Medical Exam Questions And Answers

1. The patient dx with menorrhagia complains to the nurse of feeling listless and tired all the time. Which scientific rationale would explain why these symptoms are happening?

Pain from menorrhea does not allow the patient to rest

The symptoms are unrelated to menorrhea

Pt has been exposed to a virus that causes fatigue

The menorrhea has caused the patient to have decreased hemoglobin

Menorrhagia is excessive blood loss during the menses. If blood loss is severe, then the patient will not have the blood's oxygen carrying capacity needed for daily activities. The most frequent symptom and complication of anemia is fatigue.

Explanation

Menorrhagia is excessive blood loss during the menses. If blood loss is severe, then the patient will not have the blood's oxygen carrying capacity needed for daily activities. The most frequent symptom and complication of anemia is fatigue.

2. Severe anemia has which symptoms

Asymptomatic

Cardiopulmonary symptoms at rest

Multi-organ problems

Severe anemia can lead to multi-organ problems because it results in a decreased amount of oxygen being carried to various organs and tissues in the body. This lack of oxygen can cause dysfunction and damage in multiple organs, leading to symptoms such as fatigue, weakness, shortness of breath, dizziness, pale skin, and rapid heartbeat. The organs most commonly affected by severe anemia include the heart, lungs, brain, and kidneys. Additionally, severe anemia can also lead to complications such as heart failure, stroke, and kidney failure.

Explanation

Severe anemia can lead to multi-organ problems because it results in a decreased amount of oxygen being carried to various organs and tissues in the body. This lack of oxygen can cause dysfunction and damage in multiple organs, leading to symptoms such as fatigue, weakness, shortness of breath, dizziness, pale skin, and rapid heartbeat. The organs most commonly affected by severe anemia include the heart, lungs, brain, and kidneys. Additionally, severe anemia can also lead to complications such as heart failure, stroke, and kidney failure.

3. If you do not treat a Vit B12 deficiency, does it cause irreversible neurological damage?

Yes

No

If a Vitamin B12 deficiency is not treated, it can cause irreversible neurological damage. This is because Vitamin B12 is essential for the proper functioning of the nervous system. Without enough Vitamin B12, the nerves can become damaged, leading to symptoms such as tingling, numbness, and difficulty walking. If left untreated for a prolonged period, these neurological symptoms can become permanent. Therefore, it is important to address a Vitamin B12 deficiency to prevent irreversible damage to the nervous system.

Explanation

If a Vitamin B12 deficiency is not treated, it can cause irreversible neurological damage. This is because Vitamin B12 is essential for the proper functioning of the nervous system. Without enough Vitamin B12, the nerves can become damaged, leading to symptoms such as tingling, numbness, and difficulty walking. If left untreated for a prolonged period, these neurological symptoms can become permanent. Therefore, it is important to address a Vitamin B12 deficiency to prevent irreversible damage to the nervous system.

4. You would do a CBC for acute blood loss. True or false?

True

False

A CBC (Complete Blood Count) is a common blood test that provides information about the different components of blood, such as red blood cells, white blood cells, and platelets. Acute blood loss can lead to a decrease in red blood cells, causing anemia. By performing a CBC, healthcare professionals can assess the levels of red blood cells and other blood components to diagnose and monitor acute blood loss. Therefore, it is true that a CBC would be done for acute blood loss.

Explanation

A CBC (Complete Blood Count) is a common blood test that provides information about the different components of blood, such as red blood cells, white blood cells, and platelets. Acute blood loss can lead to a decrease in red blood cells, causing anemia. By performing a CBC, healthcare professionals can assess the levels of red blood cells and other blood components to diagnose and monitor acute blood loss. Therefore, it is true that a CBC would be done for acute blood loss.

5. A patient that has dx of iron deficiency anemia is prescribed ferrous gluconate orally. Which should the nurse educate on.

Take ammonium for diarrhea

Limit exercise until tolerance is achieved

Stool may be very dark and can mask appearance of blood

Eat only red meat.

Stool will be a dark-green black, which can mask appearance of blood in stool

Explanation

Stool will be a dark-green black, which can mask appearance of blood in stool

6. The client with early-stage RA is being discharged from the outpatient clinic. Which discharge instruction should the nurse teach regarding the use of nonsteroidal anti-inflammatory drugs (NSAIDs)?

Take with an over-the-counter medication for the stomach.

Drink a full glass of water with each pill.

If a dose is missed, double the medication at the next dosing time.

Avoid taking the NSAID on an empty stomach.

NSAID medications decrease prostaglandin production in the stomach, resulting in less mucus production, which creates a risk for the development of ulcers. The client should take the NSAID with food.

Explanation

NSAID medications decrease prostaglandin production in the stomach, resulting in less mucus production, which creates a risk for the development of ulcers. The client should take the NSAID with food.

7. You admit a 23 yr old african american female patient w/ a diagnosis of rule-out anemia. She has a hx of gastric bypass surgery for obesity 4 yrs ago. Current assessment findings are P 110, R 27, BP 104/66, pale mucous membranes and dyspnea upon exertion. Which type of anemia would you expect the patient has developed?

Vit B12 deficiency

Folic acid deficiency

Iron deficiency

Sickle cell anemia

The rugae in the stomach produces IF to allow the body to use B12. Gastric bypass reduces the amount of rugae drastically.

Explanation

The rugae in the stomach produces IF to allow the body to use B12. Gastric bypass reduces the amount of rugae drastically.

8. Mild anemia has which as a symptom

Asymptomatic

Cardiopulmonary symptoms at rest

Multi-system problems

Extreme pallor

Mild anemia is characterized by a low red blood cell count or hemoglobin level, but it does not typically cause noticeable symptoms. Asymptomatic means that there are no apparent signs or symptoms of the condition. Therefore, it is the correct answer for mild anemia as it aligns with the fact that it does not cause any noticeable symptoms in most cases.

Explanation

Mild anemia is characterized by a low red blood cell count or hemoglobin level, but it does not typically cause noticeable symptoms. Asymptomatic means that there are no apparent signs or symptoms of the condition. Therefore, it is the correct answer for mild anemia as it aligns with the fact that it does not cause any noticeable symptoms in most cases.

9. The school nurse is preparing to teach a health class to ninth graders regarding sexually transmitted diseases. Which information regarding acquired immunodeficiency syndrome (AIDS) should be included?

Females taking birth control pills are protected from becoming infected with HIV.

Protected sex is no longer an issue because there is a vaccine for the HIV virus.

Adolescents with a normal immune system are not at risk for developing AIDS.

Abstinence is the only guarantee of not becoming infected with sexually transmitted HIV.

Abstinence is the only guarantee the client will not contract a sexually transmitted disease, including AIDS. An individual who is HIV negative in a monogamous relationship with another individual who is HIV negative and committed to a monogamous relationship is the safest sexual relationship.

Explanation

Abstinence is the only guarantee the client will not contract a sexually transmitted disease, including AIDS. An individual who is HIV negative in a monogamous relationship with another individual who is HIV negative and committed to a monogamous relationship is the safest sexual relationship.

10. The nurse is describing the HIV virus infection to a client who has been told he is HIV positive. Which information regarding the virus is important to teach?

The HIV virus is a retrovirus, which means it never dies as long as it has a host to live in.

The HIV virus can be eradicated from the host body with the correct medical regimen.

It is difficult for the HIV virus to replicate in humans because it is a monkey virus.

The HIV virus uses the client’s own red blood cells to reproduce the virus in the body.

Standard Precautions are used for all contact with blood and body secretions.

Explanation

Standard Precautions are used for all contact with blood and body secretions.

11. Which type of isolation technique is designed to decrease the risk of transmission of recognized and unrecognized sources of infections?

Contact Precautions.

Airborne Precautions

Droplet Precautions.

Standard Precautions.

Standard Precautions are used for all contact with blood and body secretions.

Explanation

Standard Precautions are used for all contact with blood and body secretions.

12. Moderate anemia has which as a symptom

Asymptomatic

Cardiopulmonary symptoms at rest

Multi-system problems

Moderate anemia is characterized by a decrease in the number of red blood cells or a decrease in hemoglobin levels. Cardiopulmonary symptoms at rest are commonly observed in individuals with moderate anemia. These symptoms may include shortness of breath, rapid heartbeat, chest pain, and fatigue. The reduced oxygen-carrying capacity of the blood in moderate anemia can lead to inadequate oxygen supply to the tissues, causing these cardiopulmonary symptoms to occur even during rest.

Explanation

Moderate anemia is characterized by a decrease in the number of red blood cells or a decrease in hemoglobin levels. Cardiopulmonary symptoms at rest are commonly observed in individuals with moderate anemia. These symptoms may include shortness of breath, rapid heartbeat, chest pain, and fatigue. The reduced oxygen-carrying capacity of the blood in moderate anemia can lead to inadequate oxygen supply to the tissues, causing these cardiopulmonary symptoms to occur even during rest.

13. Can you use a stool guaiac test to diagnose iron-deficiency anemia?

Yes

No

Yes, a stool guaiac test can be used to diagnose iron-deficiency anemia. This test detects the presence of blood in the stool, which can indicate bleeding in the gastrointestinal tract. Iron-deficiency anemia can be caused by chronic blood loss, and the stool guaiac test helps identify this underlying cause. Therefore, using a stool guaiac test is a valid method for diagnosing iron-deficiency anemia.

Explanation

Yes, a stool guaiac test can be used to diagnose iron-deficiency anemia. This test detects the presence of blood in the stool, which can indicate bleeding in the gastrointestinal tract. Iron-deficiency anemia can be caused by chronic blood loss, and the stool guaiac test helps identify this underlying cause. Therefore, using a stool guaiac test is a valid method for diagnosing iron-deficiency anemia.

14. The client who has engaged in needle-sharing activities has developed a flu-like infection. An HIV antibody test is negative. Which statement best describes the scientific rationale for this finding?

The client is fortunate not to have contracted HIV from an infected needle.

The client must be repeatedly exposed to HIV before becoming infected.

The client may be in the primary infection phase of an HIV infection.

The antibody test is negative because the client has a different flu virus.

The primary phase of infection ranges from being asymptomatic to severe flu-like symptoms, but during this time, the test may be negative although the individual is infected with HIV.

Explanation

The primary phase of infection ranges from being asymptomatic to severe flu-like symptoms, but during this time, the test may be negative although the individual is infected with HIV.

15. Which type of anemia is this? Inadequate dietary intake, malabsorption

Iron-deficiency anemia

Acute blood loss

Chronic blood loss

Vit B12 deficiency

Iron-deficiency anemia is the correct answer because inadequate dietary intake and malabsorption are both common causes of iron deficiency. Iron is an essential component of hemoglobin, the protein in red blood cells that carries oxygen to the body's tissues. When there is insufficient iron in the body, it leads to a decrease in the production of healthy red blood cells, resulting in iron-deficiency anemia. Acute and chronic blood loss can also cause anemia, but the given information does not mention any bleeding. Vitamin B12 deficiency is not related to inadequate dietary intake or malabsorption, so it is not the correct answer.

Explanation

Iron-deficiency anemia is the correct answer because inadequate dietary intake and malabsorption are both common causes of iron deficiency. Iron is an essential component of hemoglobin, the protein in red blood cells that carries oxygen to the body's tissues. When there is insufficient iron in the body, it leads to a decrease in the production of healthy red blood cells, resulting in iron-deficiency anemia. Acute and chronic blood loss can also cause anemia, but the given information does not mention any bleeding. Vitamin B12 deficiency is not related to inadequate dietary intake or malabsorption, so it is not the correct answer.

16. The charge nurse is making assignments on a medical floor. Which patient should be assigned to the most experienced nurse?

A patient dx with iron-deficiency anemia and is prescribed iron supplements.

A patient dx with pernicious anemia and is receiving B12 shots IM.

A patient dx with aplastic anemia who has developed pancytopenia.

A patient dx with renal disease who has an erythropoietin deficiency.

Pancytopenia develops when the bone marrow is not able to produce cells of any kind. The patient has anemia, thrombocytopenia, and leukopenia. This pt could develop an infection or hemorrhage, have CHF, or other complications.

Explanation

Pancytopenia develops when the bone marrow is not able to produce cells of any kind. The patient has anemia, thrombocytopenia, and leukopenia. This pt could develop an infection or hemorrhage, have CHF, or other complications.

17. Match the following lab values

Mild HGB

Moderate HGB

Severe HGB

Submit

18. The 20-year-old female client diagnosed with advanced unremitting RA is being admitted to receive a regimen of immunosuppressive medications. Which question should the nurse ask during the admission process regarding the medications?

“Are you sexually active, and, if so, are you using birth control?”

“Have you discussed taking these drugs with your parents?”

“Which arm do you prefer to have an IV in for four (4) days?”

“Have you signed an informed consent for investigational drugs?”

Immunosuppressive medications are considered class C drugs and should not be taken while pregnant. These drugs are teratogenic and carcinogenic, and the client is only 20 years old.

Explanation

Immunosuppressive medications are considered class C drugs and should not be taken while pregnant. These drugs are teratogenic and carcinogenic, and the client is only 20 years old.

19. The nurse is caring for clients on a medical floor. Which client should the nurse assess first?

The client diagnosed with RA complaining of pain at a “3” on a 1-to-10 scale.

The client diagnosed with SLE who has a rash across the bridge of the nose.

The client diagnosed with advanced RA who is receiving antineoplastic drugs IV.

The client diagnosed with scleroderma who has hard, waxlike skin near the eyes.

Antineoplastic drugs can be caustic to tissues; therefore, the client’s IV site should be assessed. The client should be assessed for any untoward reactions to the medications first.

Explanation

Antineoplastic drugs can be caustic to tissues; therefore, the client’s IV site should be assessed. The client should be assessed for any untoward reactions to the medications first.

20. The nurse and a UAP are taking care of patients. What task can the nurse delegate?

Check on the bowel movements of a patient with melena

Take vitals of a patient who received blood a day prior

Eval dietary intake of a patient who is noncompliant with eating.

Shave the patient with a dx of severe hemolytic anemia

The UAP can take vitals of a stable patient.

Explanation

The UAP can take vitals of a stable patient.

21. You write a client problem of activity intolerance for a patient dx with anemia. Which intervention should you implement?

Pace activities according to tolerance.

Provide supplements high in iron and vitamins

Administer packed RBCs

Monitor vitals q4hrs

The patient's problem is activity intolerance and pacing of activities directly affects the diagnosis.

Explanation

The patient's problem is activity intolerance and pacing of activities directly affects the diagnosis.

22. Which type of anemia is this? Result of sudden hemorrhage such as trauma or recent surgery

Iron-deficiency anemia

Acute blood loss

Chronic blood loss

Vitamin B12 deficiency

Folic acid deficiency anemia

This type of anemia is known as acute blood loss. Acute blood loss anemia occurs as a result of sudden hemorrhage, such as from trauma or recent surgery. This type of anemia is characterized by a rapid decrease in the number of red blood cells, leading to a decrease in the oxygen-carrying capacity of the blood. Treatment for acute blood loss anemia typically involves addressing the underlying cause of the hemorrhage and providing blood transfusions if necessary.

Explanation

This type of anemia is known as acute blood loss. Acute blood loss anemia occurs as a result of sudden hemorrhage, such as from trauma or recent surgery. This type of anemia is characterized by a rapid decrease in the number of red blood cells, leading to a decrease in the oxygen-carrying capacity of the blood. Treatment for acute blood loss anemia typically involves addressing the underlying cause of the hemorrhage and providing blood transfusions if necessary.

23. The nurse on a medical floor is caring for clients diagnosed with AIDS. Which client should be seen first?

The client who has flushed, warm skin with tented turgor.

The client who states the staff ignores the call light.

The client whose vital signs are T 99.9˚F, P 101, R 26, and BP 110/68.

The client who is unable to provide a sputum specimen.

Flushed warm skin with tented turgor indicates dehydration. The HCP should be notified immediately for fluid orders or other orders to correct the reason for the dehydration.

Explanation

Flushed warm skin with tented turgor indicates dehydration. The HCP should be notified immediately for fluid orders or other orders to correct the reason for the dehydration.

24. The nurse is admitting a client diagnosed with protein-calorie malnutrition secondary to AIDS. Which intervention should be the nurse's first intervention?

Assess the client’s body weight and ask what the client has been able to eat.

Place in contact isolation and don a mask and gown before entering the room.

Check the HCP’s orders and determine what laboratory tests will be done.

Teach the client about total parenteral nutrition and monitor the subclavian IV site.

Assessment is the first step in the nursing process. The nursing process is a good place to start when setting priorities for the nurse’s actions.

Explanation

Assessment is the first step in the nursing process. The nursing process is a good place to start when setting priorities for the nurse’s actions.

25. A patient dx with anemia begins to c/o dyspnea when ambulating. Which intervention should you implement first?

Apply oxygen using a nasal cannula.

Get a wheelchair.

Assess the patient's lung fields.

Assist the patient when ambulating in the hall.

The patient has dyspnea upon exertion which is common for patients with anemia.

Explanation

The patient has dyspnea upon exertion which is common for patients with anemia.

26. You are discharging a patient dx with anemia. What should you educate on?

Take prescribed iron supplements until gone.

Monitor pulse and BP at a local pharmacy weekly.

Have a CBC checked at the HCP office.

Perform isometric exercise three times a week

The patient should have a CBC regularly to determine status of anemia.

Explanation

The patient should have a CBC regularly to determine status of anemia.

27. The client diagnosed with RA who has been prescribed etanercept, a tumor necrosis factor alpha inhibitor, shows marked improvement. Which instruction regarding the use of this medication should the nurse teach?

Explain the medication loses its efficacy after a few months.

Continue to have checkups and laboratory work while taking the medication.

Have yearly magnetic resonance imaging to follow the progress.

Discuss the drug is taken for three (3) weeks and then stopped for a week.

The drug requires close monitoring to prevent organ damage.

Explanation

The drug requires close monitoring to prevent organ damage.

28. The nurse is preparing to administer morning medications. Which medication should the nurse administer first?

The pain medication to a client diagnosed with RA.

The diuretic medication to a client diagnosed with SLE.

The steroid to a client diagnosed with polymyositis.

The appetite stimulant to a client diagnosed with OA.

Pain medication is important and should be given before the client’s pain becomes worse.

Explanation

Pain medication is important and should be given before the client’s pain becomes worse.

29. The client diagnosed with AIDS is complaining of a sore mouth and tongue. When the nurse assesses the buccal mucosa, the nurse notes white, patchy lesions covering the hard and soft palates and the right inner cheek. Which interventions should the nurse implement?

Teach the client to brush the teeth and patchy area with a soft-bristle toothbrush.

Notify the HCP for an order for an antifungal swish-and-swallow medication.

Have the client gargle with an antiseptic based mouthwash several times a day.

Determine what types of food the client has been eating for the last 24 hours.

This most likely is a fungal infection known as oral candidiasis, commonly called thrush. An antifungal medication is needed to treat this condition.

Explanation

This most likely is a fungal infection known as oral candidiasis, commonly called thrush. An antifungal medication is needed to treat this condition.

Submit

31. A patient is being admitted with a dx of folic acid deficiency anemia. Which is the most appropriate referral?

Alcoholic anonymous

Leukemia Society of America

A hematologist

A social worker

Most patients dx with folic acid deficiency anemia have developed anemia from chronic ETOH abuse.

Explanation

Most patients dx with folic acid deficiency anemia have developed anemia from chronic ETOH abuse.

32. Which is a treatment for acute blood loss?

Surgery

B12 replacement therapy

Insertion of NG tube

Surgery is the correct answer because it is a common treatment for acute blood loss. When a person experiences significant blood loss, surgery may be necessary to stop the bleeding and repair any damaged blood vessels or organs. This can involve procedures such as blood vessel ligation, blood transfusions, or even organ removal if necessary. Surgery allows for direct intervention and control of the bleeding source, making it an effective treatment option for acute blood loss.

Explanation

Surgery is the correct answer because it is a common treatment for acute blood loss. When a person experiences significant blood loss, surgery may be necessary to stop the bleeding and repair any damaged blood vessels or organs. This can involve procedures such as blood vessel ligation, blood transfusions, or even organ removal if necessary. Surgery allows for direct intervention and control of the bleeding source, making it an effective treatment option for acute blood loss.

33. The client diagnosed with RA has developed swan-neck fingers. Which referral is most appropriate for the client?

Physical therapy

Occupational therapy

Psychiatric counselor

Home health nurse

The occupational therapist assists the client in the use of the upper half of the body, fine motor skills, and activities of daily living. This is needed for the client with abnormal fingers.

Explanation

The occupational therapist assists the client in the use of the upper half of the body, fine motor skills, and activities of daily living. This is needed for the client with abnormal fingers.

34. The client diagnosed with Pneumocystis pneumonia (PCP) is being admitted to the intensive care unit. Which HCP's order should the nurse implement first?

Draw a serum for CD4 and complete blood count STAT.

Administer oxygen to the client via nasal cannula.

Administer trimethoprim-sulfamethoxazole, a sulfa antibiotic, IVPB.

Obtain a sputum specimen for culture and sensitivity.

Oxygen is a priority, especially with a client diagnosed with a respiratory illness.

Explanation

Oxygen is a priority, especially with a client diagnosed with a respiratory illness.

35. SATA. You write a dx of altered tissue perfusion for your patient dx with anemia. Which interventions should you include

Monitor hb and hct

Move the patient closer to the nurse's station.

Limit intake of green veggies

Assess for numbness and tingling

Allow for periods of rest during the day

Nurse should monitor hb and act in all patients dx with anemia. Decreased O2 levels can cause confusion and safety issues so the patient should be near the nurses station. Numbness and tingling is a near symptom of anemia. Fatigue is the most common symptom of anemia.

Explanation

Nurse should monitor hb and act in all patients dx with anemia. Decreased O2 levels can cause confusion and safety issues so the patient should be near the nurses station. Numbness and tingling is a near symptom of anemia. Fatigue is the most common symptom of anemia.

Submit

36. Which type of anemia is this? Ulcer caused by bacteria or alcoholism. Slow bleed from injury. Menses

Iron-deficiency anemia

Acute blood loss

Chronic blood loss

Vit B12 deficiency

Folic acid deficiency anemia

The given answer, chronic blood loss, is the most appropriate explanation for the symptoms described. Chronic blood loss can occur due to conditions such as ulcers caused by bacteria or alcoholism, slow bleed from injury, or heavy menstrual bleeding. This type of anemia is characterized by a gradual decrease in red blood cell count over time, leading to a deficiency in iron stores and subsequent iron-deficiency anemia. Therefore, chronic blood loss is the most likely cause of the anemia in this case.

Explanation

The given answer, chronic blood loss, is the most appropriate explanation for the symptoms described. Chronic blood loss can occur due to conditions such as ulcers caused by bacteria or alcoholism, slow bleed from injury, or heavy menstrual bleeding. This type of anemia is characterized by a gradual decrease in red blood cell count over time, leading to a deficiency in iron stores and subsequent iron-deficiency anemia. Therefore, chronic blood loss is the most likely cause of the anemia in this case.

37. The nurse caring for a client who is HIV positive is stuck with the stylet used to start an IV. Which intervention should the nurse implement first?

Flush the skin with water and try to get the area to bleed.

Notify the charge nurse and complete an incident report.

Report to the employee health nurse for prophylactic medication.

Follow up with the infection control nurse to have laboratory work done.

The nurse should attempt to flush the skin and get the area to bleed. It is hoped this will remove contaminated blood from the body prior to infecting the nurse.

Explanation

The nurse should attempt to flush the skin and get the area to bleed. It is hoped this will remove contaminated blood from the body prior to infecting the nurse.

38. What type of anemia is missing intrinsic factor?

Pernicious anemia is a type of anemia that is characterized by the lack of intrinsic factor, a protein produced by the stomach that is necessary for the absorption of vitamin B12. Without intrinsic factor, the body is unable to properly absorb vitamin B12 from the diet, leading to a deficiency of this essential vitamin. This deficiency can result in a decrease in the production of healthy red blood cells, causing symptoms such as fatigue, weakness, and shortness of breath. Therefore, pernicious anemia is the correct answer for the type of anemia that is missing intrinsic factor.

Explanation

Pernicious anemia is a type of anemia that is characterized by the lack of intrinsic factor, a protein produced by the stomach that is necessary for the absorption of vitamin B12. Without intrinsic factor, the body is unable to properly absorb vitamin B12 from the diet, leading to a deficiency of this essential vitamin. This deficiency can result in a decrease in the production of healthy red blood cells, causing symptoms such as fatigue, weakness, and shortness of breath. Therefore, pernicious anemia is the correct answer for the type of anemia that is missing intrinsic factor.

Submit

39. The client with RA has nontender, movable nodules in the subcutaneous tissue over the elbows and shoulders. Which statement is the scientific rationale for the nodules?

The nodules indicate a rapidly progressive destruction of the affected tissue.

The nodules are small amounts of synovial fluid that have become crystallized.

The nodules are lymph nodes which have proliferated to try to fight the disease.

The nodules present a favorable prognosis and mean the client is better.

The nodules may appear over bony prominences and resolve simultaneously. They appear in clients with the rheumatoid factor and are associated with rapidly progressive and destructive disease.

Explanation

The nodules may appear over bony prominences and resolve simultaneously. They appear in clients with the rheumatoid factor and are associated with rapidly progressive and destructive disease.

40. The client on a medical floor is diagnosed with HIV encephalopathy. Which client problem is priority?

Altered nutrition, less than body requirements.

Anticipatory grieving.

Knowledge deficit, procedures and prognosis.

Risk for injury.

Safety is always an issue with a client with diminished mental capacity.

Explanation

Safety is always an issue with a client with diminished mental capacity.

41. Which -scopy can diagnose iron-deficiency anemia?

Endoscopy

Colonoscopy

Bronchoscopy

Cystoscopy

Both endoscopy and colonoscopy can be used to diagnose iron-deficiency anemia. Endoscopy is a procedure that allows a doctor to examine the upper digestive system, including the esophagus, stomach, and small intestine. Colonoscopy, on the other hand, is a procedure that examines the large intestine and rectum. Iron-deficiency anemia can be caused by bleeding in the gastrointestinal tract, which can be detected and diagnosed through both endoscopy and colonoscopy.

Explanation

Both endoscopy and colonoscopy can be used to diagnose iron-deficiency anemia. Endoscopy is a procedure that allows a doctor to examine the upper digestive system, including the esophagus, stomach, and small intestine. Colonoscopy, on the other hand, is a procedure that examines the large intestine and rectum. Iron-deficiency anemia can be caused by bleeding in the gastrointestinal tract, which can be detected and diagnosed through both endoscopy and colonoscopy.

Submit

42. The client diagnosed with AIDS is angry and yells at everyone entering the room, and none of the staff members wants to care for the client. Which intervention is most appropriate for the nurse manager to use in resolving this situation?

Assign a different nurse every shift to the client.

Ask the HCP to tell the client not to yell at the staff.

Call a team meeting and discuss options with the staff.

Tell one (1) staff member to care for the client a week at a time.

The health-care team should meet to discuss ways to best help the client deal with the anger being expressed, and the staff should be consistent in working with the client.

Explanation

The health-care team should meet to discuss ways to best help the client deal with the anger being expressed, and the staff should be consistent in working with the client.

43. What plays a key role in the production of RBCs

Erythropoietin is a hormone that plays a crucial role in the production of red blood cells (RBCs). It is produced primarily by the kidneys and stimulates the bone marrow to produce more RBCs. When the body detects low oxygen levels, such as during high altitude or in cases of anemia, it releases erythropoietin to increase RBC production. This hormone helps maintain the balance of oxygen-carrying RBCs in the bloodstream, ensuring adequate oxygen supply to tissues and organs.

Explanation

Erythropoietin is a hormone that plays a crucial role in the production of red blood cells (RBCs). It is produced primarily by the kidneys and stimulates the bone marrow to produce more RBCs. When the body detects low oxygen levels, such as during high altitude or in cases of anemia, it releases erythropoietin to increase RBC production. This hormone helps maintain the balance of oxygen-carrying RBCs in the bloodstream, ensuring adequate oxygen supply to tissues and organs.

Submit

44. What is needed to absorb B12?

In order to absorb B12, the body requires a substance called intrinsic factor. This factor is essential for the absorption of B12 in the small intestine. Without intrinsic factor, the body would not be able to effectively absorb B12 from the diet, leading to a deficiency in this important vitamin.

Explanation

In order to absorb B12, the body requires a substance called intrinsic factor. This factor is essential for the absorption of B12 in the small intestine. Without intrinsic factor, the body would not be able to effectively absorb B12 from the diet, leading to a deficiency in this important vitamin.

Submit

45. The nurse is assessing a client diagnosed with RA. Which assessment findings warrant immediate intervention?

The client complains of joint stiffness and the knees feel warm to the touch.

The client has experienced one (1)-kg weight loss and is very tired.

The client requires a heating pad applied to the hips and back to sleep.

The client is crying, has a flat facial affect, and refuses to speak to the nurse.

The client has the signs and symptoms of depression. The nurse should attempt to intervene with therapeutic conversation and discuss these findings with the HCP.

Explanation

The client has the signs and symptoms of depression. The nurse should attempt to intervene with therapeutic conversation and discuss these findings with the HCP.

46. The nurse and a licensed practical nurse are caring for clients in a rheumatologist's office. Which task can the nurse assign to the licensed practical nurse?

Administer methotrexate, an antineoplastic medication, IV.

Assess the lung sounds of a client with RA who is coughing.

Demonstrate how to use clothing equipped with Velcro fasteners.

Discuss methods of birth control compatible with treatment medications.

The nurse cannot assign assessment, evaluation, or teaching or any medication requiring specialized knowledge or skills to administer safely.

Explanation

The nurse cannot assign assessment, evaluation, or teaching or any medication requiring specialized knowledge or skills to administer safely.

47. What are s/sx of acute blood loss?

Increased HR

Increased RR

Internal pain

Numbness

Glossitis

Cheilitis

The symptoms and signs of acute blood loss include increased heart rate (HR) and increased respiratory rate (RR) as the body tries to compensate for the loss of blood volume. Internal pain may be experienced due to organ ischemia or damage caused by inadequate blood supply. Numbness may occur as a result of reduced blood flow to certain areas of the body. Glossitis, which is inflammation of the tongue, and cheilitis, which is inflammation of the lips, are not typically associated with acute blood loss.

Explanation

The symptoms and signs of acute blood loss include increased heart rate (HR) and increased respiratory rate (RR) as the body tries to compensate for the loss of blood volume. Internal pain may be experienced due to organ ischemia or damage caused by inadequate blood supply. Numbness may occur as a result of reduced blood flow to certain areas of the body. Glossitis, which is inflammation of the tongue, and cheilitis, which is inflammation of the lips, are not typically associated with acute blood loss.

Submit

48. Which intervention is an important psychosocial consideration for the client diagnosed with AIDS?

Perform a thorough head-to-toe assessment.

Maintain the client’s ideal body weight.

Complete an advance directive.

Increase the client’s activity tolerance.

Clients diagnosed with AIDS should be encouraged to discuss their end-of-life issue with the significant others and to put those wishes in writing. This is important for all clients, not just those diagnosed with AIDS.

Explanation

Clients diagnosed with AIDS should be encouraged to discuss their end-of-life issue with the significant others and to put those wishes in writing. This is important for all clients, not just those diagnosed with AIDS.

49. Which labs are most important in iron-deficiency anemia?

Hb

HCT

Platelets

Folate levels

Serum B12

The labs that are most important in iron-deficiency anemia are Hb (hemoglobin), HCT (hematocrit), and platelets. Hemoglobin and hematocrit levels are used to assess the severity of anemia and determine the need for treatment. Low platelet levels may indicate bleeding or other complications associated with iron-deficiency anemia. Folate levels and serum B12 are not specific to iron-deficiency anemia and may be useful in diagnosing other types of anemia.

Explanation

The labs that are most important in iron-deficiency anemia are Hb (hemoglobin), HCT (hematocrit), and platelets. Hemoglobin and hematocrit levels are used to assess the severity of anemia and determine the need for treatment. Low platelet levels may indicate bleeding or other complications associated with iron-deficiency anemia. Folate levels and serum B12 are not specific to iron-deficiency anemia and may be useful in diagnosing other types of anemia.

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50. Which client problem is priority for a client diagnosed with RA?

Activity intolerance

Fluid and electrolyte imbalance

Alteration in comfort

Excessive nutritional intake

The client diagnosed with RA has chronic pain; therefore, alteration in comfort is a priority problem.

Explanation

The client diagnosed with RA has chronic pain; therefore, alteration in comfort is a priority problem.

51. The client diagnosed with RA is being seen in the outpatient clinic. Which preventive care should the nurse include in the regularly scheduled clinic visits?

Perform joint x-rays to determine progression of the disease.

Send blood to the laboratory for an erythrocyte sedimentation rate.

Recommend the flu and pneumonia vaccines.

Assess the client for increasing joint involvement.

RA is a disease with many immunological abnormalities. The clients have increased susceptibility to infectious disease, such as the flu or pneumonia, and, therefore, vaccines, which are preventive, should be recommended.

Explanation

RA is a disease with many immunological abnormalities. The clients have increased susceptibility to infectious disease, such as the flu or pneumonia, and, therefore, vaccines, which are preventive, should be recommended.

52. The nurse is planning the care for a client diagnosed with RA. Which intervention should be implemented?

Plan a strenuous exercise program.

Order a mechanical soft diet.

Maintain a keep-open IV.

Obtain an order for a sedative.

Sleep deprivation resulting from pain is common in clients diagnosed with RA. A mild sedative can increase the client’s ability to sleep, promote rest, and increase the client’s tolerance of pain.

Explanation

Sleep deprivation resulting from pain is common in clients diagnosed with RA. A mild sedative can increase the client’s ability to sleep, promote rest, and increase the client’s tolerance of pain.

53. Which is a symptom of iron-deficiency anemia?

Pallor

Glossitis

Cheilitis

Pica

Internal pain

Impaired thought processes

Internal pain is a sx of acute blood loss and impaired though processes is a sx of folic acid deficiency anemia

Explanation

Internal pain is a sx of acute blood loss and impaired though processes is a sx of folic acid deficiency anemia

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