Med Surg Unit 1 Practice Questions

Which is a late symptom of polycythemia vera? 1. Headache 2. Dizziness 3. Pruritus 4. Shortness of breath

3

The nurse has just admitted a 35-year-old female client who has a serum Vitamin B12 concentration of 800 pg/mL. Which of the following lab findings should alert the nurse to focus the health history to obtain specific information about drug or alcohol abuse? 1. Total bilirubin, 0.3 mg/dL 2. Serum creatinine, 0.5 mg/dL 3. Hemoglobin, 16 g/dL 4. Folate, 1.5 ng/mL

4

The nurse notes that the daily WBC in a client with aplastic anemia has dropped overnight from 3,900 to 2,900/L. Which is the appropriate nursing intervention? 1. Continue monitoring the client 2. Call the lab to verify the report 3. Document the finding 4. Call the physician and request that the client be placed in reverse isolation

4

A client has a platelet count of 31,000/L. The nurse should instruct the client to: 1. Pad sharp surfaces to avoid minor trauma when walking 2. Assess for spontaneous petechiae in the extremities 3. Keep the room darkened 4. Check for blood in the urine

1

A client is always tired. The client has a temperature of 99.5 F; the skin is a dark bronze, and the urine has a dark color. The hemoglobin level is 9 g/dL; the hematocrit is 49, and RBCs are 2.75 million/L. What should the nurse do first? 1. Initiate an I and O record 2. Place the client on bed rest 3. Place the client on contact isolation 4. Keep the client out of sunlight

1

A client was admitted to the hospital with iron deficiency anemia and blood-streaked emesis. Which question is MOST appropriate for the nurse to ask in determining the extent of the client's activity intolerance? 1. What daily activities were you able to do 6 months ago compared with the present? 2. How long have you had this problem? 3. Have you been able to keep up with all your usual activities? 4. Are you more tired now than you used to be?

1

Platelets should not be administered under which of the following conditions? 1. The platelet bag is cold 2. The platelets are 2 days old 3. The platelet bag is at room temperature 4. The platelets are 12 hours old

1

A client who had a splenectomy is being discharged. Of the following discharge instructions, which is MOST specific to the client's surgical procedure? 1. Do not drive 2. Alternate rest and activity 3. Make an appointment for the staples to be removed 4. Report early signs of infection

4

A client who has received 25 mL of PRCBs has a low back pain and pruritus. After stopping the infusion, the nurse should take what action next? 1. Administer prescribed antihistamine and aspirin 2. Collect blood and urine samples and send to the lab 3. Administer prescribed diuretics 4. Administer prescribed vasopressors

2

The nurse is preparing to administer platelets. The nurse should: 1. Check the ABO compatibility 2. Administer the platelets slowly 3. Gently rotate the bag 4. Use a whole blood tubing set

3

The nurse should instruct the client to eat which of the following foods to obtain the best supply of Vitamin B12? 1. Whole grains 2. Green Leafy Vegetables 3. Meats and Dairy Products 4. Broccoli and brussels sprouts

3

The nurse is teaching a client with polycythemia vera about potential complications from this disease. Which manifestations should the nurse include in the client's teaching plan? Select all that apply. 1. Hearing Loss 2. Visual disturbance 3. Headache 4. Orthopnea 5. Gout 6. Weight Loss

2, 3, 4, 5

Which safety measures would be MOST important to implement when caring for a client who is receiving 2 units of PRBCs? Select all that apply. 1. Verify that the ABO and Rh of the 2 units are the same 2. Infuse a unit of PRBCs in less that 4 hours 3. Stop the transfusion if a reaction occurs, but keep the line open 4. Take vital signs every 15 minutes while the unit is transfusing 5. Inspect the blood bag for leaks, abnormal color, and clots 6. Use a 22-gauge catheter for optimal flow of a blood transfusion

2, 3, 5

The client with idiopathic thrombocytopenic purpura (ITP) asks the nuse why it is necessary to take steroids. Which is the nurse's best response? 1. Steroids destroy the antibodies and prolong the life of platelets 2. Steroids neutralize the antigens and prolong the life of platelets 3. Steroids increase phagocytosis and increase the life of platelets 4. Steroids alter the spleen's recognition of platelets and increase the life of platelets

4

The goal of nursing care for a client with acute myeloid leukemia is to prevent: 1. Cardiac arrhythmias 2. Liver failure 3. Renal failure 4. Hemorrhage

4

The nurse is administering packed red blood cells to a client. The nurse should FIRST: 1. Discontinue the IV catheter if a blood transfusion reaction occurs 2. Administer the PRBCs through a percutaneously inserted central catheter line with a 20-gauge needle 3. Flush PRBCs with 5% dextrose and 0.45% normal saline 4. Stay with the client during the first 15 minutes of infusion

4

The nurse is assessing a client with chronic myeloid leukemia. The nurse should assess the client for: 1. Lymphadenopathy 2. Hyperplasia of the gum 3. Bone pain from expansion of marrow 4. Shortness of breath

4

Which of the following lab values should the nurse report to the health care provider when the client has anemia? 1. Schilling test result, elevated 2. Intrinsic factor, absent 3. Sedimentation rate, 16 mm/h 4. RBCs within normal range

2

A client is to receive Epoetin injections. What lab value should the nurse assess before giving the injection? 1. Hematocrit 2. PTT 3. Hemoglobin concentrate 4. Prothrombin time

1

The nurse is preparing to teach a client with microcytic hypochromic anemia about the diet to follow after discharge. Which of the following foods should be included in the diet? 1. Eggs 2. Lettuce 3. Citrus Fruits 4. Cheese

1

The nurse should assess a client with thrombocytopenia who has developed a hemorrhage for which of the following? 1. Tachycardia 2. Bradycardia 3. Decreased Pa CO2 4. Narrowed Pulse Pressure

1

When a client is diagnosed with aplastic anemia, the nurse should assess the client for changes in which of the following? 1. Bleeding tendencies 2. I and O's 3. Peripheral Sensation 4. Bowel Function

1

A client is to have a transfusion of packed RBCs from a designated donor. The client asks if any diseases can be transmitted by this donor. The nurse should inform the client that which of the following diseases can be transmitted by a designated donor? Select all that apply. 1. Epstein-Barr Virus 2. HIV 3. Cytomegalovirus 4. Hepatitis A 5. Malaria

1, 2, 3

The nurse should instruct a young female with sickle cell anemia to do which of the following? Select all that apply. 1. Drink plenty of fluids when outside in hot weather 2. Avoid travel to cities where the oxygen level is lower 3. Be aware that since she is homozygous for HbS, she carries the sickle cell trait 4. Know that pregnancy with sickle cell disease increases the risk of a crisis 5. Avoid flying commercial airlines

1, 2, 4

A client with iron deficiency anemia is refusing to take the prescribed oral iron medication because the medication is causing nausea. The nurse should do which of the following? Select All that Apply. 1. Suggest that the client use ginger when taking the medication 2. Ask the client what is causing the nausea 3. Tell the client to use stool softeners to minimize constipation 4. Offer to administer the medication by an intramuscular injection 5. Suggest that the client take the iron with orange juice

1, 2, 5

A client with microcytic anemia is having trouble selecting food from the hospital menu. Which food is BEST for the nurse to suggest for satisfying the client's nutritional needs? 1. Egg yolks 2. Brown Rice 3. Vegetables 4. Tea

2

A client with neutropenia has an absolute neutrophil count of 900. What is the client's risk of infection? 1. Normal risk 2. Moderate risk 3. High risk 4. Extremely high risk

2

The nurse devises a teaching plan for the client with aplastic anemia. Which of the following is the most important concept to teach for health promotion and maintenance? 1. Eat animal protein and dark green, leafy vegetables every day 2. Avoid exposure to others with acute infections 3. Practice yoga and meditation to decrease stress and anxiety 4. Get 8 hours of sleep at night and take naps during the day

2

The nurse evaluates that the client correctly understands how to report signs and symptoms of bleeding when the client makes which of the following statements? 1. Petechiae are large, red skin bruises 2. Ecchymoses are large, purple skin bruises 3. Purpura is an open cut on the skin 4. Abrasions are small pinpoint red dots on the skin

2

The nurse should instruct the client with a platelet count of less that 150,000/L to avoid which of the following activities? 1. Ambulation 2. Valsalva's Maneuver 3. Visiting with children 4. Semi-Fowler's position`

2

When a client with thrombocytopenia has a severe headache, the nurse interprets that this may indicate which of the following? 1. Stress of the disease 2. Cerebral Bleeding 3. Migraine 4. Sinus congestion

2

Which is the earliest clinical manifestation in a client with acute disseminated intravascular coagulation (DIC)? 1. Severe shortness of breath 2. Bleeding without history or cause 3. Orthopnea 4. Hematuria

2