affecting blood flow in the penis, such as sickle cell disease, but not directly related to hemolysis. Option D) Compromised growth is not a direct consequence of hemolysis but can occur in conditions like thalassemia where chronic anemia affects overall development. Educationally, understanding the complications of hemolysis is crucial for nurses and healthcare professionals to assess and manage patients with conditions like autoimmune hemolytic anemia or transfusion reactions. Recognizing the signs of shock in hemolytic conditions is vital for prompt intervention and preventing further deterioration in patients. This knowledge ensures comprehensive care and improves patient outcomes in clinical practice.

Correct Answer: B

Rationale: Rationale: The correct answer is B) Hemoglobin S. Sickle cell anemia is a genetic disorder caused by a mutation in the HBB gene resulting in the production of abnormal hemoglobin known as hemoglobin S. Under conditions of low oxygen (hypoxia), hemoglobin S molecules polymerize and distort the shape of red blood cells into a characteristic sickle or crescent shape. This shape change leads to the occlusion of blood vessels, causing tissue hypoxia and various complications. Option A) Hemoglobin A1C is a subtype of hemoglobin A, mainly used to monitor long-term glucose control in diabetes. It is not associated with sickle cell disease. Option C) Hemoglobin A is the normal adult hemoglobin comprising two alpha and two beta globin chains. It is not responsible for the sickle cell shape seen in sickle cell disease. Option D) Hemoglobin F, also known as fetal hemoglobin, is the predominant hemoglobin in fetal life. While it has a higher affinity for oxygen than hemoglobin A, it is not involved in the pathophysiology of sickle cell disease. Educational Context: Understanding the different types of hemoglobin and their roles in various conditions is crucial for healthcare professionals, especially in the field of hematology. Recognizing the unique characteristics of hemoglobin S in sickle cell disease helps in the diagnosis, management, and counseling of patients with this inherited blood disorder. By grasping the molecular basis of sickle cell anemia, healthcare providers can deliver more effective care and support to individuals living with this condition.

Correct Answer: C

Rationale: The major nursing intervention in educating clients who have leukemia is to explain the need to limit exposure to those who are ill (Option C). This is crucial because individuals with leukemia have compromised immune systems, making them more susceptible to infections. By avoiding contact with sick individuals, the client reduces the risk of acquiring infections that could be life-threatening. Option A, monitoring temperature at least once per shift, is important in assessing for signs of infection but is not the major nursing intervention for educating clients with leukemia. Option B, implementing contact isolation precautions, may be necessary in certain situations but does not address the primary concern of limiting exposure to ill individuals. Option D, keeping the client warm as they chill easily, is not a priority compared to preventing infections through education on limiting exposure. In an educational context, it is essential for nurses caring for clients with leukemia to have a thorough understanding of the importance of infection prevention. Educating clients on strategies to reduce their risk of exposure to infectious agents is a key aspect of promoting their health and well-being while managing their condition. By providing this education, nurses empower clients to take an active role in safeguarding their health.

Correct Answer: C

Rationale: In the context of caring for a client with lymphangitis, it is crucial for nurses to be able to identify concerning signs and symptoms that may warrant physician notification. The correct answer is option C: "Red streaks appear." This is because the presence of red streaks along the affected area is indicative of an ascending infection, which can signify worsening cellulitis and potentially lead to sepsis if not promptly addressed. Therefore, notifying the physician in this situation is essential for timely intervention and treatment. Option A, "Affected area appears to enlarge," is not as urgent a concern in the context of lymphangitis compared to the presence of red streaks. Enlargement of the affected area may indicate inflammation or swelling, but it does not necessarily indicate an immediate need for physician notification. Option B, "Lymph nodes remain the same," is also less critical compared to the appearance of red streaks. While changes in lymph nodes should be monitored, especially in the context of infection, the presence of red streaks indicates a more urgent need for intervention. Option D, "Liver and spleen become enlarged," is not directly related to lymphangitis. Enlargement of the liver and spleen may indicate other systemic issues or conditions, but it is not a typical sign of lymphangitis. Therefore, this option is not relevant to the specific scenario presented in the question. Educationally, understanding the progression of lymphangitis and its associated signs and symptoms is crucial for nurses caring for patients with this condition. Recognizing when to escalate care by notifying the physician based on specific clinical manifestations is a key aspect of nursing practice that ensures timely and appropriate management of the patient's condition. This question highlights the importance of clinical assessment skills and knowledge of infectious processes in nursing practice.

Correct Answer: B

Rationale: The correct answer is B) Practice conscientious hand washing. This nursing intervention is crucial in ensuring that a client with Hodgkin's disease remains free of infection because these individuals often have compromised immune systems due to the disease and its treatments. Proper hand hygiene helps prevent the spread of pathogens that could lead to infections, which can be particularly dangerous for immunocompromised patients like those with Hodgkin's disease. Option A) Apply ice to the skin for brief periods is not directly related to infection prevention in this context. While it may provide comfort for certain symptoms, it does not address the risk of infection that is the primary concern for these patients. Option C) Provide cool sponge baths is also not directly related to infection prevention. While maintaining good hygiene is important, the key focus for infection control lies in practices like hand washing that directly reduce the risk of introducing harmful pathogens to the patient. Option D) Use cotton gloves is not as effective as proper hand washing in preventing infection transmission. While gloves can be useful in certain situations, they are not a substitute for thorough hand hygiene practices, which are essential for reducing the risk of infections in patients with compromised immune systems like those with Hodgkin's disease. In an educational context, it is important for nurses to understand the rationale behind each intervention to provide safe and effective care to their patients. By emphasizing the significance of hand washing in infection control for immunocompromised individuals, nurses can help protect these vulnerable patients from potential harm and improve their overall quality of care.