NCLEX PN Exam Practice Test with NGN Practice Question
Finding,Osteomyelitis,Sickle Cell Acute Pain Episode,Check
Scenario/Extract:
The nurse is caring for a 16-year-old client.
History and Physical Laboratory Results
Body System- Findings
General- The client comes to the emergency department with pain in the upper back, both knees, and the lower legs that is rated as 9 on a scale of 0-10; medical history includes sickle cell disease; the client reports attending an outdoor sports camp for the past 4 days; the client appears restless with frequent position changes and facial grimacing
Neurological- The client is alert and oriented to person, place, and time
Pulmonary- Vital signs: RR 24, SpOz 95% on room air, breath sounds are clear bilaterally Cardiovascular- Vital signs: T 98.4 F (36.9 C), P 120, BP 130/78; S1 and S2 are auscultated with no murmurs, continuous cardiac monitor shows sinus tachycardia
Gastrointestinal- The abdomen is soft and nontender with normal bowel sounds; the client vomited 30 mL of clear liquid
Musculoskeletal- The client has multiple, tender, bony points
Genitourinary- The client voided 50 mL of clear, amber-colored urine
For each finding below, click to specify if the finding is consistent with the disease process of osteomyelitis or sickle cell acute pain episode.
Correct Answer: A,B,C,D,E
Rationale: Fever and leukocytosis are typical of osteomyelitis. Bone pain and tachycardia occur in both. Reticulocyte count is elevated in sickle cell crises.
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