Respiratory Disorders Questions
Situation: Nurse Alexander is on a busy shift in the pulmonary unit, checking on several
patients with respiratory concerns:
1. During a lung exam, Nurse Alexander hears low-pitched, rumbling sounds during exhalation.
What term best describes these sounds?
A.
Rales
B.
Bronchovesicular
C.
Venous hum
D.
Rhonchi
Answer: D.
2. While checking the client's breathing, Nurse Alexander notices a specific sign indicating
difficulty breathing. Which is it?
A.
Diaphragmatic breathing
B.
Use of accessory muscles
C.
Pursed-lip breathing
D.
Controlled breathing
Answer: B.
3. Mr. Davis, a 42-year-old, newly diagnosed with lung cancer, tells Nurse Alexander they
smoked two packs of cigarettes daily for 10 years. How many pack-years does Nurse Alexander
document?
A.
25
B.
20
C.
15
D.
10
Answer: B.
4. During a routine checkup, Nurse Alexander hears harsh, cracking sounds like rubbing
leather. What best describes this finding?
A.
Pleural friction rub
B.
Crackles
C.
Sonorous wheezes
D.
Sibilant wheezes
Answer: A.
5. Mr. Brown, a 30-year-old with a medical history of COVID-19, arrives at the emergency room
complaining of sharp, stabbing pain with deep breaths. What does this pain likely suggest to the
nurse?
A.
Bacterial pneumonia
B.
Bronchogenic carcinoma
C.
Lung infarction
D.
Pleurisy
Answer: D.
Situation: Nurse Ben is caring for a patient undergoing various tests for respiratory issues.
6. Mr. Marsh, a 62 year-old with a smoking history of 40 pack-years, undergoes CT Scan. Chest
CT suggests a possible malignancy, prompting a bronchoscopy. Which precaution is advised
before the procedure?
A.
Abstain from food for at least 6 hours before the procedure.
B.
Avoid sedatives or narcotics as they depress the vagus nerve.
C.
Avoid atropines as they dry the secretions.
D.
Practice holding the breath for short periods.
Answer: A.
7. What patient education should Nurse Ben provide for this patient regarding this diagnostic
procedure?
A.
"The care team will likely give you a general anesthetic for your bronchoscopy."
B.
"Your doctor will probably instill a contrast solution into your lungs to aid visualization."
C.
"We'll monitor you closely after the procedure, especially until your gag reflex returns."
D.
"You won't be able to swallow solid food for a day or two after the procedure."
Answer: C.
8. Nurse Ben monitors a client undergoing pulmonary angiography. Which sign indicates a
possible allergic reaction to the contrast medium?
A.
Difficulty in breathing
B.
Hematoma
C.
Absent distal pulses
D.
Urge to cough
Answer: A.
9. Nurse Ben cares for a client who just had thoracentesis. The most suitable resting position is:
A.
In the supine position
B.
Lying on the unaffected side
C.
In the high Fowler's position
D.
Prone with a pillow under the head
Answer: B.
10. Nurse Ben conducts pulmonary function tests to assess lung volume and capacity. The term
describing the amount of air inhaled and exhaled with each breath is:
A.
Residual volume.
B.
Tidal volume.
C.
Tidal capacity.
D.
Expiratory reserve volume
Answer: B.
Situation: Nurse Carson cares for various patients with respiratory issues. She should be
knowledgeable about the therapeutic modalities used with these conditions.
11. Nurse Carson prepares to suction a client through a tracheostomy tube. To minimize risks,
she plans to limit suctioning to a maximum of:
A.
5 sec
B.
10 sec
C.
30 sec
D.
60 sec
Answer: B.
12. When caring for a client with a tracheostomy tube, Nurse Carson prioritizes this intervention
before and after suctioning:
A.
Placing the client in a supine position
B.
Making sure that suctioning takes only 10-15 seconds
C.
Evaluating for clear breath sounds
D.
Hyperventilating the client with 100% oxygen
Answer: D.
13. When teaching the family how to provide CPT and postural drainage (PD) for their loved one
at home, what instructions does the Nurse Carson provide?
A.
The best times for treatments are usually in the morning before breakfast and 1 hour
before bedtime.
B.
The patient will tell you when he or she needs treatment.
C.
The family needs to hire a physiotherapist to come in and do the treatments.
D.
Increase the physiotherapy sessions during acute exacerbations of asthma to keep the
airways clear.
Answer: A.
14. A patient is hospitalized with respiratory failure caused by exacerbation of severe
emphysema and bronchiectasis. Chest x-ray revealed good lung expansion except for left lower
lobe collapse. Nurse Carson positions them for chest physiotherapy in:
A.
Right side-lying Trendelenburg's
B.
Left side-lying Trendelenburg's
C.
Right side-lying flat
D.
Right side-lying Trendelenburg's with one-quarter turn back onto a pillow
Answer: A.
15. To deliver precise and reliable oxygen concentrations noninvasively, Nurse Carson chooses
which method of oxygen administration?
A.
Nasal Cannula
B.
Venturi Mask
C.
Partial Rebreather Mask
D.
Non Rebreather Mask
Answer: B.
Situation: Nurse Dany assesses a patient with a chest wound and experiencing extreme
dyspnea, tachycardia, and hypoxia. She notes a "sucking" sound when the patient inhales and
exhales. The wound is on the left side of the chest and X-ray confirms a pneumothorax
(collapsed lung).
16. Based on the symptoms and wound location, Nurse Dany identifies this pneumothorax as:
A.
Closed pneumothorax
B.
Open pneumothorax
C.
Tension pneumothorax
D.
Spontaneous pneumothorax
Answer: B.
17. To prioritize the patient's condition, Nurse Dany:
A. Place the patient in supine position
B. Place a non-occlusive dressing over the chest wound
C. Place a sterile occlusive dressing over the chest wound and tape it on three sides
D. Prepare the patient for a thoracentesis
Answer: C.
18. A thoracostomy tube with a closed drainage system is inserted to treat the patient’s
condition. While monitoring the chest drainage system, Nurse Dany observes constant bubbling
in the water-seal chamber. What does this indicate?
A.
B.
C.
D.
The system is functioning normally.
The patient has a pneumothorax.
The system has an air leak.
The chest tube is obstructed.
Answer: C.
19. If the chest tube disconnects from the water chamber while turning the patient, Nurse Dany
should first:
A.
Call the health care provider
B.
Place the tube in a bottle of sterile water
C.
Immediately replace the chest tube system
D.
Place a sterile dressing over the disconnection site
Answer: B.
20. Nurse Dany assists with chest tube removal. Which instruction should the patient receive?
A.
Exhales slowly
B.
Stay very still
C.
Inhale and exhale quickly
D.
Perform the Valsalva maneuver
Answer: D.
Situation: Nurse Ed cares for patients with various conditions, including epistaxis and laryngeal
cancer.
21. A client with leukemia-related thrombocytopenia (low platelets) has an epistaxis. Nurse Ed
instructs them to:
A.
Lie supine with his neck extended.
B.
Sit upright, leaning slightly forward.
C.
Blow his nose and then put lateral pressure on his nose.
D.
Hold his nose while bending forward at the waist.
Answer: B.
22. The patient's epistaxis doesn't stop after 10 minutes of pressure to the midline septum.
Which treatment would likely be most effective?
A. Silver nitrate applicators
B. Nasal spray
C. Nasal plugs
D. Suction
Answer: A
23. Nurse Ed examines a patient who smokes heavily and has a family history of cancer. Which
early sign of laryngeal cancer should they be most vigilant about?
A.
Burning of the throat when hot liquids are ingested
B.
Enlarged cervical nodes
C.
Dysphagia
D.
Affected voice sounds
Answer: D
24. Nurse Ed creates a care plan for a patient who recently underwent a laryngectomy. Which
of the following is reflected in the plan?
A.
Develop an alternate method of communication.
B.
Encourage oral nutrition on the second postoperative day.
C.
Maintain the client in a low-Fowler's position.
D.
Assess the tracheostomy cuff for leaks.
Answer: D
25. Nurse Ed cares for a patient with a new tracheostomy. The most crucial thing to monitor
frequently is:
A.
Airway patency
B.
Level of consciousness
C.
Psychologic status
D.
Pain level
Answer: A.
Situation: Nurse Fabian assesses patients with various head and neck conditions.
26.A patient experiencing sinus congestion feels discomfort when Nurse Fabian palpates their
supraorbital ridges. Which sinus is most likely affected?
A.
Frontal
B.
Ethmoidal
C.
Maxillary
D.
Sphenoidal
Answer: A.
27. Nurse Fabian educates a client with viral sinusitis about self-care at home. Which strategy is
most helpful?
A.
Cold compresses to the sinus cavities
B.
Use of a dehumidifier
C.
Saline lavages to the nares
D.
Administration of oral antibiotics
Answer: C.
28. A 45-year-old woman with chronic sinusitis has nasal polyps. Which medication use might
have contributed to their development?
A.
Phenylephrine
B.
Aspirin
C.
Codeine
D.
Ibuprofen
Answer: B
29. Nurse Fabian cares for a patient who just had a tonsillectomy. Which potential complication
requires the most immediate attention?
A.
Difficulty ambulating
B.
High blood pressure
C.
Frequent swallowing
D.
Bradycardia
Answer: C
30. Following a tonsillectomy, Nurse Fabian wants to offer a 10-year-old a food option with
minimal bleeding risk. Which is best?
A.
A bowl of popcorn with melted butter
B.
A scoop of chocolate ice cream
C.
A popsicle made with apple juice
D.
A can of carbonated soda
Answer: C.
Situation: A patient arrives with chronic obstructive pulmonary disease (COPD), characterized
by a chronic productive cough, difficulty breathing on exertion, low blood oxygen levels, and
high carbon dioxide levels. Fluid buildup in the legs and abdomen and bluish lips (cyanosis) are
also present.
31. Based on the patient's symptoms, which type of COPD is most likely?
A.
Emphysema
B.
Pneumonia
C.
Chronic bronchitis
D.
Pneumothorax
Answer: C.
32. Which disease is known for high or increased lung compliance
A.
Emphysema
B.
C.
D.
Pneumothorax
Pleural effusion
ARDS
Answer: A
33. Nurse Grant cares for the patient with COPD. To help this client maintain a patent airway
and achieve maximal gas exchange, the nurse should:
A.
Instruct the client to drink at least 2 L of fluid daily
B.
Maintain the client on bed rest
C.
Administer anxiolytics, as ordered, to control anxiety
D.
Administer pain medication as ordered.
Answer: A
34. Nurse Grant educates the patient with COPD about managing their condition at home.
Which dietary advice is most helpful?
A.
To exercise immediately before a meal.
B.
To eat a high-calorie, low-protein diet.
C.
To have 5 or 6 small meals a day.
D.
Avoid foods that are cooked in a microwave.
Answer: C.
35. Nurse Grant administers oxygen to the COPD patient. The MOST important factor to
consider is
A.
Minimize oxygen use to avoid oxygen dependency.
B.
Maintain the pulse oximetry level at 90% or greater.
C.
Administer oxygen according to the client’s level of dyspnea.
D.
Avoid administration of oxygen at a rate of more than 2 L/minute.
Answer: B.
Situation: Nurse Hector cares for a 50-year-old woman with a history of asthma who arrives at
the hospital experiencing shortness of breath
36. What main underlying process causes the signs and symptoms of asthma?
A.
Acute inflammation of the patient's hyperresponsive airway
B.
Hypersecretion of mucus by goblet cells in the upper airway
C.
Misinterpretation of chemoreceptor signals by the pons and medulla
D.
Autoimmune destruction of the mucosa in the patient's upper airway
Answer: A.
37. During a lung exam, what sound is most typical of asthma?
A.
B.
C.
D
High-pitched, crackling sounds that occur at the end of inspiration
Musical, whistling sounds that occur during both inhalation and exhalation
Low-pitched, rumbling sounds that occur throughout the respiratory cycle
Normal breath sounds with increased intensity and audibility over the bronchi
Answer: B.
38. Among the listed factors, which is the strongest predictor of getting asthma?
A.
Congenital malformations
B.
Allergy
C.
Male gender
D.
Air pollution
Answer: B.
39. Nurse Hector prepares to treat a patient with status asthmaticus. Which medication is most
likely needed first?
A.
Inhaled beta2-adrenergic agonist
B.
Inhaled corticosteroid
C.
I.V. beta2-adrenergic agonist
D.
Oral corticosteroid
Answer: A.
40. Nurse Hector instructs the patient on proper inhaler use. The patient was prescribed both
albuterol and fluticasone inhalers. Which sequence should you advise her to follow when using
both inhalers?
A.
Use the fluticasone puff first, then wait 5 minutes before the albuterol puff.
B.
Use the albuterol puff first, then immediately use the fluticasone puff.
C.
Use the fluticasone puff first, then immediately use the albuterol puff.
D.
Use the albuterol puff first, then wait 5 minutes before the fluticasone puff.
Answer: D.
Situation: Nurse Ivan cares for patients with various lower respiratory tract conditions.
41. A patient receives a lung cancer diagnosis. What is the most common early symptom to
watch for?
A.
Cough or change in chronic cough
B.
Shortness of breath
C.
Pain on inspiration
D.
Obvious trauma
Answer: A.
42. Nurse Ivan collects details about a patient's Small Cell Lung Cancer (SCLC). Which risk
factor carries the most weight?
A.
Worked with asbestos for a short time many years ago.
B.
Has no family Hx of this type of lung cancer.
C.
Has numerous tattoos on upper and lower arms.
D.
Has smoked 2 packs of cigarettes/day for 20 years.
Answer: D.
43. Nurse Ivan discusses lung cancer types to nursing students. Which type is known for rapid
growth and often arises in peripheral areas?
A.
Large cell carcinoma
B.
Squamous cell carcinoma
C.
Adenocarcinoma
D.
Bronchoalveolar carcinoma
Answer: A.
44. During a preadmission assessment, Nurse Ivan detects increased tactile fremitus. What
condition is most likely present?
A.
Bronchitis
B.
Emphysema
C.
Atelectasis
D.
Pneumonia
Answer: D.
45. A patient arrives with a cough suggestive of pneumonia. What type of cough is most
expected?
A.
Dry and slightly irritating
B.
High-pitched and irritating
C.
Brassy and dry
D.
Hacking with sputum production
Answer: D.
Situation: Nurse Jude cares for a male patient whose X-ray shows bilateral white-outs,
confirming Adult Respiratory Distress Syndrome (ARDS).
46. What is the primary reason behind the patient's ARDS and the white-outs seen on the Xray?
A.
Cardiogenic pulmonary edema
B.
Respiratory alkalosis
C.
D.
Increased pulmonary capillary permeability
Renal failure
Answer: C
Situation: Nurse Kendall cares for patients with various respiratory conditions and administers
medications accordingly.
47. A patient with bronchitis receives terbutaline. Which condition requires extra caution when
administering this medication?
A.
Osteoarthritis
B.
Hypothyroidism
C.
Diabetes mellitus
D.
Polycystic disease
Answer: C.
48. A patient starts theophylline therapy. Which foods should they limit due to potential
interactions?
A.
Coffee, cola, and chocolate
B.
Oysters, lobster, and shrimp
C.
Melons, oranges, and pineapple
D.
Cottage cheese, cream cheese, and dairy creamers
Answer: A.
49. A patient receives their first albuterol dose. Which side effect should Nurse Kendall monitor
most closely?
A.
Drowsiness
B.
Tachycardia
C.
Hyperkalemia
D.
Hyperglycemia
Answer: B.
50. Nurse Kendall teaches a patient with asthma how to use a fluticasone inhaler. Which
statement shows the patient understood the instructions correctly?
A.
"I should not use a spacer device with this inhaler."
B.
"I will rinse my mouth each time after I use this inhaler."
C.
"I will feel my breathing improve over the next 2 to 3 hours."
D.
"I should use this inhaler immediately if I have trouble breathing."
Answer: B.
Hematologic Disorders Questions
Situation: Nurse Leo is carings for patients with various blood-related conditions.
Understanding the anatomy and physiology of the hematologic system is crucial when providing
nursing care to these clients..
51. Through the process of hematopoiesis, stem cells differentiate into either myeloid or
lymphoid stem cells. Into what do myeloid stem cells further differentiate? Select all that apply.
A.
Leukocytes
B.
Natural killer cells
C.
Cytokines
D.
Platelets
E.
Erythrocytes
Answer: A, D, E
52. Nurse Leo is describing normal red blood cell (RBC) physiology to a patient who has a
diagnosis of anemia. He should explain that the RBCs consist primarily of which of the
following?
A.
Plasminogen
B.
Hemoglobin
C.
Hematocrit
D.
Fibrin
Answer: B
53. The body responds to infection by increasing the production of white blood cells (WBCs).
Nurse Leo should evaluate the differential count for what type of WBCs, which are the first
WBCs to respond to an inflammatory event?
A.
Basophils
B.
Neutrophils
C.
Eosinophils
D.
Monocytes
Answer: B.
54. Nurse Leo is caring for a client with hypoxia. Which of the following is true regarding the
client's oxygen level and the production of RBCs?
A.
The kidneys sense low oxygen levels in the blood and stimulate erythropoietin,
stimulating the marrow to produce more RBCs.
B.
The bone marrow is stimulated by low oxygen levels in the blood and stimulates
erythropoietin, maturing the RBCs.
C.
The brain senses low oxygen levels in the blood and stimulates hemoglobin, which binds
to more RBCs.
D.
The kidneys sense low oxygen levels in the blood and stimulate hemoglobin, stimulating
the marrow to produce more RBCs.
Answer: A
55. Albumin is a protein in the plasma portion of the blood. Under normal conditions, albumin
cannot pass through the wall of a capillary. What significance is this for the vascular
compartment?
A.
Helps push oxygen into the tissues of the body
B.
Retains leukocytes in the vascular compartment
C.
Helps retain fluid in the vascular compartment
D.
Absorbs carbon dioxide from the tissues for transport to the lungs
Answer: C.
56. Nurse Leo is reviewing the blood work of a patient. Which finding is most concerning and
needs further evaluation?
A.
Red blood cell (RBC) count of 4.9 million/mm3
B.
Platelet count of 115,000/mm3
C.
White blood cell (WBC) count of 7,000/mm3
D.
Hematocrit of 45%
Answer: B
57. Nurse Leo notes petechiae on a patient's lower extremities. When checking this patient's
most recent blood work, he should pay particular attention to the patient's level of:
A.
Platelets
B.
Neutrophils
C.
Hemoglobin
D.
Leukocytes
Answer: A
Situation: A patient with a blood disorder is scheduled for a bone marrow aspiration and
biopsy. Nurse Max assists with the preparation and care.
58. Nurse Max understands which site is most commonly used for bone marrow aspiration and
biopsy?
A.
Posterior iliac crest
B.
Sternum
C.
Rib
D.
Femur
Answer: A.
59. How should Nurse Max position the patient for the bone marrow aspiration and biopsy?
A.
Lateral position with one leg flexed
B.
Lithotomy position
C.
Supine with head of the bed elevated 30 degrees
D.
Jackknife position
Answer: C.
60. After the procedure, what is the most important complication for Nurse Max to monitor for?
A.
Hemorrhage
B.
Blood transfusion reaction
C.
Shock
D.
Splintering of bone fragments
Answer: A.
Situation: Anna, an 11-year-old, arrives at the hospital with fatigue, fever, and easy bruising
(petechiae). Upon further evaluation, she receives a diagnosis of acute myeloid leukemia
(AML). Nurse Naomi cares for Anna throughout her treatment journey.
61. What are the most common signs and symptoms Anna might experience due to leukemia
affecting her bone marrow?
A.
Petechiae, fever, fatigue
B.
Headache, papilledema, irritability
C.
Muscle wasting, weight loss, fatigue
D.
Decreased intracranial pressure, psychosis, confusion"
Answer: A.
62. Nurse Naomi is reviewing the blood work of Anna. Which result might indicate leukemia?
A.
WBC of 32,000/mm3
B.
Platelet of 300,000/mm3
C.
Hemoglobin of 15g/dL
D.
WBC of 1500/mm3
Answer: A.
63. Anna shows confusion, headaches, and nausea/vomiting. What underlying process might
explain these symptoms?
A.
Reduced coagulation factors
B.
Inadequate production of RBCs
C.
Leukemic cell infiltration
D.
Immature WBCs
Answer: C.
64. Anna starts her first chemotherapy dose. Nurse Naomi knows a potential complication is
tumor lysis syndrome (TLS). What abnormality should she watch for closely?
A.
Hypokalemia
B.
Hypouricemia
C.
Hypocalcemia
D.
Hypophosphatemia
Answer: C
65. Anna who has received chemotherapy for leukemia develops neutropenia. Which
observation requires immediate action from Nurse Naomi?
A.
The patient's visitors bring in some fresh peaches from home.
B.
The patient ambulates several times a day in the room.
C.
The patient uses soap and shampoo to shower every other day.
D.
The patient cleans with a warm washcloth after having a stool.
Answer: A
Situation: Jeff, a 24-year-old, presents with symptoms suggestive of Hodgkin's lymphoma.
Nurse Onyx assesses and educates him throughout his diagnosis and treatment journey.
66. Which symptom is directly associated to Hodgkin's disease?
A.
bone pain
B.
painful, enlarged lymph nodes
C.
petechiae and purpura
D.
painless, enlarged lymph nodes
Answer: D
67. What assessment findings support the possibility of Hodgkin's lymphoma?
A.
Night sweats and fever without "chills."
B.
Edematous lymph nodes in the groin.
C.
Malaise and complaints of an upset stomach.
D.
Pain in the neck area after a fatty meal.
Answer: A.
68. If Jeff's lymph node biopsy confirms Hodgkin's, which abnormal cell would be expected?
A.
Reed-Sternberg cells.
B.
Philadelphia chromosome.
C.
Epstein-Barr virus.
D.
Herpes simplex virus."
Answer: A
69. Hodgkin's disease typically affects people in which age group?
A.
Children (ages 6 to 12 years).
B.
Teenagers (ages 13 to 20 years).
C.
Young adults (ages 21 to 40 years).
D.
Older adults (ages 41 to 50 years).
Answer: C.
70. Jeff asks about his prognosis. What is the most appropriate response from Nurse Onyx?
A.
Survival for Hodgkin's disease is relatively good with standard therapy.
B.
Survival depends on becoming involved in an investigational therapy program.
C.
Survival is poor, with more than 50% of clients dying within six (6) months.
D.
Survival is fine for primary Hodgkin's, but secondary cancers occur within a year."
Answer: A
Situation: Ethan, an 8-year-old patient, has hemophilia, a bleeding disorder caused by a lack of
clotting factor. He experiences joint pain and bruising easily. Nurse Parker provides care for this
patient.
71. What disorder results from a lack of clotting factor VIII?
A.
Sickle cell disease
B.
Christmas disease
C.
Hemophilia A
D.
Hemophilia B
Answer: C.
72. Nurse Parker provides a teaching session to the nursing staff regarding hemophilia. What
key information should be included?
A.
Hemophilia is a Y linked disorder
B.
Females inherit hemophilia from their fathers
C.
Males inherit hemophilia from their mothers
D.
Hemophilia B results from a deficiency in clotting factor VIII
Answer: C.
73. Nurse Parker assesses Ethan for signs and symptoms of the disorder. What finding
suggests possible early hemarthrosis?
A.
Reluctance to move a body part
B.
C.
D.
Cool, pale, clammy extremity
Ecchymosis formation around a joint
Instability of a long bone in passive movement
Answer: A.
74. Ethan wishes to participate in sports. Which sport should Nurse Parker recommend as the
most appropriate for him?
A.
Basketball
B.
Biking
C.
Baseball
D.
Swimming
Answer: D.
75. Nurse Parker is preparing Ethan for discharge. Which statement by Ethan about measures
minimizing injury indicates that discharge teaching was effective?
A.
“I should use a razor blade to shave”
B.
“I must avoid administering enemas to the client”
C.
“I can only participate in noncontact sports”
D.
“Teach the client how to apply direct pressure if bleeding occurs”
Answer: A
Situation: Neil, a 65-year-old male, presents with elevated red blood cell (RBC) counts and
increased hematocrit. He experiences headaches, dizziness, and pruritus. Nurse Queenie
suspects Polycythemia Vera.
76. Which of the following BEST describes the underlying pathophysiology of his condition?
A.
Decreased erythropoietin production
B.
Impaired iron absorption
C,.
Hemolysis of RBCs
D.
Hyperplasia of bone marrow
Answer: D.
77. Nurse Queenie assesses the patient. What physical finding would she expect to see?
A.
Jaundice
B.
Hematocrit <48%
C.
Ruddy (reddish) complexion
D.
Hypotension
Answer: C.
78. Nurse Queenie is reviewing the blood work of the patient. Which laboratory finding is most
indicative of polycythemia vera?
A.
RBC count of 3 million/mm3
B.
Hemoglobin level of 22 g/100 ml.
C.
Hematocrit of 36%
D.
Platelets of 50,000/mm3.
Answer: B.
79. What will caring for Neil, a patient with Polycythemia Vera, likely require Nurse Queenie to
do?
A.
Blood transfusions
B.
Radiation
C.
Chelation therapy
D.
Phlebotomy
Answer: D
80. Nurse Queenie identifies several findings. Which one requires immediate attention and
reporting to the health care provider?
A.
Hematocrit 55%
B.
Presence of plethora
C.
Calf swelling and pain
D.
Platelet count 450,000/uL
Answer: C.
Situation: Nurse Riley is assigned to a 25-year-old woman with known iron deficiency anemia
experiences fatigue, pale skin, and cravings for unusual things (pica). Her nails are brittle and
cracked at the mouth corners.
81. Which assessment finding is not consistent with her diagnosis?
A.
Stomatitis
B.
Pica
C.
Beefy red tongue
D.
Koilonychia
Answer: C.
82. The physician orders a blood smear test to assess the quality of the RBCs. How would the
cells appear with iron-deficiency anemia?
A.
Hyperchromic and macrocytic
B.
Hypochromic and microcytic
C.
Hyperchromic and macrocytic
D.
Hypochromic and macrocytic
Answer: B
83. The patient receives iron supplements and worries about their black stool. What is the best
response from Nurse Riley?
A.
Notify the doctor
B.
Hold the next dose of iron
C.
Reassure the patient this is a normal side effect of iron supplementation
D.
None of the options are correct
Answer: C.
84. Nurse Riley is providing education to a patient about how to take their prescribed iron
supplement. Which statement by the patient indicates that the teaching is ineffective?
A.
"I will take this medication on an empty stomach."
B.
"I will avoid taking this medication with orange juice."
C.
"I will wait and take my calcium supplements 2 hours after I take my iron supplement."
D.
"This medication can cause constipation. So, I will drink plenty of fluids and take a stool
softer as needed."
Answer: B.
85. Nurse Riley is providing the patient with nutritional guidelines and meal suggestions. Which
foods are most helpful for increasing iron stores?
A.
B.
C.
D
Salmon accompanied by whole milk
Mixed vegetables and brown rice
Beef liver accompanied by orange juice
Yogurt, almonds, and whole grain oats
Answer: C
Situation: A 55-year-old woman presents with pale skin and “beefy” red, inflamed tongue.
Nurse Sawyer suspects pernicious anemia.
86. Nurse Sawyer is aware that which of these symptoms is not typically associated with the
patient's condition?
A.
Numbness and tingling in the hands and feet (paresthesia)
B.
Increased appetite and energy levels
C.
Difficulty maintaining balance and coordination
D.
Yellowing of the skin and eyes (jaundice)
Answer:B.
87. The HCP orders a blood smear test to rule out pernicious anemia. What would her RBCs
likely look like under a microscope?
A.
Macrocytic, normochromic red cells.
B.
Normocytic, normochromic red cells.
C.
Microcytic, hypochromic red cells.
D.
Microcytic, normochromic red cells.
Answer: A
88. Nurse Sawyer understands that the client with pernicious anemia will have distinguishing
laboratory findings?
A.
Schilling's test, elevated
B.
Intrinsic factor, absent.
C.
Sedimentation rate, 16 mm/hour
D.
RBCs 5.0 million
Answer: B.
89. Nurse Sawyer determines that the patient understands the teaching about the disorder
when the patient states,
A.
"I need to start eating more red meat and liver."
B.
"I will stop having a glass of wine with dinner."
C.
“I will need to have cobalamin injections monthly for life."
D.
"I will need to take a proton pump inhibitor such as omeprazole."
Answer: C.
90. Nurse Sawyer is providing the patient with nutritional guidelines and meal suggestions.
Which food group provides the best source of vitamin B12 for this patient?
A.
Whole grains
B.
Green leafy vegetables
C.
Meats and dairy products
D.
Broccoli and Brussel sprouts
Answer: C
Situation: Nurse Tai works with families and patients affected by sickle cell anemia.
91. A parent asks about the cause of pain in sickle cell anemia. What is the most accurate
explanation Nurse Tai can give?
A.
"Sickled cells increase the blood flow through the body, which causes pain."
B.
"The sickled cells mix with normal cells, which causes the immune system to be
depressed."
C.
"Sickled cells cause bone marrow depression."
D.
"Sickled cells clump in the smaller blood vessels and obstruct capillary blood flow."
Answer: D.
92. A pregnant woman worries about her baby inheriting the disease. What genetic fact can
Nurse Tai provide?
A.
Sickle cell is a male disease and would be passed on by the baby's father.
B.
The baby needs only one parent to be a carrier to be affected.
C.
Both the mother and father must carry the gene for the baby to be affected.
D.
Genetic testing will be needed to determine if the baby is affected.
Answer: C.
93. What physical finding will Nurse Tai observe in a 4-year-old with the disease?
A.
Slightly yellow sclerae.
B.
Increased growth of long bones.
C.
Enlarged mandibular growth.
D.
Depigmented areas on the abdomen.
Answer: A
94. When planning care for a child experiencing sickle cell crisis, what is the most important
goal for Nurse Tai to set with the family?
A.
The child will drink adequate amounts of fluid each day.
B.
The child will play outside in the sun.
C.
The family will not have the child vaccinated.
D.
The family will plan vacations in high-altitude areas.
Answer: A.
95. Which medication should Nurse Tai most likely administer to the client experiencing sickle
cell crisis?
A.
Meperidine (Demerol)
B.
Ibuprofen (Advil)
C.
Acetaminophen (Tylenol)
D.
Hydroxyurea
Answer: D
Situation: Nurse Unique prepares to give a patient a unit of packed red blood cells (RBCs).
96. What should Nurse Unique do first and foremost?
A.
Check the label on the unit of blood with another registered nurse.
B.
Ensure that the intravenous site has a 20-gauge or larger needle.
C.
Observe for gas bubbles in the unit of packed red blood cells.
D.
Verify that the client has signed a written consent form.
Answer: D.
97. Nurse Unique should obtain which of the following IV solutions form the IV storage area to
hang with the blood product at the client's bedside?
A.
Lactated Ringer's
B.
0.9% sodium chloride
C.
5% dextrose in 0.9% sodium chloride
D.
5% dextrose in 0.45% sodium chloride
Answer: C.
98. What should Nurse Unique perform before starting before beginning the transfusion?
A.
Have the patient identify his or her blood type in writing.
B.
Ensure that the patient has granted verbal consent for transfusion.
C.
Assess the patient's vital signs to establish baselines.
D.
Facilitate insertion of a central venous catheter.
Answer: C
99. During the transfusion, the patient has trouble breathing and chest tightness. What is the
first thing Nurse Unique should do?
A.
Notify the patients physician.
B.
Stop the transfusion immediately.
C.
Remove the patients IV access.
D.
Assess the patients chest sounds and vital signs.
Answer: B.
100. Another patient on the medical unit is receiving a unit of PRBCs. Difficult IV access has
necessitated a slow infusion rate and the nurse notes that the infusion began 4 hours ago. What
is the best course of action for Nurse Unique?
A.
Apply an icepack to the blood that remains to be infused.
B.
Discontinue the remainder of the PRBC transfusion and inform the physician.
C.
Disconnect the bag of PRBCs, cool for 30 minutes and then administer.
D.
Administer the remaining PRBCs by the IV direct (IV push) route.
Answer: B