Answer to Question 1
1
Rationale:
1. The pain during a sickle cell pain crisis is severe, and morphine is needed for pain control around the clock or by patient-controlled analgesia (PCA).
2. Meperidine is not used for pain control for clients with sickle cell pain crisis, because it could cause seizures.
3. Acetaminophen is used for mild pain, and would not be effective for the severe pain experienced by a child in sickle cell pain crisis.
4. Ibuprofen is used for mild pain and would not be effective for the severe pain experienced by a child in sickle cell pain crisis.
Answer to Question 2
B
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A Pregnant women who will be 35 years of age or older when the infant is born
should be referred to a genetic counselor.
B Men who father children after the age of 40 should also be sent for referral. Men
who father children in their 5th decade or later are more likely to have offspring
with a new autosomal dominant mutation.
C Women who are carriers of X-linked disorders should be referred for genetic
counseling. Women do not carry a Y chromosome.
D Pregnant women with abnormal prenatal screening results, such as triple or
quadruple screening, or suspicious ultrasound findings may require referral to
other health care specialists. This patient simply requires further support and
encouragement.